WO1995025475A1 - Device for detecting position of surgical instruments - Google Patents

Device for detecting position of surgical instruments Download PDF

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Publication number
WO1995025475A1
WO1995025475A1 PCT/SE1995/000286 SE9500286W WO9525475A1 WO 1995025475 A1 WO1995025475 A1 WO 1995025475A1 SE 9500286 W SE9500286 W SE 9500286W WO 9525475 A1 WO9525475 A1 WO 9525475A1
Authority
WO
WIPO (PCT)
Prior art keywords
demand
substrate
light
surgical instruments
furnished
Prior art date
Application number
PCT/SE1995/000286
Other languages
French (fr)
Inventor
Håkan HåKANSSON
Original Assignee
Elekta Instrument Ab
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
Application filed by Elekta Instrument Ab filed Critical Elekta Instrument Ab
Priority to EP95914621A priority Critical patent/EP0738129A1/en
Publication of WO1995025475A1 publication Critical patent/WO1995025475A1/en

Links

Classifications

    • 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
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2055—Optical tracking 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
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3937—Visible markers
    • A61B2090/3945—Active visible markers, e.g. light emitting diodes
    • 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
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Definitions

  • Dev i ce fo r detect i ng pos i t i on of su rg i ca l i ns t rument s .
  • CT- and/or MR- pictures can be filed in a computer and then by help of the localization procedure described above, let a surgical instrument's position in the operation area control the presentation of the constructed data picture that responds to the instrument's position.
  • special instruments provided with reference points, must be used. Since a large number of instruments are used during surgery and the individual doctor prefers his own set of instruments, most instruments in the hospital need to be replaced or modified to be usable during operations with a localization system.
  • the invention described below refers to a device that easily adapts normal surgical instruments to above localization system. Furthermore, it is designed not to affect the instruments used to the same extent as the present systems do.
  • This invention combines technology from semi-conducted manufacturing with the medical technical. See illustrations 1-6 showing different designs of the invention.
  • 111 1 describes the complete system consisting of a computer based main unit (1) with belonging detection unit (2) and an indication device (reference system) (3).
  • the detection unit is provided with a filter (4).
  • Ill 2 describes a reference system (3) with a substrate of glass fiber laminate (5) with conducting pattern (7) on which LEDs (6) have been applied as chips.
  • the system is cable-connected to the equipment.
  • the top side of the device is covered with a LED-translucent plastic material, which also protects the system against solutions and steam which otherwise could affect the functioning of the structure. Underneath a self-adhesive coating is applied.
  • Ill 3 describes in detail how a LED chip (6) is attached to the substrate (5) and connected with a bonding wire (1 1) to the printed pattern (7).
  • Ill 4 describes in detail how a LED in surface mounted design with a substrate (13), outlet (14), LED (6) and protective translucent plastic layer (12).
  • Ill 5 describes a device, see ill 2 above, completed with a battery unit (15), generator part (16) and an on-off switch for the battery power. This supplement makes the equipment possible to use without having it connected by cable to the rest of the system (1).
  • Ill 6 shows a practical example where the reference unit (3) is attached to an electrode (20) for electro stimulation. By using the reference unit the position of the electrode's point (18) can be set. Description of the invention
  • the invention described below is applicable within the medical technical field and especially within surgery.
  • the whole system consists of :
  • identification devices could for example consist of LEDs, preferably emissioning radiation in the infrared range (700-1200 nm).
  • the advantage of using the infrared light as communication is that it is beyond the visible range (400- 700nm) and therefore the operator will not be disturbed by the emitted light and that all other visible light in the surroundings can be filtrated and will therefore not interfere with the transmission of information from the instrument to the detecting equipment.
  • the identification arrangement can be made as a fixed pattern of light diodes attached on a preferably stiff carrier which allows that different types can be supplied with the identification arrangement.
  • 111 1 describes the total system with the reference system (3) and the detectors (2) connected to the central unit (1) where the built-in computer calculation of the references' positions takes place.
  • a filter (4) is placed in front of the detectors which screens off the visible light but allows the light from the reference points to pass.
  • Light diode chips (6) are glued with conducting epoxy glue on a carrier of glass fiber laminate (5) and on the top there is a pattern (7) etched in copper.
  • One of the diode's contact points has in this example been connected to a mutual conductor while the diode's other contact point by means of bonding technique (see figure 3) has been connected to separate conductors to allow the diodes to be activated independently from each other.
  • the top surface of the indicator is covered with a plastic coating, which is translucent for the emitted light, to protect the diodes from mechanical wear and galvanic isolation of the electric parts of the system. Underneath the carrier material there is a self-adhesive surface coating for attaching the surgical instrument (10).
  • light diode chip (6) As an alternative to the light diode chip (6) that is attached directly to the laminate, (5) light diodes meant for surface attachment can be used, se ill 4.
  • the light diode chip is attached to a substrate (13) with two contact points (14) for external connection.
  • the chip (6) with its bonding wire (11) is protected by an epoxy glue coating (12).
  • the component is attached by welding or conducting glue directly to the conductors (7) on the laminate (5).
  • Typical size of these components is length 3 mm, width 1,3 mm and height 1,2 mm.
  • Example of performance 2 (ill 5) Example of performance 2 (ill 5)
  • the unit (3) also has been supplied with a lithium battery (15) which can be switched on-/off (17).
  • the system also includes a generator (16), which can supply the different light diodes (6) with for each of them a characteristic pulse frequency, to make the reference system (3) coded. This results in that the central unit (1) via the detector unit (2) can determine which individual reference system has sent the signal. The entire system is kept in a tight plastic cover which gives protection to surrounding fluids but lets the emitted light through.
  • the reference system (3) is applied to a stimulating electrode (20) which via the cable (21) is connected to a stimulating generator.
  • the electrode is furnished with a handle on which the reference system (3) is attached.
  • the point of the electrode (18) is electrically conducted while the connection tube (19) is electrically isolated.
  • the point's position can be indicated by the reference system, thus for instance by submitting the coordinates position to an imaging system a presentation of the point's position in comparison with earlier X-ray pictures can be made like in US 4,722,056.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Length Measuring Devices With Unspecified Measuring Means (AREA)
  • Machine Tool Sensing Apparatuses (AREA)
  • Numerical Control (AREA)

Abstract

The invention is a device consisting of a main unit for detecting optical signals and a reference system which detects the position of an operating tool in space as well as its identity. Even if the operation tool is changed during the session the system will detect it. The method comprises a system consisting of a substrate on which light emitting diode chips are mounted. The reference system is connected with a cable to the computerized main unit which feeds the reference system with signals used for detection. The invention can also be made in a battery supplied version. This implies that the system do not need to be galvanically coupled to the main unit.

Description

Dev i ce fo r detect i ng pos i t i on of su rg i ca l i ns t rument s .
Method for applying infrared LEDs for detection of the position of surgical tools
This technique states:
From the patents US 4,722,056 and WO/92/06645 it is known how to detect an object's position in space by use of CCD cameras that study a number of reference points attached to the object. These references can be objects of different colors or like in WO/92/06645 infrared light emissioning diodes LED. The infrared light has the advantage that it cannot be seen by the human eye and therefore it does not disturb the user.
Especially within the medical technical field this technique has been found useful. For instance, CT- and/or MR- pictures can be filed in a computer and then by help of the localization procedure described above, let a surgical instrument's position in the operation area control the presentation of the constructed data picture that responds to the instrument's position. The disadvantage with the above technique is that special instruments, provided with reference points, must be used. Since a large number of instruments are used during surgery and the individual doctor prefers his own set of instruments, most instruments in the hospital need to be replaced or modified to be usable during operations with a localization system.
The invention described below refers to a device that easily adapts normal surgical instruments to above localization system. Furthermore, it is designed not to affect the instruments used to the same extent as the present systems do. This invention combines technology from semi-conducted manufacturing with the medical technical. See illustrations 1-6 showing different designs of the invention.
CONFIRMATION COW Description of Illustrations
111 1 describes the complete system consisting of a computer based main unit (1) with belonging detection unit (2) and an indication device (reference system) (3). The detection unit is provided with a filter (4).
Ill 2 describes a reference system (3) with a substrate of glass fiber laminate (5) with conducting pattern (7) on which LEDs (6) have been applied as chips. The system is cable-connected to the equipment. The top side of the device is covered with a LED-translucent plastic material, which also protects the system against solutions and steam which otherwise could affect the functioning of the structure. Underneath a self-adhesive coating is applied.
Ill 3 describes in detail how a LED chip (6) is attached to the substrate (5) and connected with a bonding wire (1 1) to the printed pattern (7).
Ill 4 describes in detail how a LED in surface mounted design with a substrate (13), outlet (14), LED (6) and protective translucent plastic layer (12).
Ill 5 describes a device, see ill 2 above, completed with a battery unit (15), generator part (16) and an on-off switch for the battery power. This supplement makes the equipment possible to use without having it connected by cable to the rest of the system (1).
Ill 6 shows a practical example where the reference unit (3) is attached to an electrode (20) for electro stimulation. By using the reference unit the position of the electrode's point (18) can be set. Description of the invention
The invention described below is applicable within the medical technical field and especially within surgery.
The whole system consists of :
• a main system connected to two or more cameras usually of CCD type
• a hand-held instrument (cable-connected to the main unit) on which identification devices are attached.
These identification devices could for example consist of LEDs, preferably emissioning radiation in the infrared range (700-1200 nm). The advantage of using the infrared light as communication is that it is beyond the visible range (400- 700nm) and therefore the operator will not be disturbed by the emitted light and that all other visible light in the surroundings can be filtrated and will therefore not interfere with the transmission of information from the instrument to the detecting equipment.
Several different methods can be used to detect which specific instrument is connected to the system. You can for example use the physical distances between the diodes or by allowing the diodes to emit the light pulses of different pulse frequency, pulse form or wave for identification. Even if the instrument is exchanged during operation the system can reveal that an exchange has taken place and consider this at calculations and presentations.
The identification arrangement can be made as a fixed pattern of light diodes attached on a preferably stiff carrier which allows that different types can be supplied with the identification arrangement. 111 1 describes the total system with the reference system (3) and the detectors (2) connected to the central unit (1) where the built-in computer calculation of the references' positions takes place. A filter (4) is placed in front of the detectors which screens off the visible light but allows the light from the reference points to pass.
Example of performance (see ill 2)
Light diode chips (6) are glued with conducting epoxy glue on a carrier of glass fiber laminate (5) and on the top there is a pattern (7) etched in copper. One of the diode's contact points has in this example been connected to a mutual conductor while the diode's other contact point by means of bonding technique (see figure 3) has been connected to separate conductors to allow the diodes to be activated independently from each other. From the carrier laminate (5) there is a cable to the central unit (1) from where the power is received. The cable is supported by an enforcement strap (9) to withstand higher loads. The top surface of the indicator is covered with a plastic coating, which is translucent for the emitted light, to protect the diodes from mechanical wear and galvanic isolation of the electric parts of the system. Underneath the carrier material there is a self-adhesive surface coating for attaching the surgical instrument (10).
As an alternative to the light diode chip (6) that is attached directly to the laminate, (5) light diodes meant for surface attachment can be used, se ill 4. In this design the light diode chip is attached to a substrate (13) with two contact points (14) for external connection. The chip (6) with its bonding wire (11) is protected by an epoxy glue coating (12). The component is attached by welding or conducting glue directly to the conductors (7) on the laminate (5). Typical size of these components is length 3 mm, width 1,3 mm and height 1,2 mm. Example of performance 2 (ill 5)
In this example aluminum oxide, which is a ceramic material, has been chosen as carrying material (5). The wiring (7) is in this design silver epoxy conductor printed by means of thick film technique onto which light diode elements (6) are glued with conducting glue. In this example the unit (3) also has been supplied with a lithium battery (15) which can be switched on-/off (17). The system also includes a generator (16), which can supply the different light diodes (6) with for each of them a characteristic pulse frequency, to make the reference system (3) coded. This results in that the central unit (1) via the detector unit (2) can determine which individual reference system has sent the signal. The entire system is kept in a tight plastic cover which gives protection to surrounding fluids but lets the emitted light through.
Example of performance (see ill 6)
In this example the reference system (3) is applied to a stimulating electrode (20) which via the cable (21) is connected to a stimulating generator. The electrode is furnished with a handle on which the reference system (3) is attached. The point of the electrode (18) is electrically conducted while the connection tube (19) is electrically isolated. The point's position can be indicated by the reference system, thus for instance by submitting the coordinates position to an imaging system a presentation of the point's position in comparison with earlier X-ray pictures can be made like in US 4,722,056.
For an expert it is obvious that the above examples only present a few of the combinations that can be used and makes use of the invention. For instance the self-adhesive coating as attachment for the surgical instrument might as well be replaced by different kinds of clips.

Claims

Patent demands:
1. Device for identifying the position of surgical instruments including a control system, main system, central system, with at least two optical detectors for receiving signals from a reference arrangement with at least two identifying points characterized by that they are light emitting diode chips and attached to a stiff substrate of such material that the distance between the diodes is kept constant.
2. Device according to demand 1 characterized by the substrate is of non¬ conducting plastic material preferably glass fiber plastic.
3. Device according to demand 1 characterized by the substrate to be made of ceramic material such as aluminum oxide.
4. Device according to demand 1 characterized by the conducting pattern is produced by printing and/or etching.
5. Device according to demand 1 characterized by the light diodes are emitting in the infrared range.
6. Device according to demand 1 characterized by that the back of the substrate is furnished with self-adhesive material for attaching the surgical instruments.
7. Device according to demand 1-6 characterized by that the equipment is also furnished with a generator part and power supplied by a battery attached to the substrate.
8. Device according to demand 1-6 characterized by that the detectors in the main system are furnished with a filter to filtrate visible light.
PCT/SE1995/000286 1994-03-24 1995-03-21 Device for detecting position of surgical instruments WO1995025475A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP95914621A EP0738129A1 (en) 1994-03-24 1995-03-21 Device for detecting position of surgical instruments

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9400987A SE9400987L (en) 1994-03-24 1994-03-24 Device for detecting instruments
SE9400987-5 1994-03-24

Publications (1)

Publication Number Publication Date
WO1995025475A1 true WO1995025475A1 (en) 1995-09-28

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EP (1) EP0738129A1 (en)
SE (1) SE9400987L (en)
WO (1) WO1995025475A1 (en)

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999033406A1 (en) * 1997-12-31 1999-07-08 Surgical Navigation Technologies, Inc. Wireless probe system for use with a stereotactic surgical device
WO2000053115A1 (en) * 1999-03-05 2000-09-14 Northern Digital Inc. Active instrument for determining a position in navigation systems for assisting surgical interventions
EP1341465A1 (en) * 1998-05-14 2003-09-10 Calypso Medical, Inc Systems and methods for locating and defining a target location within a human body
US8857043B2 (en) 2002-12-30 2014-10-14 Varian Medical Systems, Inc. Method of manufacturing an implantable marker with a leadless signal transmitter
US9072895B2 (en) 2001-06-08 2015-07-07 Varian Medical Systems, Inc. Guided radiation therapy system
US9238151B2 (en) 2004-07-23 2016-01-19 Varian Medical Systems, Inc. Dynamic/adaptive treatment planning for radiation therapy
US9237860B2 (en) 2008-06-05 2016-01-19 Varian Medical Systems, Inc. Motion compensation for medical imaging and associated systems and methods
US9248003B2 (en) 2002-12-30 2016-02-02 Varian Medical Systems, Inc. Receiver used in marker localization sensing system and tunable to marker frequency
US9586059B2 (en) 2004-07-23 2017-03-07 Varian Medical Systems, Inc. User interface for guided radiation therapy
US9616248B2 (en) 2002-06-05 2017-04-11 Varian Medical Systems, Inc. Integrated radiation therapy systems and methods for treating a target in a patient
US9623208B2 (en) 2004-01-12 2017-04-18 Varian Medical Systems, Inc. Instruments with location markers and methods for tracking instruments through anatomical passageways
US9919165B2 (en) 2014-05-07 2018-03-20 Varian Medical Systems, Inc. Systems and methods for fiducial to plan association
US10043284B2 (en) 2014-05-07 2018-08-07 Varian Medical Systems, Inc. Systems and methods for real-time tumor tracking

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0114505A1 (en) * 1982-12-28 1984-08-01 Diffracto Ltd. Apparatus and method for robot calibration
EP0427358A1 (en) * 1989-11-08 1991-05-15 George S. Allen Mechanical arm for and interactive image-guided surgical system
EP0456103A2 (en) * 1990-05-11 1991-11-13 International Business Machines Corporation Image-directed robotic system for precise surgery
DE4202505A1 (en) * 1992-01-30 1993-08-05 Zeiss Carl Fa Medical and surgical instrument, e.g. microscope, positioning system - uses optical transmitter e.g laser fixed to surgeons headband operating as steering system and positioning electronics to control support arm and microscope

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0114505A1 (en) * 1982-12-28 1984-08-01 Diffracto Ltd. Apparatus and method for robot calibration
EP0427358A1 (en) * 1989-11-08 1991-05-15 George S. Allen Mechanical arm for and interactive image-guided surgical system
EP0456103A2 (en) * 1990-05-11 1991-11-13 International Business Machines Corporation Image-directed robotic system for precise surgery
DE4202505A1 (en) * 1992-01-30 1993-08-05 Zeiss Carl Fa Medical and surgical instrument, e.g. microscope, positioning system - uses optical transmitter e.g laser fixed to surgeons headband operating as steering system and positioning electronics to control support arm and microscope

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999033406A1 (en) * 1997-12-31 1999-07-08 Surgical Navigation Technologies, Inc. Wireless probe system for use with a stereotactic surgical device
EP1341465A1 (en) * 1998-05-14 2003-09-10 Calypso Medical, Inc Systems and methods for locating and defining a target location within a human body
EP1341465A4 (en) * 1998-05-14 2006-08-23 Calypso Medical Inc Systems and methods for locating and defining a target location within a human body
WO2000053115A1 (en) * 1999-03-05 2000-09-14 Northern Digital Inc. Active instrument for determining a position in navigation systems for assisting surgical interventions
US9072895B2 (en) 2001-06-08 2015-07-07 Varian Medical Systems, Inc. Guided radiation therapy system
US9616248B2 (en) 2002-06-05 2017-04-11 Varian Medical Systems, Inc. Integrated radiation therapy systems and methods for treating a target in a patient
US9682253B2 (en) 2002-06-05 2017-06-20 Varian Medical Systems, Inc. Integrated radiation therapy systems and methods for treating a target in a patient
US8857043B2 (en) 2002-12-30 2014-10-14 Varian Medical Systems, Inc. Method of manufacturing an implantable marker with a leadless signal transmitter
US9248003B2 (en) 2002-12-30 2016-02-02 Varian Medical Systems, Inc. Receiver used in marker localization sensing system and tunable to marker frequency
US9623208B2 (en) 2004-01-12 2017-04-18 Varian Medical Systems, Inc. Instruments with location markers and methods for tracking instruments through anatomical passageways
US9238151B2 (en) 2004-07-23 2016-01-19 Varian Medical Systems, Inc. Dynamic/adaptive treatment planning for radiation therapy
US9586059B2 (en) 2004-07-23 2017-03-07 Varian Medical Systems, Inc. User interface for guided radiation therapy
US9237860B2 (en) 2008-06-05 2016-01-19 Varian Medical Systems, Inc. Motion compensation for medical imaging and associated systems and methods
US9919165B2 (en) 2014-05-07 2018-03-20 Varian Medical Systems, Inc. Systems and methods for fiducial to plan association
US10043284B2 (en) 2014-05-07 2018-08-07 Varian Medical Systems, Inc. Systems and methods for real-time tumor tracking

Also Published As

Publication number Publication date
SE9400987D0 (en) 1994-03-24
EP0738129A1 (en) 1996-10-23
SE9400987L (en) 1995-09-25

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