WO2004029908A1 - Systeme ameliore de simulation informatisee d'une intervention chirurgicale peu invasive - Google Patents

Systeme ameliore de simulation informatisee d'une intervention chirurgicale peu invasive Download PDF

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Publication number
WO2004029908A1
WO2004029908A1 PCT/SE2003/001512 SE0301512W WO2004029908A1 WO 2004029908 A1 WO2004029908 A1 WO 2004029908A1 SE 0301512 W SE0301512 W SE 0301512W WO 2004029908 A1 WO2004029908 A1 WO 2004029908A1
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WIPO (PCT)
Prior art keywords
surgical tool
simulated
input device
parameter
tool
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PCT/SE2003/001512
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English (en)
Inventor
Anders Hyltander
Hans LÖNROTH
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Surgical Science Sweden 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.)
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Publication date
Application filed by Surgical Science Sweden Ab filed Critical Surgical Science Sweden Ab
Priority to AU2003265193A priority Critical patent/AU2003265193A1/en
Publication of WO2004029908A1 publication Critical patent/WO2004029908A1/fr

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    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine

Definitions

  • This invention relates to a computer-based minimal- invasive surgery simulation system.
  • a camera is used to supply picture information from the patient to the surgeon.
  • the display screen shows the picture that the camera catches of the inside of, for example, the abdominal cavity. All the instruments and the anatomy with which the surgeon works are reproduced by means of the camera and the display screen.
  • the surgeon uses the information on the display screen to control and operate his or her instruments and carry out the procedures which are required to perform the surgical operation. Since the minimal invasive techniques supply information to the surgeon by means of a display screen, the three- dimensional reality is reduced to two dimensions on the display screen.
  • the picture therefore lacks, among other things, the information as to depth that exists in reality. The surgeon has to make up for this loss of information by studying lighting conditions, colours, etc.
  • a computer-based minimal-invasive surgery simulation system comprising: a virtual anatomic environment simulator, for simulating a virtual anatomic environment; a surgical tool simulator, for simulating a surgical tool within said virtual anatomic environment; a surgical tool input device, being arranged to be manipulated by a user of the system, whereby said manipulation results in a corresponding manipulation of the tool simulated by said surgical tool simulator; a surgical tool parameter input device, for user controlled input of parameters for controlling the simulated surgical tool; an interaction simulation device, for simulating the interaction between the virtual anatomic environment and the simulated surgical tool, whereby said interaction is adapted to the effects of said inputted parameters to the actions of the surgical tool; and a display device, for displaying the simulated interaction between the simulated tool and the simulated virtual anatomic environment.
  • the surgical simulation may be improved regarding the handling of the surgical tool, since the surgical tool parameter input device provides for a realistic simulated surgical environment, enabling improved testing of the user skills of handling the surgical tool.
  • the surgical tool parameter input device comprises a detection device positioned on a handle of said surgical tool input device for detection of a gripping force applied on said handle by a user, whereby this information is transmitted as a parameter to the interaction simulation device.
  • this information is transmitted as a parameter to the interaction simulation device.
  • the surgical tool parameter input device comprises a user input device, for inputting information regarding what type of instrument that is to be simulated by said surgical tool simulator, whereby this information is transmitted as a parameter to the interaction simulation device.
  • type as used in this document should be included the form, technical function and size of a surgical tool. This enables improved testing of the user's skill regarding appropriate choice of instrument for a certain procedure.
  • the surgical tool parameter input device comprises a user input device, for inputting information regarding what type of energy is to be applied by said simulated surgical tool, whereby this information is transmitted as a parameter to the interaction simulation device.
  • said energy is set to be one of thermal energy (generated by means of an electrical current or the like) , ultrasonic energy, or radiation energy, such as laser energy, providing the possibility of choosing the most common types used in surgical procedures.
  • the user input device further suitably comprises means for setting a desired energy level to be applied by said simulated surgical tool, whereby this information is transmitted as a parameter to the interaction simulation device. This enables testing of a user's ability to use an appropriate energy level for a certain procedure, and also to display for the user what happens if he chooses a less suitable alternative .
  • the user input device further comprises means for manually setting a desired sharpness of the simulated surgical tool, being yet a factor that effects the result of the surgical procedure .
  • the tool parameter input device further comprises a device for detecting a simulated applied pressure by a simulated surgical tool on a tissue of the virtual anatomic environment, whereby this information is transmitted as a parameter to the interaction simulation device.
  • the tool parameter input device further comprises a device for measuring a time during which the simulated surgical tool is applied to a tissue of the virtual anatomic environment, whereby this information is transmitted as a parameter to the interaction simulation device.
  • a device for measuring a time during which the simulated surgical tool is applied to a tissue of the virtual anatomic environment whereby this information is transmitted as a parameter to the interaction simulation device.
  • the computer-based minimal-invasive surgery simulation device further comprises a surgical tool parameter consequence library, for providing the interaction simulator with consequence information for a variety of values or states for each parameter. This enables realistic information regarding the impact of the parameter value on the total simulation.
  • said library suitable includes a video library for providing visual consequence information for a variety of values or states for each parameter, to be displayed on said display device. This enables realistic visualisation of the effects of the parameter values in question, to be viewed and analysed by the user of the system.
  • Fig 1 is a schematic view of the basic components of a simulation system in which the present invention may be implemented.
  • Fig 2 is a block diagram of a simulation system according to an embodiment of the invention.
  • Fig 3 is a schematic view of a computer interface of an embodiment of a surgical tool input device according to the invention.
  • Such a system essentially comprises a processing unit 12 for simulating a minimal-invasive surgery situation, a surgical tool input device 4, for inputting information regarding movements etc of a surgical tool to be manoeuvred by a user to the processing unit 12, and a display device 7 for displaying the simulated surgery procedure in order to visualise the simulated surgery situation for the user.
  • the processing unit may, for example, comprise a personal computer which is preferably equipped with a graphics card having 3D- circuits .
  • the surgical tool input device 4 may or may not be provided with a system for tactile feedback to the user of the system.
  • the system for computer- based minimal-invasive surgery simulation comprises a surgical tool input device 4, i.e. an instrument to be hold and manoeuvred by the user, and that is arranged to imitate a real surgical tool.
  • the movements and the position of the surgical tool input device 4 is arranged to be registered by a position tracker device (not shown) and the registered information regarding the movements and position of the surgical tool input device 4 is arranged to be transmitted to the processing unit 12 through a first input terminal 13.
  • the system comprises a surgical tool parameter input device 5, for user-controlled input of one or more parameters relating to the action of the surgical tool .
  • Information regarding the inputted parameters is arranged to be transmitted to the processing unit 12 through a second input terminal 14.
  • the surgical tool parameter input device 5 may be arranged in connection with the surgical tool input device 4, whereby said information regarding the inputted parameters may be arranged to be transmitted to the processing unit by said first input terminal 13. Further, the surgical tool parameter input device 5 may be subdivided so that information is transmitted to the processing unit 12 through both terminals 13, 14.
  • the processing unit mainly comprises a surgical tool simulator 3, for simulating the surgical tool to be manoeuvred by the user, an anatomic environment simulator 2, for simulating the anatomic environment in which simulated surgery is to be performed, and an interaction simulator 6, being arranged to simulate the interaction between the simulated tool and the simulated anatomic environment, in order to provide total simulation of a procedure performed by a user.
  • the total simulation provided by the interaction simulator 6 is arranged to be outputted from the processing unit 12 by a first output terminal 15, and displayed on a screen of a display device 7, to be viewed by the user of said simulation system.
  • the surgical tool simulator 3 is connected with the first and second input terminals 13, 14 of the processing unit 12, as indicated above being arranged to receive information from said surgical tool input device 4 and said surgical tool parameter input device 5.
  • the surgical tool parameter input device 5 comprises one or more parameter input components, so that the user may input parameters affecting the desired use and effect of the tool to be simulated.
  • the system according to the invention may comprise any one of the below components, or any combination of the below components, in order to generate a simulation system having a suitable level of difficulty for the intended user.
  • a system primarily designed for an inexperienced user may comprise fewer of the below components, in order to facilitate complicity, while a system primarily designed for an experienced user may comprise many or all of the below components, in order to provide a simulation in which the handling of the surgical tool is simulated in a realistic way.
  • other components than the ones described below may also be included in the surgical tool parameter input device 5.
  • the surgical tool parameter input device 5 may comprise a gripping force detection device (not shown), positioned on a handle of the surgical tool input device 4, so that the gripping force applied on said handle by a user may be detected.
  • the gripping force of the surgical tool affects the surgical effect of the tool in a way that may be predicted and simulated.
  • the applied gripping force may affect the surgery result in several ways. A too low gripping force results in sliding of the instrument on the tissue, making the procedure or specific task impossible to perform. This will also possibly damage the tissue, by causing bleeding or leakage. A too high gripping force will deform and possibly damage the tissue with the above-mentioned consequences.
  • the gripping force may be detected discrete or continuous, i.e.
  • the magnitude of the force may be detected as being on a certain level on a grade scale, for example a three grade scale (low, medium, high) , or the magnitude may be detected by measuring the actual value.
  • the detected gripping force is thereafter transmitted to the surgical tool simulator, in which the effect of the certain gripping force (or the gripping force level) is stored in a memory of a surgical tool parameter consequence library or the like, whereby the effect of the applied gripping force is taken into consideration when generating the simulated surgical tool in the surgical tool simulator 3.
  • the surgical tool parameter consequence library comprises information, such as video information or digital information for providing information regarding visual consequences for the measured parameter value, which information is transmitted to the display device for display. Hence, the consequence of a certain gripping force on the surgical procedure will be displayed on the display.
  • the surgical tool parameter input device 5 may comprise a user input device (not shown) , by which a user actively may select settings to be used for the simulated surgical tool .
  • a user input device may either be realised as selection controls on the handle of said surgical tool input device 4 or on a separate selection control unit, but may also be provided by means of a computer device or the like (not shown) providing computerised selection controls for the parameters in question.
  • the user input device may comprise input selection controls for one or more of the following parameters; type of tool to be simulated; type of energy to be applied by the tool to be simulated; level of energy to be applied by the tool to be simulated, sharpness of tool to be simulated and so on.
  • the user input device will be described in the form of a computer device, but it shall be understood that the corresponding functionality may be achieved by a plurality of switches or the like, being arranged on the handle of the surgical tool input device 4 or alternatively in a separated unit.
  • An example of a- computer interface for the user input device is disclosed in fig 3. In fig 3, three menus are disclosed. Selection within each of the menus may be performed by the user by means of a selection device, such as a computer mouse or a key board. Alternatively, the display screen of the user input device may be provided as a touch screen.
  • a first menu 16 is used to select the type of tool that is to be used in the simulated procedure, i.e. what tool is to be simulated.
  • tools that may be used m the simulation and hence may be chosen in said first menu are scissors, ultrasound scissors, forceps, diathermy blade diathermy hook, suction device, stapler machine, laser probe, ports or a needle driver (for illustrative purposes, only a few of the above instruments are displayed in fig 3) .
  • This selection gives the user the possibility to actively select what tool is to be used for a special surgical procedure, hence testing the user's ability of choosing an appropriate tool for the procedure in question.
  • the tool choice is thereafter transmitted to the surgical tool simulator, in which the effect of the certain tool is stored in a memory of a surgical tool parameter consequence library or the like, whereby the effect of the chosen tool is taken into consideration when generating the simulated surgical tool in the surgical tool simulator 3.
  • the surgical tool parameter consequence library may comprise information, such as video information or digital information for providing information regarding visual consequences for using the chosen tool, which information is transmitted to the display device for display.
  • a second menu 17 may be used to select what kind of energy is to be applied.
  • the available choices of this second menu is connected to the user choice made in the above-described first menu 16.
  • the second menu 17 may be used what type of energy is to be applied by the blade tool. Examples of appropriate types of energies are; thermal energy; ultrasonic energy; or radiation energy, such as laser energy. It is known in the art of surgery, that application of different kinds of energy to tissue has various different effects. By the above inventive possibility, this property is incorporated into the simulation.
  • the energy type choice is transmitted to the surgical tool simulator, in which the effect of the certain energy type on tissue is stored in a memory of a surgical tool parameter consequence library or the like, whereby the effect of the chosen energy type is taken into consideration when generating the simulated surgical tool in the surgical tool simulator 3.
  • the surgical tool parameter consequence library may comprise information, such as video information or digital information for providing information regarding visual consequences for using the chosen energy type, which information is transmitted to the display device for display.
  • Thermal energy which is generated by electricity, is used for haemostasis (stop bleeding) from small vessels and dissections of tissues.
  • Ultrasonic energy is often used in a special type of scissors for coagulation of bigger blood vessels (having a diameter of ⁇ 5 mm) , i.e. stop bleeding there from and in the same movement cut the vessel. This is also used for dissection of tissue.
  • the advantage is that one may use the same instrument for haemostasis and division of structures and tissues.
  • Laser Energy is used for dissection and to some extent also haemostasis of small vessels.
  • tissue gets charred (it turns black) and becomes shrivelled and, in a more peripheral area surrounding the central area, the tissue o through a colour change and assumes a grey or white colour.
  • the tissue is visually unchanged by the energy application.
  • the visual result of each tool may be incorporated into the picture of the simulation displayed on the display device 7.
  • Other features that may be incorporated with the present invention is that different types of tissue react differently to different kinds of energy, and hence different visual effects are achieved depending on tissue type.
  • the contact area between the tool and the tissue affects the result of energy application, and this aspect may also be included with the present invention.
  • a third menu 18 may be provided, which in the present case is used to select the level of energy that is to be applied by the chosen tool.
  • the available choices of this third menu is connected to the user choice made in the above-described first menu 16 and second menu 17.
  • the choices of this menu may be; low energy level; medium energy level; and high energy level.
  • a continuous scale or a discrete scale comprising more or less steps may be used. Different levels of applied energy result in different effect when applied to tissue, and hence it is of great importance to learn what energy level is to be applied for a desired surgical result.
  • the present invention provides a system for training this ability.
  • the chosen energy level to be applied is transmitted to the surgical tool simulator, in which the effect of the certain energy level is stored in a memory of a surgical tool parameter consequence library or the like, whereby the effect of the chosen energy level is taken into consideration when generating the simulated surgical tool in the surgical tool simulator 3.
  • the surgical tool parameter consequence library comprises information, such as video information or digital information for providing information regarding visual consequences for using the chosen energy level, which information is transmitted to the display device for display.
  • the inventive system tests the user's ability to chose the correct tool for a certain procedure, to chose the correct kind of energy for a certain desired result (such as cutting or coagulation) and to chose a correct level of energy to be applied (for example in order to cut through a tissue without harming underlying tissues) .
  • the surgical tool parameter input device 5 may comprise a device 10 for detecting a simulated applied pressure by a simulated surgical tool on a tissue of the virtual anatomic environment. This is suitably realised by feeding back a signal comprising information regarding contact and degree of contact between the simulated surgical tool and the tissue in question from the interaction simulation device, whereafter the simulated applied pressure is obtained. Thereafter, the simulated applied pressure is transmitted to the surgical tool simulator, in which the effect of the simulated applied pressure is stored in a memory of a surgical tool parameter consequence library or the like, whereby the effect of the applied pressure is transmitted to the interaction simulation device and taken into consideration when generating the total simulation.
  • the surgical tool parameter consequence library comprises information, such as video information or digital information for providing information regarding visual consequences for the applied pressure, which information is transmitted to the display device for display.
  • the surgical tool parameter input device 5 may comprise a device 11 for measuring a time during which a simulated surgical tool is applied to a tissue in the virtual anatomic environment . This is suitably realised by feeding back a signal comprising information regarding the contact time between the simulated surgical tool and the tissue in question from the interaction simulation device. Thereafter, the contact time is transmitted to the surgical tool simulator, in which the effect of the contact time is stored in a memory of a surgical tool parameter consequence library or the like, whereby the effect of the contact time is transmitted to the interaction simulation device and taken into consideration when generating the total simulation.
  • the surgical tool parameter consequence library comprises information, such as video information or digital information for providing information regarding visual consequences for the contact time, which information is transmitted to the display device for display.
  • the feed-back signal from the interaction simulation device may be feed directly to the surgical tool parameter consequence library, and in this case, the devices 10 and 11 may be said to form part of the tool parameter device 5 (not shown) .
  • the correspondence between a movement of the surgical input device 4 and the corresponding movement of the tool simulated by the surgical tool simulator 3 may be linear or non-linear. According to this invention, the correspondence between the surgical input device 4 and the tool simulated by the surgical tool simulator 3 may be varied, in order to further improve the realism of the simulation.
  • the position and movement of the simulated instrument is linearly dependant upon the position and movement of the input device 4.
  • the input device and the simulated instrument are linearly synchronised, i.e. the motion of an instrument in the simulation is proportional to the motion of the input device. This state may be used for all interaction in the simulated environment.
  • the dependency between the simulated instrument and the input device 4 may be varied according to set rules. Such a change may be used when two instrument are about to collide in the virtual environment, or if an instrument in the virtual environment is about to push or pull elastic tissue, or otherwise soft tissue.
  • the system may make visual simulation of for instance tissue, that start out soft, and get harder when it is stretched, in that case changing the dependency gradually as the tissue is stretched.
  • a system according to the invention may include any on of, or any combination of components as defined above. It shall also be realised that the effects to be displayed due to different tool actions are obvious for a man skilled in the art, but for example, bleeding may be displayed as a result of excess pressure of the tool, coagulating and cutting of tissue may be displayed as the result of energy application and so on.

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Abstract

L'invention concerne un système de simulation informatisée d'une intervention chirurgicale peu invasive. Ce système comprend un simulateur d'environnement anatomique virtuel (2) permettant de simuler un environnement anatomique virtuel (1); un simulateur d'instrument chirurgical (3) permettant de simuler un instrument chirurgical dans cet environnement anatomique virtuel (1); un dispositif d'entrée (4) destiné à un instrument chirurgical et conçu pour être manipulé par un utilisateur du système, cette manipulation entraînant la manipulation correspondante de l'instrument simulée par ce simulateur d'instrument chirurgical (3). Ce système comprend également un dispositif d'entrée de paramètre d'instrument chirurgical (5) permettant l'entrée par l'utilisateur de paramètres permettant de commander l'instrument chirurgical simulé; un dispositif de simulation d'interaction (6) permettant de simuler l'interaction entre l'environnement anatomique virtuel (1) et l'instrument chirurgical simulé, cette interaction étant adaptée aux effets des paramètres entrés pour les actions de l'instrument chirurgical et enfin un dispositif d'affichage (7) permettant d'afficher l'interaction simulée entre l'instrument simulé et l'environnement anatomique virtuel.
PCT/SE2003/001512 2002-09-30 2003-09-30 Systeme ameliore de simulation informatisee d'une intervention chirurgicale peu invasive WO2004029908A1 (fr)

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Application Number Priority Date Filing Date Title
AU2003265193A AU2003265193A1 (en) 2002-09-30 2003-09-30 Improved computer-based minimal-invasive surgery simulation system

Applications Claiming Priority (2)

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SE0202863A SE0202863D0 (sv) 2002-09-30 2002-09-30 Improved computer-based minimal-invasive surgery simulation system
SE0202863-7 2002-09-30

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Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7764985B2 (en) 2003-10-20 2010-07-27 Smith & Nephew, Inc. Surgical navigation system component fault interfaces and related processes
US7794467B2 (en) 2003-11-14 2010-09-14 Smith & Nephew, Inc. Adjustable surgical cutting systems
US7862570B2 (en) 2003-10-03 2011-01-04 Smith & Nephew, Inc. Surgical positioners
WO2010105237A3 (fr) * 2009-03-12 2011-01-13 Health Research Inc. Méthode et système de formation à la chirurgie très peu invasive
US8109942B2 (en) 2004-04-21 2012-02-07 Smith & Nephew, Inc. Computer-aided methods, systems, and apparatuses for shoulder arthroplasty
US8177788B2 (en) 2005-02-22 2012-05-15 Smith & Nephew, Inc. In-line milling system
EP2691946A4 (fr) * 2011-03-30 2015-09-23 Mordechai Avisar Procédé et système pour simuler des procédures chirurgicales
US10056012B2 (en) 2012-05-25 2018-08-21 Surgical Theatre LLC Hybrid image/scene renderer with hands free control
US10178155B2 (en) 2009-10-19 2019-01-08 Surgical Theater LLC Method and system for simulating surgical procedures
US10810907B2 (en) 2016-12-19 2020-10-20 National Board Of Medical Examiners Medical training and performance assessment instruments, methods, and systems
US10861236B2 (en) 2017-09-08 2020-12-08 Surgical Theater, Inc. Dual mode augmented reality surgical system and method
US11197722B2 (en) 2015-10-14 2021-12-14 Surgical Theater, Inc. Surgical navigation inside a body
US11547499B2 (en) 2014-04-04 2023-01-10 Surgical Theater, Inc. Dynamic and interactive navigation in a surgical environment

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WO1999039317A1 (fr) * 1998-01-28 1999-08-05 Ht Medical Systems, Inc. Procede et dispositif d'interface entre des instruments et un systeme de simulation de procedure medicale
US6106301A (en) * 1996-09-04 2000-08-22 Ht Medical Systems, Inc. Interventional radiology interface apparatus and method
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WO2001078039A2 (fr) * 2000-04-12 2001-10-18 Simbionix Ltd. Systeme didacticiel d'endoscopie destine a l'urologie

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US5771181A (en) * 1994-12-14 1998-06-23 Moore; Robert S. Generation for virtual reality simulator systems
US6106301A (en) * 1996-09-04 2000-08-22 Ht Medical Systems, Inc. Interventional radiology interface apparatus and method
WO1999039317A1 (fr) * 1998-01-28 1999-08-05 Ht Medical Systems, Inc. Procede et dispositif d'interface entre des instruments et un systeme de simulation de procedure medicale
US6113395A (en) * 1998-08-18 2000-09-05 Hon; David C. Selectable instruments with homing devices for haptic virtual reality medical simulation
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Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7862570B2 (en) 2003-10-03 2011-01-04 Smith & Nephew, Inc. Surgical positioners
US8491597B2 (en) 2003-10-03 2013-07-23 Smith & Nephew, Inc. (partial interest) Surgical positioners
US7764985B2 (en) 2003-10-20 2010-07-27 Smith & Nephew, Inc. Surgical navigation system component fault interfaces and related processes
US7794467B2 (en) 2003-11-14 2010-09-14 Smith & Nephew, Inc. Adjustable surgical cutting systems
US8109942B2 (en) 2004-04-21 2012-02-07 Smith & Nephew, Inc. Computer-aided methods, systems, and apparatuses for shoulder arthroplasty
US8177788B2 (en) 2005-02-22 2012-05-15 Smith & Nephew, Inc. In-line milling system
WO2010105237A3 (fr) * 2009-03-12 2011-01-13 Health Research Inc. Méthode et système de formation à la chirurgie très peu invasive
US10178155B2 (en) 2009-10-19 2019-01-08 Surgical Theater LLC Method and system for simulating surgical procedures
US10178157B2 (en) 2009-10-19 2019-01-08 Surgical Theater LLC Method and system for simulating surgical procedures
US9788905B2 (en) 2011-03-30 2017-10-17 Surgical Theater LLC Method and system for simulating surgical procedures
EP2691946A4 (fr) * 2011-03-30 2015-09-23 Mordechai Avisar Procédé et système pour simuler des procédures chirurgicales
US11024414B2 (en) 2011-03-30 2021-06-01 Surgical Theater, Inc. Method and system for simulating surgical procedures
US10056012B2 (en) 2012-05-25 2018-08-21 Surgical Theatre LLC Hybrid image/scene renderer with hands free control
US10943505B2 (en) 2012-05-25 2021-03-09 Surgical Theater, Inc. Hybrid image/scene renderer with hands free control
US11547499B2 (en) 2014-04-04 2023-01-10 Surgical Theater, Inc. Dynamic and interactive navigation in a surgical environment
US11197722B2 (en) 2015-10-14 2021-12-14 Surgical Theater, Inc. Surgical navigation inside a body
US10810907B2 (en) 2016-12-19 2020-10-20 National Board Of Medical Examiners Medical training and performance assessment instruments, methods, and systems
US10861236B2 (en) 2017-09-08 2020-12-08 Surgical Theater, Inc. Dual mode augmented reality surgical system and method
US11532135B2 (en) 2017-09-08 2022-12-20 Surgical Theater, Inc. Dual mode augmented reality surgical system and method

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SE0202863D0 (sv) 2002-09-30

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