WO2017036023A1

WO2017036023A1 - Positioning system for use in surgical operation

Info

Publication number: WO2017036023A1
Application number: PCT/CN2015/099144
Authority: WO
Inventors: 樊昊
Original assignee: 北京医千创科技有限公司
Priority date: 2015-09-06
Filing date: 2015-12-28
Publication date: 2017-03-09
Also published as: CN105213032B; CN105213032A

Abstract

A positioning system for use in a surgical operation, positioning according to a direct comparison between a visible-light real-time image and an imaging non-real-time image. The system comprises: a DICOM data login module (100), a data visualization computation and processing module (200), a visible light image input module (300), a central processing module (400), and an image display output module. The system is configured to generate, based on imaging data, a non-real-time 3D imaging model, and subsequently combine the non-real-time 3D imaging model with a real-time camera image taken during an operation, thereby reducing operation equipment requirements, e.g., not requiring professional laparoscopic ultrasound or endoscopic ultrasound equipment but only employing a standard pre-surgical testing result. Theoretically, the system can absolutely ensure a location of a pathological change to be shown in the 3D model, and consequently, a camera can be operated based only on a relative location of a surgical instrument and a major anatomical structure in the 3D map.

Description

Surgical positioning system

Technical field

The present invention relates to the field of medical device technology, and in particular, to a surgical positioning system.

Background technique

Today's medical examination and treatment has entered the era of minimally invasive surgery. Laparoscopic, endoscopic (eg gastroscopy, colonoscopy, bronchoscopy) and surgical robots are all representative of minimally invasive techniques. Among these representative technologies, various cameras are the main observation tools. They replace the human eye and are mainly used to perform two tasks: 1. Identify the location of the lesion and lesion in the human body; 2. Identify the position of the surgical instrument and the instrument in the human body.

The surgical instruments are relatively large and the camera is not difficult to recognize. However, for identifying lesions, especially early lesions, the camera is difficult. The reasons are: 1. The camera imaging technology uses visible light. Visible light can see the surface of the lesion or the structure of the organizer, and can not see the lesion or tissue structure hidden in the deep layer. For example, in laparoscopic surgery, the camera can see large tumors, but can not see the deep supply of tumor blood vessels. 2. The technique of finding lesions before surgery is not necessarily a camera-type technique, but may also be other influential examinations such as ultrasound, nuclear magnetic, and CT. The original signal acquisition methods of these technologies are different from the original signal acquisition methods of the cameras, and the types of lesions that they are good at discovering are also different. Some early lesions can be detected early with other techniques, and camera technology will have to wait until later to discover. For example, some early breast cancers discovered by nuclear magnetic or molybdenum targets are not much different from normal tissues under the observation of the camera and are difficult to distinguish.

At present, the commonly used methods are: 1. Early surgery, doctors combined with those images before surgery, artificially estimate a general lesion area (such as the 1/4 quadrant of the left breast) to narrow the scope of some explorations in the future, in anticipation of Increase the probability of finding a lesion. 2, continue to observe, and other lesions grow up, relatively not so early, and then surgery. But these two methods still have their own shortcomings. The latter undoubtedly delayed the condition and delayed treatment. Although the former can increase the probability of some early discoveries, the range estimation based on human estimation is still not accurate enough. It takes a lot of time and effort to locate in the operation, and it still cannot theoretically ensure the detection of lesions.

There are also some people who propose new solutions. The CN200680020112 patent mentions a technique for providing a surgical robot with a laparoscopic ultrasound probe specifically for use in surgery, which produces a 2D image that can be processed by the processor to generate at least a portion of the 3D anatomical image. After that, the image and the camera image are transmitted to the processor, and after processing, the camera image is the main image on the display screen, and the ultrasonic image is displayed in the form of the auxiliary image. And the design can also compare the 3D camera view with the 2D ultrasound image slice.

The CN201310298142 patent mentions another technique. The technique converts the pre-operative 3D image into a virtual ultrasound image, which is registered with the intraoperative ultrasound, and the resulting image is then fused with the endoscopic image during the operation, and finally the postoperative evaluation is performed on the cloud platform.

Both of the above patents use the comparison technique of instant ultrasound images and instant camera images, and also introduce the concept of endoscopic ultrasound probes or endoscopic ultrasound probes (also referred to as probes). Since the images are instantaneous images at the same time and at the same time, the processor omits the problem of which ultrasound image to look for compared with the current camera image, which simplifies the software operation, and the price is to add dedicated hardware. A speculum ultrasound probe or a laparoscopic ultrasound probe (also referred to as a probe). However, these two programs are not available in hospitals without specialized endoscopic ultrasound probes or endoscopic ultrasound probes (also referred to as probes), which limits the scope of application. In the actual medical environment, there is a need for a solution to reduce the dependence on hardware devices by improving software.

The CN201310298142 patent has other problems: 1) The cloud server function of this technology is post-installed, and the function of the cloud server is placed in the final stage of the process - the post-evaluation phase. 2/Cloud server function in parallel with other registration functions, reducing the user's dependence on the cloud server. The doctor uses the system, without using the cloud server, can complete the pre-operative 3D image acquisition, the intra-operative ultrasound image fusion, the new fusion image and the process of the camera image fusion. The above two points make a lot of computing work must be done on the local processor, which puts certain requirements on the configuration of the local processor. Mobile devices and wearable devices are inherently limited in size, and compared to desktops and even workstations, these configuration requirements are not easily met.

Based on the above, a special intraoperative ultrasound device is provided, which can realize the comparison between the pre-operative non-instant image data and the intra-operative visible light image; the software running environment is low, and the mobile device or the wearable device is convenient for the 3D image. Read and even show the results of the fusion; it is also theoretically guaranteed that as long as the early detection can find the location of the lesion, the localization system of the lesion can be found during surgery. Popularizing early detection, early treatment has important medical implications.

Summary of the invention

In order to solve the above technical problems, an object of the present invention is to provide a surgical positioning system which provides an original and optical camera for the deficiencies of the original laparoscopic, medical endoscope and robotic surgical positioning system. The data acquisition method with different signal acquisition methods is performed on the cloud server side to perform 3D visualization processing and then merged with the video or image data of the optical camera to improve the surgical positioning system of the lesion discovery rate in the operation.

The object of the invention is achieved by the following technical solutions:

a surgical positioning system that performs positioning by direct comparison between visible light images and non-instant images of imaging; the system includes a DICOM data input module, a data visualization processing module, a visible light image input module, a central processing module, and an image Display output module;

The data visualization operation processing module is located in the cloud, is connected to the central processing module, receives the data of the DICOM data input module, and visualizes the received data, and transmits the patient's 3D model data to the central processing module and/or the image display output. Module

The DICOM data input module is connected to the data visualization operation processing module, and is configured to upload the detected data in a format of a DICOM file;

The visible light image input module is connected to the central processing module for transmitting the intraoperative real-time image data to the central processing module;

a central processing module, configured to receive image data transmitted by the visible light image input module and 3D model data transmitted by the visualization processing module;

The image display output module is divided into a central processing pre-display output module and a central processing display output module; the two display output modules respectively exist independently and run separately; the central processing pre-display output module is connected with the cloud data visualization operation processing module for The 3D model is displayed; a centrally processed display output module is coupled to the central processing module for displaying an optical image and a 3D model.

One or more embodiments of the present invention may have the following advantages over the prior art:

1. Based on imaging data, generate pre-operative non-instant image 3D models, and then intraoperative Instant camera image fusion can reduce the requirements of intraoperative equipment, such as no need for special endoscopic ultrasound or endoscopic ultrasound equipment, just use the regular preoperative image examination results. The method theoretically ensures that the position of the 100% lesion is displayed on the 3D model, and the camera only needs to pay attention to the corresponding position of the surgical instrument and the iconic anatomical structure on the 3D map.

2. Complete a large number of complex operations in the cloud to generate a 3D model, and the cloud computing module and other modules are in a series process, which can force the use of the cloud module, reduce the system requirements for the local hardware environment, and facilitate the 3D image when planning before surgery. Displayed on mobile devices or wearable devices configured at the low end.

DRAWINGS

Figure 1 is a schematic view showing the structure of a surgical positioning system.

detailed description

The present invention will be further described in detail below with reference to the embodiments and the accompanying drawings.

As shown in FIG. 1 , it is a structural diagram of a surgical positioning system, which is positioned by direct comparison between a visible image of visible light and a non-instant image of imaging; the system includes a DICOM data input module 100 and a data visualization operation processing module 200. , visible light image input module 300, central processing module 400, image display output module;

The image display output module is divided into a central processing pre-display output module 501 and a central processing post-display output module 502; the two display output modules respectively exist independently and run separately; The output module is connected to the cloud data visualization operation processing module for displaying the 3D model; the central processing display output module is connected to the central processing module for displaying an optical image and a 3D model.

The specific implementation process of the above embodiment is described in detail by the following embodiments:

Example 1

A CT scan of a patient with a strong renal diverticulum revealed a stone embedded in the renal parenchyma (the diverticulum stone), and CT contrast enhanced the internal lumen structure of the kidney and ureter (aggregate system). The doctor uploads the patient's CT data to the cloud server in the form of a DICOM file. After data visualization, the 3D model data of the patient's kidney and the location data of the stones in the kidney are transmitted to the central processing module. The central processing module accepts the image data transmitted from the ureteroscope camera and the 3D data transmitted from the data visualization processing module. Through registration and fusion, it is determined which relative position of the patient's 3D model is in the lens, and arrives at the buried position. The path of travel required for the stones in the chamber. In this way, along the path prompted by the central processing module, the diverticulum stones buried in the tissue can be found.

Example 2

A kidney tumor patient needs to have a partial laparoscopic nephrectomy. The doctor uploads the patient's kidney CT data to the cloud server in the form of a DICOM file. After data visualization, the 3D model data of the patient's kidney, the location data of the tumor in the kidney, and the location of the renal blood vessels are transmitted to the central processing module. The center processing module is also located in the cloud, and receives the image data transmitted from the laparoscopic camera and the 3D data transmitted from the data visualization processing module. Through registration and fusion, the direction of the renal tumor blood vessels supplied under the renal capsule is judged. Wear the device (glasses). The doctor thus selectively blocks only the blood vessels supplying the kidney tumor and completes the surgery. Conventional methods are needed to block larger arteries and veins, resulting in more extensive renal tissue ischemia and impaired renal function.

Example 3

A peripheral lung cancer patient needs a bronchoscopy biopsy. The doctor uploads the patient's DICOM file to the cloud server. Through data visualization, the 3D model data of the patient's lungs and bronchial tubes, the location of the tumor in the lungs, and the location of the blood vessels around the tumor are transmitted to the central processing module. The central processing module receives the image data transmitted from the bronchoscope camera and the 3D data transmitted from the data visualization processing module. Through registration and fusion, it is determined which relative position of the bronchial lens is in the patient 3D model, and which bronchus the tumor needs to pass. Rumor, there is no biopsy around the tumor Need to avoid blood vessels, etc. It can even help identify and select biopsy at the marginal site of the tumor because the edge of the tumor is detected at a higher rate than the central cancer cell of the tumor (the ratio of necrotic cells in the center of the tumor is too high).

Example 4

A breast cancer patient needs a total laparoscopic mastectomy. Before surgery, tiny early breast cancer lesions were found by NMR, and it was difficult to identify cancer lesions by the camera alone. The doctor sends the patient's nuclear magnetic DICOM file to the medical data visualization processing module. After data visualization, the patient's mammary gland along with the tumor's 3D model data is passed to the central processing module. The central processing module receives the image data transmitted from the endoscope camera and the 3D data transmitted from the data visualization processing module. Through registration and fusion, it is determined which relative position of the patient's 3D model is located, and where the tumor needs to be moved. In the end, the tumor is not easily recognized by the camera and the tumor is removed.

Example 5

For a liver cancer patient, a partial liver resection of the robot is required. The patient's color Doppler ultrasound results in the location of liver cancer and the abnormal proliferation of vascular tumors. The doctor sends the patient's preoperative color ultrasound DICOM file to the medical data visualization processing module. After data visualization, the patient's liver, tumor and blood vessel 3D model data are transmitted to the central processing module and the mobile phone. The doctor had a general understanding of the blood vessel distribution at the surgical site by the mobile phone before surgery. The intraoperative central processing module accepts the image data transmitted from the robot camera and the 3D data transmitted from the data visualization processing module. Through registration and fusion, it is determined which relative position of the surgical instrument is in the patient 3D model, and where the tumor needs to be reached. The moving, abnormally proliferating blood vessels are buried there, helping the doctor to find a surgical path that avoids the abnormally proliferating variegated blood vessels, and finally removes the tumor easily.

While the embodiments of the present invention have been described above, the described embodiments are merely illustrative of the embodiments of the invention, and are not intended to limit the invention. Any modification and variation of the form and details of the invention may be made by those skilled in the art without departing from the spirit and scope of the invention. It is still subject to the scope defined by the appended claims.

Claims

The surgical positioning system is characterized in that the surgical positioning system completes positioning by direct comparison between the visible light image and the non-instant image of the imaging; the system comprises a DICOM data input module, a data visualization operation processing module, a visible light image input module, and a center Processing module, image display output module;

The data visualization operation processing module is located in the cloud, is connected to the central processing module, receives the data of the DICOM data input module, and visualizes the received data, and transmits the patient's 3D model data to the central processing module and/or the image display output. Module

The DICOM data input module is connected to the data visualization operation processing module, and is configured to upload the detected data in a format of a DICOM file;

The visible light image input module is connected to the central processing module for transmitting the intraoperative real-time image data to the central processing module;

a central processing module, configured to receive image data transmitted by the visible light image input module and 3D model data transmitted by the visualization processing module;

The image display output module is divided into a central processing pre-display output module and a central processing display output module; the two display output modules respectively exist independently and run separately; the central processing pre-display output module is connected with the cloud data visualization operation processing module for The 3D model is displayed; a centrally processed display output module is coupled to the central processing module for displaying an optical image and a 3D model.
The surgical positioning system of claim 1 wherein the image source of the visible light image input module is derived from a camera different from the imaging principle of the inspection device from which the DICOM data is derived.
The surgical positioning system of claim 1 wherein said central processing module performs direct comparison of the imagery non-immediate image and the visible light instant image.
The surgical positioning system of claim 1 wherein said central processing module is at the local end or in the cloud.