WO2023029363A1 - 一种手术机器人导航定位系统及方法 - Google Patents

一种手术机器人导航定位系统及方法 Download PDF

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WO2023029363A1
WO2023029363A1 PCT/CN2022/073192 CN2022073192W WO2023029363A1 WO 2023029363 A1 WO2023029363 A1 WO 2023029363A1 CN 2022073192 W CN2022073192 W CN 2022073192W WO 2023029363 A1 WO2023029363 A1 WO 2023029363A1
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spatial position
bone
model
surgical
dimensional
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PCT/CN2022/073192
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English (en)
French (fr)
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张逸凌
刘星宇
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北京长木谷医疗科技有限公司
张逸凌
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Publication of WO2023029363A1 publication Critical patent/WO2023029363A1/zh

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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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Definitions

  • the present application relates to the technical field of medical devices, in particular to a navigation and positioning system and method for a surgical robot.
  • Existing operations such as total knee replacement, hip replacement, and spinal treatment operations, mainly refer to the patient's preoperative radiographic X-ray films, and conduct local analysis and diagnosis based on the surgeon's clinical experience. Tools and instruments are used for placement and implantation of prostheses, resulting in low surgical accuracy.
  • the present application provides a surgical robot navigation and positioning system and method, which are used to solve the defect of low surgical accuracy in the prior art, to ensure the accuracy of the cutting position of the surgical actuator, and to improve the navigation accuracy during the surgical operation.
  • the present application provides a surgical robot navigation and positioning system, including:
  • the registration module is configured to register the three-dimensional skeleton model according to the first spatial position, the second spatial position and the third spatial position to obtain a registration result; wherein the first spatial position is the target position The spatial position of the preoperative planning point in the three-dimensional bone model in the three-dimensional model coordinate system, the second spatial position is the spatial position of the intraoperative marker point on the bone of the entity target position in the world coordinate system, and the third space The space position of the dashed point set on the bone whose position is the target position of the entity in the world coordinate system;
  • the tracking module is configured to obtain a fourth spatial position, and transform the fourth spatial position into a three-dimensional model coordinate system according to the registration result to obtain a fifth spatial position; wherein, the fourth spatial position is an operation The spatial position of the actuator and the bone in the world coordinate system, the fifth spatial position is the spatial position of the surgical actuator and the bone in the three-dimensional model coordinate system;
  • the position adjustment module is configured to adjust the cut-in position of the surgical implement according to the fifth spatial position.
  • the tracking module is further configured to optically track the spatial position of the surgical actuator in the world coordinate system within a 360° angle range.
  • the registration module includes:
  • a first registration module configured to register the first spatial position with the second spatial position to obtain a registration matrix
  • the second registration module is configured to register the third spatial position with the three-dimensional model according to the registration matrix to obtain a registration result.
  • the surgical actuator is installed on a hand-held power device
  • the position adjustment module includes:
  • the hand-held control module is configured to determine the adjustment path of the surgical implement according to the fifth spatial position, so that the operator controls the hand-held power device according to the adjustment path, and manually adjusts the cut-in position of the surgical implement.
  • the surgical actuator is installed at the end of the mechanical arm
  • the position adjustment module includes:
  • the robotic arm control module is configured to determine an adjustment path of the surgical implement according to the fifth spatial position, so that the operator operates the robotic arm according to the adjustment path to adjust the cut-in position of the surgical implement at the end of the robotic arm.
  • the position adjustment module is further configured to determine the spatial position of the current operating region of the bone at the planned target position in the three-dimensional model coordinate system when the surgical actuator is running during the surgical operation .
  • the tracking module acquires the fourth spatial position through multiple tracking balls of the surgical actuator and multiple tracking balls on the bone.
  • the system also includes:
  • the preoperative planning module is configured to, after acquiring the medical image of the target position, perform segmentation and three-dimensional reconstruction on the medical image to obtain a three-dimensional bone model of the target position.
  • the preoperative planning module is further configured to mark the preoperative planning points on the three-dimensional bone model, determine the bone prosthesis model based on the three-dimensional bone model, and determine the operating area based on the bone prosthesis model .
  • the present application also provides a navigation and positioning method for a surgical robot, comprising the following steps:
  • the three-dimensional bone model is registered to obtain a registration result; wherein, the first spatial position is the operation in the three-dimensional bone model of the target position The spatial position of the pre-planning point in the three-dimensional model coordinate system, the second spatial position is the spatial position of the intraoperative marker point on the bone of the entity target position in the world coordinate system, and the third spatial position is the bone of the entity target position The spatial position of the dashed point set on the world coordinate system;
  • the spatial position under the coordinate system, the fifth spatial position is the spatial position of the surgical actuator and the skeleton under the three-dimensional model coordinate system;
  • the cut-in position of the surgical implement is adjusted according to the fifth spatial position.
  • the present application also provides an electronic device, including a memory, a processor, and a computer program stored on the memory and operable on the processor.
  • the processor executes the program, it realizes the surgical robot navigation as described above. The steps of the positioning method.
  • the present application also provides a non-transitory computer-readable storage medium, on which a computer program is stored, and when the computer program is executed by a processor, the steps of any one of the surgical robot navigation and positioning methods described above are implemented.
  • the present application also provides a computer program product, including a computer program.
  • a computer program product including a computer program.
  • the computer program is executed by a processor, the steps of any one of the surgical robot navigation and positioning methods described above are implemented.
  • the surgical robot navigation and positioning system and method provided by this application obtain the spatial position of the line point set on the bone of the knee joint of the entity in the world coordinate system through the line line operation, so as to place the line point set in the world coordinate system according to the registration matrix.
  • the spatial position under the coordinate system is registered with the three-dimensional bone model, which improves the registration efficiency and registration accuracy compared with the traditional point-taking registration algorithm; through multiple tracking balls on the surgical actuator and on the bone
  • the multiple tracking balls can obtain the spatial position of the surgical actuator and bones in the 3D model coordinate system in real time, which can improve the tracking accuracy of the navigation system for the surgical actuator and bones; according to the space of the surgical actuator and bones in the 3D model coordinate system
  • the position adjusts the cut-in position of the surgical actuator, so as to control the surgical actuator to perform a surgical operation.
  • the surgical robot navigation and positioning system and method provided in the present application can ensure the accuracy of the cutting position of the surgical actuator and improve the navigation accuracy during the operation.
  • Fig. 1 is the structural representation of the surgical robot navigation and positioning system provided by the present application
  • Fig. 2 is a structural schematic diagram of a hand-held power device in the surgical robot navigation and positioning system provided by the present application;
  • FIG. 3 is a schematic diagram of one application scenario of the surgical robot navigation and positioning system provided by the present application.
  • FIG. 4 is a schematic diagram of another application scenario of the surgical robot navigation and positioning system provided by the present application.
  • Fig. 5 is a schematic flow chart of the surgical robot navigation and positioning method provided by the present application.
  • FIG. 6 is a schematic structural diagram of an electronic device provided by the present application.
  • the surgical robot navigation and positioning system provided in this application can be applied to joint replacement surgery or spine surgery, and the joint replacement surgery can be knee joint replacement surgery or hip joint replacement surgery.
  • the surgical robot navigation and positioning system may include an upper computer main control system 11 and an optical navigator system 13, and the upper computer main control system 11 mainly includes an upper computer and a display screen. Among them, the upper computer is used to perform various operations on the image.
  • the optical navigator system 13 includes a tracking camera (for example, a binocular infrared camera) and a display screen, and the display screen of the host control system 11 and the optical navigator system 13 can simultaneously display a three-dimensional skeleton model.
  • the doctor Before surgery, the doctor can respectively implant fixation nails on the bone of the patient's target location and install a tracer on the bone.
  • a plurality of tracking balls are set on the tracker, and the position of the tracking balls can be tracked by the tracking camera (to determine the intraoperative marker points and the marking point set according to the position of the tracking balls tracked by the tracking camera)
  • the spatial positions in the world coordinate system are used to adjust the cutting-in position of the surgical actuator.
  • FIG. 1 it is a schematic structural diagram of a surgical robot navigation and positioning system in an embodiment, including: a registration module 102, a tracking module 104 and a position adjustment module 106, and both the registration module 102 and the tracking module 104 can be located in the host computer ,in:
  • the registration module 102 is configured to perform registration on the three-dimensional skeleton model according to the first spatial position, the second spatial position and the third spatial position to obtain a registration result.
  • the first spatial position is the spatial position of the preoperative planning point in the three-dimensional bone model of the target position in the three-dimensional model coordinate system
  • the second spatial position is the intraoperative marker point on the bone of the entity target position in the world coordinate system
  • the third spatial position is the spatial position of the line point set on the bone of the entity target position in the world coordinate system.
  • the tracking module 104 is configured to obtain the fourth spatial position, and transform it into the 3D model coordinate system according to the registration result to obtain the fifth spatial position.
  • the fourth spatial position is the spatial position of the surgical actuator and the bone in the world coordinate system
  • the fifth spatial position is the spatial position of the surgical actuator and the bone in the three-dimensional model coordinate system.
  • the tracking module 104 acquires the fourth spatial position in real time through multiple tracking balls of the surgical implement and multiple tracking balls on the bone.
  • the position adjustment module 106 is configured to adjust the cut-in position of the surgical implement according to the fifth spatial position, so as to control the surgical implement to perform surgical operations.
  • Target locations can be knee joints, hip joints, or spine, among others.
  • a 3D skeleton model is a 3D digital skeleton model of a knee joint, hip joint or spine.
  • the three-dimensional femoral model may include a three-dimensional femoral model and a three-dimensional tibial model in some possible embodiments.
  • the three-dimensional bone model may include a three-dimensional acetabular model and a three-dimensional femoral model in some possible embodiments.
  • the preoperative planning points are the points planned in advance in the three-dimensional bone model for registration.
  • the intraoperative marking points are multiple points marked by the doctor on the bone of the joint through the surgical probe during the operation.
  • the line-marking point set is a plurality of points determined by the doctor to use the surgical probe to carry out the line-line operation on the bone during the operation.
  • the position of the tracking ball can be tracked by the tracking camera, so as to determine the spatial positions of the intraoperative marker points and the marking point set in the world coordinate system according to the position of the tracking ball tracked by the tracking camera.
  • the spatial position of the preoperative planning point in the three-dimensional bone model of the target position in the three-dimensional model coordinate system is obtained.
  • register and register the bones at the target position sequentially according to the position information obtained above. Registration refers to registering the world coordinate system where the target position of the entity is located to the 3D model coordinate system where the 3D skeleton model of the pre-acquired target position is located.
  • the registration module 102 also includes:
  • the first registration module is configured to roughly register the first spatial position and the second spatial position to obtain a registration matrix.
  • the second registration module is configured to perform fine registration on the third spatial position and the three-dimensional model according to the registration matrix to obtain a registration result.
  • the spatial position of the tracking ball on the surgical probe in the world coordinate system is tracked by the tracking camera, so as to determine the target position of the surgical probe in the entity according to the spatial position of the tracking ball in the world coordinate system
  • the spatial position of the preoperative planning point in the bone in the 3D model of the target position in the 3D model coordinate system is performed on the spatial position in the world coordinate system to obtain the registration matrix.
  • the doctor’s intraoperative operation can be aligned with the 3D model, and the initial coordinate system between the world coordinate system and the 3D model coordinate system can be obtained. Transformation relationship, that is, the registration matrix.
  • the coarse registration process of the first registration module is used to search the point cloud in the preset 3D space, according to the spatial position of the preoperative planning point in the 3D model coordinate system,
  • the preoperative planning points are triangulated
  • the intraoperative marked points are triangulated according to the spatial position of the intraoperative marked points in the world coordinate system, and the actual triangle sequence corresponding to the intraoperative marked points and the corresponding preoperative planning points are obtained.
  • the planning triangle sequence through the preset 3D space point cloud search method, the spatial position of the preoperative planning point in the 3D model coordinate system is corrected according to the planning triangle sequence, and the corrected preoperative planning point is obtained; through the registration algorithm, the The intraoperative marker points corresponding to the practical triangle sequence were registered with the corrected preoperative planning points to obtain a registration matrix.
  • the preoperative planning points For the preoperative planning points, assuming that the order of point clouds in the preoperative planning points is P1, P2, P3...Pn, the first three points automatically form a triangle, and starting from the fourth point, it is necessary to start from the previous Select two points from the points to form a triangle with the current point.
  • the selection principle is that the perimeter of the triangle formed after selection is the largest. According to this principle, several triangle sequences are obtained.
  • the way of generating the triangular sequence of marked points during operation is the same as the way of planning points before operation.
  • the rough configuration module is used to determine the neighbors of the preoperative planning points in the 3D model coordinate system on the 3D model through the preset 3D space point cloud search method during the correction process of the preoperative planning points.
  • domain space point set The neighborhood space point set includes a large number of points.
  • the planning triangle sequence includes multiple triangles, and each triangle includes three triangle points.
  • the target point corresponding to each triangle point of the current triangle is screened in the neighborhood space point set to obtain the first set of target points.
  • the default screening strategy is that the triangle formed by the screened three target points is congruent with the triangle in the practical triangle sequence.
  • the spatial positions of the three triangular points of the current triangle under the coordinates of the 3D model can be corrected to the positions of the corresponding target points, and the correction process can be repeated to achieve continuous alignment of a large number of triangles in the planned triangle sequence.
  • the spatial position of the pre-planning point under the coordinates of the three-dimensional model is corrected, and then the corrected pre-operative planning point closest to the intraoperative marker point is obtained.
  • the registration algorithm in this embodiment may be ICP (Iterative Closest Point, iterative closest point algorithm).
  • ICP Intelligent Closest Point, iterative closest point algorithm
  • the preoperative planning points can become transparent.
  • the preoperative planning points are corrected according to the planning triangle sequence, and the corrected preoperative planning points are obtained. Since the triangle is unique and sufficient The stability of the registration is improved, and the preoperative planning points are corrected in advance, which effectively improves the accuracy of registration.
  • the second stage of fine registration can be performed.
  • preoperative planning is not required, and calibration equipment such as surgical probes can be used to draw lines on the bone surface of the physical target position during the operation.
  • the scribing area of the scribing operation is the key bone area on the bone surface, that is, the area containing the key bone points. Track the spatial position of the tracking ball on the surgical probe in the world coordinate system through the tracking camera, so as to determine the stroke of the surgical probe on the bone at the target position of the entity according to the spatial position of the tracking ball in the world coordinate system The spatial position of the line point set in the world coordinate system.
  • a surgical probe may be used to perform sampling at a frequency S, and a point collection operation is performed on the line, and the entire line segment is subdivided into several point sets, so as to obtain the marking point set.
  • the second registration module is configured to reflect the spatial position of the lined point set in the world coordinate system back to the 3D model coordinate system according to the registration matrix, and obtain the space position of the lined point set in the 3D model coordinate system
  • the position under according to the position of the dashed point set in the 3D model coordinate system, search the neighborhood space point set on the 3D model; according to the searched neighborhood space point set and the space position of the dashed point set in the world coordinate system Correct the spatial position of the dashed point set in the 3D model coordinate system to obtain the corrected dashed point set; register the corrected dashed point set with the spatial position of the dashed point set in the world coordinate system .
  • the second registration module is also configured to: according to the spatial position of the dashed point set in the world coordinate system, perform triangular pairing on the points in the dashed point set to obtain a paired triangle sequence; according to the searched neighborhood space point set and pairing
  • the triangle sequence corrects the spatial position of the dashed point set in the three-dimensional model coordinate system.
  • the dashed point set is composed of points on multiple line segments, for example, may include points in three line segments.
  • the points in the set of dashed points are paired in triangles, and a point is selected in each line segment, and every three points form a triangle.
  • the principle of composition is that the perimeter of the triangle is the largest.
  • a sequence of paired triangles is obtained.
  • the sequence of paired triangles includes a plurality of triangles.
  • the correction method of the line point set in the second registration module is the same as the correction method of the preoperative planning points in the first registration module.
  • the second registration module is further configured to: filter out the first target point set from the searched neighborhood space point set during the correction process of the lined point set; The spatial position under the three-dimensional model coordinate system is corrected to the position of the first target point set.
  • the searched neighborhood space point set includes a large number of points.
  • the paired triangle sequence includes multiple triangles, and each triangle includes three triangle points. For the current triangle, the target point corresponding to each triangle point of the current triangle can be screened in the second neighborhood space point set according to the paired triangle sequence to obtain the first A set of target points.
  • the default screening strategy is that the triangle formed by the screened three target points is congruent with the triangle in the paired triangle sequence. Since the error of congruent triangles is extremely small, the spatial positions of the three triangle points of the current triangle under the coordinates of the three-dimensional model can be respectively corrected to the positions corresponding to the target points in the first target point set, and the correction process can be repeated to achieve A large number of triangles continuously correct the spatial position of the dashed point set in the 3D model coordinates, making the spatial position of the dashed point set reflected in the 3D model coordinate system more accurate.
  • ICP Intelligent Closest Point, iterative closest point algorithm
  • the registration result can be the transformation relationship between the final world coordinate system and the three-dimensional coordinates, and the accuracy of the intraoperative operation can be improved through the registration result.
  • the spatial position of the lined point set on the bone of the knee joint of the entity in the world coordinate system is obtained through the line drawing operation, so that the spatial position of the lined point set in the world coordinate system is obtained according to the registration matrix Compared with the traditional point-taking registration algorithm for fine registration with the 3D bone model, the registration efficiency is greatly improved, and the registration accuracy is also greatly improved.
  • the current spatial position and operation of the surgical implement can be determined.
  • the current spatial position of the region is converted to the three-dimensional model coordinate system according to the registration result, so that the spatial position of the surgical actuator in the three-dimensional model coordinate system and the spatial position of the operation area in the three-dimensional model coordinate system can be determined in real time.
  • the tracking module 104 is also configured to optically track the spatial position of the surgical implement in the world coordinate system in a 360° angle range through multiple tracking balls of the surgical implement.
  • Multiple tracking balls on the skeleton perform optical tracking of the spatial position of the skeleton in the world coordinate system in a range of 360° angles.
  • the number of tracking balls set on the surgical implement and the tracker on the bone at the target position may be eight.
  • Multiple positioning surfaces that are different in space can be constructed by setting multiple tracking balls, so that each positioning surface has obvious mutuality, which is convenient for the navigation and positioning system to accurately identify and distinguish each positioning surface, and improve the registration of the positioning surface Accuracy, which can improve the tracking accuracy of the navigation system for surgical actuators and bones.
  • the surgical actuator may include a grinding rod 15 or a saw blade.
  • the surgical actuator may include the grinding rod 15 to grind the acetabular cup.
  • the surgical actuator may include a saw blade for osteotomy.
  • Fig. 3 shows an application scenario where the surgical robot navigation and positioning system is applied to hip joint replacement
  • Fig. 4 shows an application scenario where the surgical robot navigation and positioning system is applied to knee joint replacement.
  • the surgical robot navigation and positioning system may further include a handheld power device 14 .
  • FIG. 2 shows a schematic structural view of a handheld power device 14 in one embodiment, and a surgical actuator is installed at the end of the handheld power device 14 .
  • the surgical implement is installed on the installation port 100 at the front end of the connector 1 of the hand-held power device 14, and the connector 1 is detachably installed with a navigation bracket 3.
  • the navigation bracket 3 is provided with a plurality of tracking balls 2 (that is to say, in this embodiment, the plurality of tracking balls of the aforementioned surgical implements are arranged on the hand-held power for the optical navigation system 13).
  • the tracking ball 2) on the device 14 is formed with an annular support surface 4 on the navigation bracket 3, the track of the annular support surface 4 can extend circumferentially, and a plurality of tracking balls 2 are distributed around the surface of the annular support surface 4.
  • the tracking camera performs optical tracking of the spatial position of the surgical actuator in a 360° angle range through multiple tracking balls 2 .
  • the spatial position of the surgical actuator and the bone is optically tracked in a 360° angle range to obtain accurate surgery
  • the spatial position of the actuator and the bone so as to adjust the cut-in position of the surgical actuator according to the obtained spatial position of the surgical actuator and the bone.
  • the position adjustment module includes a hand-held control module.
  • the hand-held control module can be located in the host computer, and the hand-held control module is configured to The spatial position determines the adjustment path of the surgical implement, so that the operator controls the hand-held power device 14 according to the adjustment path, and manually adjusts the cut-in position of the surgical implement.
  • the surgical actuator is pre-installed on the handheld power device.
  • the handheld control module is configured to The spatial position in the coordinate system determines the spatial position of the surgical actuator in the three-dimensional model coordinate system, and the spatial position of the current operation area in the three-dimensional model coordinate system. Determine the position difference between the spatial position of the current operating area and the current spatial position of the surgical implement according to the spatial position of the surgical implement and the current operating area, and determine the operated displacement of the hand-held power device 14 according to the positional difference, thereby according to This displacement determines the adjustment path of the surgical implement.
  • the adjustment path is displayed in the three-dimensional bone model to guide the doctor to hold the hand-held power device 14 so that the hand-held power device 14 drives the surgical actuator to move to the vicinity of the operation area.
  • the surgical robot navigation and positioning system may further include a robotic arm system 12, the robotic arm system 12 includes a robotic arm control device and a robotic arm, and a surgical actuator may be connected to the end of the robotic arm.
  • the plurality of tracking balls of the aforementioned surgical implement may be tracking balls installed on the tracker at the end of the mechanical arm, or may be tracking balls on the tracker installed on the surgical implement itself. track ball.
  • the position adjustment module 106 also includes a robotic arm control module.
  • the robotic arm control module is located in the robotic arm control device and is configured to The spatial position of determines the adjustment path of the surgical implement, so that the operator operates the mechanical arm according to the adjustment path to adjust the cut-in position of the surgical implement at the end of the mechanical arm.
  • the adjustment path will be displayed in the 3D skeleton model to guide the doctor to drag the robotic arm so that the robotic arm can drive the surgical actuator to the operating area to adjust the robotic arm The entry position of the surgical actuator at the end.
  • the position adjustment module 106 is also configured to determine the space of the current operating region of the bone at the planned target position in the three-dimensional model coordinate system when the surgical implement is running during the surgical operation. position to confine the movement of the surgical implement within the current operating region.
  • the position adjustment module 106 controls the surgical implement through the hand-held control module, it determines the safe operating range of the surgical implement, that is, the spatial position of the current operating area of the bone at the planned target position in the three-dimensional model coordinate system, so that the operator can operate the hand-held Power equipment to control the movement of surgical actuators in the current operating area.
  • the offset of the surgical implement relative to the current operating area is determined according to the spatial position of the surgical implement and the spatial position of the current operating area of the target position; The amount is used to control the robotic arm to limit the movement of the surgical actuator to the current operating area.
  • the operating area of the target position may be the operating area of the hip joint
  • the incision position of the surgical actuator may be a pre-planned specific position of the hip joint.
  • the operating area of the target position can be each osteotomy plane of the knee joint, and the incision position of the surgical actuator can be the outer edge of the current operating area (current osteotomy plane) and align with the current operating area.
  • the three-dimensional model will display the pre-planned order in which multiple target areas are operated, providing a reference for the doctor during the operation, so that the doctor can choose one of the target areas as the current target area being operated.
  • the Cartesian damping control mode modeled with virtual springs and dampers is activated, and the robotic arm is based on each virtual spring in the direction of multiple degrees of freedom
  • the stiffness-damping model of the virtual spring is also called Cartesian Impedance Control Mode (CICM).
  • CICM Cartesian Impedance Control Mode
  • the behavior of the robot is compliance-sensitive and reacts to external influences such as obstacles or process forces. Applying an external force can cause the robot to deviate from the planned orbital path.
  • the above system also includes:
  • the preoperative planning module is configured to segment and three-dimensionally reconstruct the medical image after obtaining the medical image of the target position to obtain a three-dimensional bone model of the target position; mark preoperative planning points on the three-dimensional bone model; based on the three-dimensional bone model A skeletal prosthesis model is determined, and an operation region is determined based on the skeletal prosthesis model.
  • the preoperative planning module may select bony landmarks on the three-dimensional bone model as preoperative planning points.
  • the step of determining the bone prosthesis model based on the three-dimensional bone model may include: determining key parameters of the bone based on the three-dimensional bone model; determining the type and model of the three-dimensional bone prosthesis model based on the key parameters of the bone.
  • the preoperative planning module can also be configured to: implant the selected 3D bone prosthesis model into the 3D bone model; adjust the placement position and placement angle of the 3D bone prosthesis model based on key bone parameters and the type and model of the 3D bone prosthesis model .
  • the medical image of the target position may be CT or MRI image data of the knee joint, CT or MRI image data of the hip joint, CT or MRI image data of the spine.
  • the medical image can be segmented through the neural network model, and can be segmented into regions of different granularities as needed.
  • the medical image of the target position when the medical image of the target position is the knee joint For CT or MRI image data, it can be divided into femoral area and tibial area, or can also be divided into femoral area, tibial area, fibula area and patella area as needed; when the medical image of the target position is CT or MRI image data of the hip joint , it can be divided into femoral and acetabular regions. Then, three-dimensional reconstruction can be performed on the images of each segmented region to obtain a three-dimensional bone model of each bone region.
  • the key bone parameters can include bone key anatomical points, bone key axes, and bone size parameters.
  • the key bone anatomical points can be identified based on deep learning algorithms, such as neural network models, and the identified Skeletal key anatomical points are marked.
  • the bone size parameter may include the left and right diameter of the femur, the anteroposterior diameter of the femur, the left and right diameter of the tibia, and the anteroposterior diameter of the tibia.
  • the left and right femur diameters were determined according to the line connecting the medial and lateral borders of the femur, the anteroposterior diameter of the femur was determined according to the tangent line to the anterior cortex of the femur and the tangent line to the posterior condyle of the femur, the left and right diameters of the tibia were determined according to the connecting line between the medial and lateral borders of the tibia, and the anteroposterior diameter of the tibia was determined according to the line connecting the anterior and posterior borders of the tibia.
  • the key axis of the bone is determined based on the key anatomical points of the bone, and the key angle of the bone is determined based on the key axis of the bone. However, based on the key axis of the bone and the key angle of the bone, it is helpful to determine the type and model of the three-dimensional bone prosthesis model.
  • the three-dimensional skeletal prosthesis model of the knee joint generally includes a three-dimensional femoral prosthesis model, a three-dimensional tibial prosthesis model, and a spacer model connecting the three-dimensional tibial prosthesis model and the three-dimensional femoral prosthesis model.
  • the 3D skeletal prosthesis model of the knee joint can be a prosthesis model for total knee replacement that is currently on the market.
  • There are many types of the 3D skeletal prosthesis model and each type of 3D skeletal prosthesis model has multiple models.
  • the types of three-dimensional femoral prosthesis models include ATTUNE-PS, ATTUNE-CR, SIGMA-PS150, etc.
  • the models of ATTUNE-PS include 1, 2, 3, 3N, 4, 4N, 5, 5N, 6, 6N.
  • the selected three-dimensional bone prosthesis model of the knee joint is implanted into the corresponding three-dimensional bone model of the knee joint, and the placement position and angle of the three-dimensional bone prosthesis model are adjusted based on the key parameters of the bone and the type and model of the three-dimensional bone prosthesis model.
  • the three-dimensional visual display of the matching adjustment process and matching effect of the bone and the prosthesis is realized.
  • tibial varus angle femoral valgus angle
  • left and right tibial diameter tibial anteroposterior diameter
  • the three-dimensional model includes a three-dimensional femoral model
  • the three-dimensional bone prosthesis model includes a three-dimensional femoral prosthesis model
  • key bone parameters include femoral key parameters
  • femoral key parameters include femoral mechanical axis, femoral condyle line, posterior condyle connection line, left and right femur diameter, and femur anteroposterior diameter
  • the steps of adjusting the placement position and placement angle of the three-dimensional bone prosthesis model based on the key bone parameters and the type and model of the three-dimensional bone prosthesis model include: based on the left and right femur diameter and Adjust the placement position of the 3D femoral prosthesis model; adjust the varus or valgus angle of the 3D femoral prosthesis model so that the cross section of the 3D femoral prosthesis model is perpendicular to the mechanical axis of the femur; adjust the 3D femoral prosthesis Internal rotation angle
  • the installation position of the femoral prosthesis model satisfies that the femoral prosthesis model can cover the left and right sides of the femur and the front and back of the femur, the installation position is appropriate.
  • the femoral valgus angle and femoral varus angle can be determined according to the relative angle between the central axis of the femoral prosthesis model in the upper and lower direction of the coronal plane and the femoral force line, and according to the transverse axis of the femoral prosthesis model
  • the external rotation angle and internal rotation angle are determined by the relative angle to the condylar line;
  • the femoral flexion angle is determined by the angle between the femoral mechanical axis and the central axis of the femoral prosthesis model in the sagittal front-posterior direction.
  • the installation angle of the three-dimensional femoral prosthesis model is appropriate. For example, when the varus/valgus angle is adjusted to 0°, and the PCA is adjusted to 3°, it can be determined as the correct installation angle of the femoral prosthesis model. Adjust the placement position and placement angle to a suitable position.
  • the three-dimensional bone model also includes a three-dimensional tibial model
  • the three-dimensional femoral prosthesis model also includes a three-dimensional tibial prosthetic model
  • the bone key parameters also include tibial key parameters
  • the tibial key parameters include tibial mechanical axis , left and right tibial diameter, and tibial anteroposterior diameter
  • the steps of adjusting the placement position and placement angle of the three-dimensional bone prosthesis model based on the key bone parameters and the type and model of the three-dimensional bone prosthesis model include: adjusting the three-dimensional The placement position of the tibial prosthesis model; adjust the varus or valgus angle of the three-dimensional tibial prosthesis so that the mechanical axis of the tibia is perpendicular to the cross-section of the three-dimensional tibial prosthesis.
  • the posterior inclination angle of the tibial prosthesis can also be determined according to the design principles of the tibial prosthesis, and the adjustment of the flexion angle of the tibial prosthesis can be based on the patient's physiological The characteristics are determined, adjust to 0° or other, avoid notch (gap), Over.
  • the method further includes: performing simulation based on the matching relationship between the 3D skeletal prosthesis model and the 3D skeletal prosthesis model Osteotomy to obtain a three-dimensional postoperative simulation model of the bone; perform motion simulation on the three-dimensional femoral postoperative simulation model including extension and flexion; determine the extension gap in the extension state, and determine the flexion gap in the flexion state; compare the extension Gap and buckling gap, the matching verification of the three-dimensional bone prosthesis model.
  • the femoral osteotomy thickness is determined according to the design principles of the femoral prosthesis, and different femoral prostheses may correspond to different osteotomy thicknesses;
  • the osteotomy plane can be determined.
  • the osteotomy planes may include femoral osteotomy planes and tibial osteotomy planes, and the number of tibial osteotomy planes may be one plane area.
  • the femoral osteotomy plane its quantity can include 5 plane areas, and the 5 plane areas respectively include the femoral frontal osteotomy plane, the femoral anterior oblique osteotomy plane, the femoral posterior condyle osteotomy plane, the femoral posterior oblique osteotomy plane, the femoral Distal osteotomy plane.
  • the motion simulation can be performed, and the extension gap and flexion gap can be determined through the extension position simulation map and the flexion position simulation map. Based on the extension gap and the flexion gap, it is determined whether the three-dimensional bone prosthesis model fits the osteotomized three-dimensional model. By simulating the installation effect of the prosthesis, it is possible to observe whether the size and position of the prosthesis are suitable from different angles, whether there is collision or dislocation of the prosthesis, and then accurately determine whether the prosthesis and the bone fit. The user can determine whether to adjust the 3D skeletal prosthesis model through the final simulation image.
  • the preoperative planning method further includes: determining the three-dimensional coordinates of the center point of the femoral medullary cavity based on the three-dimensional femoral model; creating an intramedullary positioning analog rod by a circular fitting method; using the intramedullary positioning analog rod Determine the opening point of the femur.
  • the intramedullary locating analog rod and the opening point of the femur are visualized on the three-dimensional bone model to guide the doctor to open the pulp.
  • the key bone parameters can be determined according to the three-dimensional bone model of the hip joint, which includes a three-dimensional acetabular model and a three-dimensional femoral model.
  • Skeletal key parameters may include acetabular center of rotation, acetabular diameter, acetabular anteversion, acetabular abduction, femoral head rotation center, femoral canal morphology, femoral canal anatomical axis, and femoral neck-shaft angle.
  • the type and model of the three-dimensional acetabular prosthesis model were determined.
  • the type and model of the three-dimensional femoral prosthesis model were determined according to the center of rotation of the femoral head, the shape of the femoral medullary canal, the anatomical axis of the femoral medullary canal, and the femoral neck-shaft angle, and the leg length difference and femoral joint eccentricity were also considered.
  • the three-dimensional bone model also includes a three-dimensional acetabular model
  • the key parameters of the bone also include the acetabular rotation center, acetabular diameter, acetabular anteversion angle, acetabular abduction angle, comprehensive consideration of the acetabular Acetabular cup coverage
  • 3D skeletal prosthesis model also includes 3D acetabular prosthesis model; adjust the placement position and placement angle of the 3D skeletal prosthesis model based on the key parameters of the bone and the type and model of the 3D skeletal prosthesis model including: based on the acetabulum Rotation center, acetabular diameter, acetabular anteversion angle, acetabular abduction angle and acetabular cup coverage, adjust the placement position of the three-dimensional acetabular prosthesis model, so that the acetabular cup is placed in a safe area.
  • the three-dimensional bone model also includes a three-dimensional femoral model
  • the key bone parameters also include the center of rotation of the femoral head, the shape of the femoral medullary canal, the anatomical axis of the femoral medullary canal, and the femoral neck-shaft angle
  • the body model also includes a three-dimensional femoral prosthesis model; adjusting the placement position and placement angle of the three-dimensional bone prosthesis model based on key bone parameters and the type and model of the three-dimensional bone prosthesis model includes: based on the femoral head rotation center, femoral medullary cavity shape, The anatomical axis of the femoral medullary cavity and the femoral neck-shaft angle were adjusted to adjust the placement position of the three-dimensional femoral prosthesis model so that the three-dimensional femoral prosthesis model fit the femur.
  • key bone parameters are determined based on the three-dimensional bone model, and the type and model of the three-dimensional bone prosthesis model are determined based on the key bone parameters, so that the selected three-dimensional bone prosthesis model is implanted into the three-dimensional bone model, and based on the key bone parameters and
  • the type and model of the three-dimensional bone prosthesis model Adjust the placement position and placement angle of the three-dimensional bone prosthesis model. It can improve the accuracy of the position of the prosthesis, and is beneficial to improve the accuracy of joint replacement surgery.
  • a surgical robot navigation and positioning method including the following steps 502 to 506:
  • Step 502 register the three-dimensional skeleton model according to the first spatial position, the second spatial position and the third spatial position, and obtain a registration result.
  • the first spatial position is the spatial position of the preoperative planning point in the three-dimensional bone model of the target position in the three-dimensional model coordinate system
  • the second spatial position is the intraoperative marker point on the bone of the entity target position in the world coordinates
  • the third spatial position is the spatial position of the line point set on the bone of the entity target position in the world coordinate system.
  • Step 504 obtain the fourth spatial position, and transform it into the 3D model coordinate system according to the registration result to obtain the fifth spatial position.
  • the fourth spatial position is the spatial position of the surgical actuator and the bone in the world coordinate system
  • the fifth spatial position is the spatial position of the surgical actuator and the bone in the three-dimensional model coordinate system.
  • Step 506 adjust the cut-in position of the surgical implement according to the fifth spatial position, so as to control the surgical implement to perform the surgical operation.
  • the above method further includes: optically tracking the spatial position of the surgical implement in the world coordinate system with a range of 360° angles through a plurality of tracking balls on the surgical implement.
  • step 502 includes:
  • the surgical implement is mounted on a hand-held power device; adjusting the cut-in position of the surgical implement according to the fifth spatial position includes:
  • the adjustment path of the surgical implement is determined according to the fifth spatial position, so that the operator controls the hand-held power device according to the adjustment path, and manually adjusts the cut-in position of the surgical implement.
  • the surgical implement is installed at the end of the robotic arm; adjusting the cut-in position of the surgical implement according to the fifth spatial position includes:
  • the adjustment path of the surgical implement is determined according to the fifth spatial position, so that the operator operates the mechanical arm according to the adjustment path to adjust the cut-in position of the surgical implement at the end of the mechanical arm.
  • the above method also includes:
  • the spatial position of the current operating region of the bone at the planned target position in the three-dimensional model coordinate system is determined, so as to limit the movement of the surgical implementer within the current operating region.
  • the above method also includes:
  • the medical image is segmented and three-dimensionally reconstructed to obtain the three-dimensional bone model of the target position; the key parameters of the bone are determined based on the three-dimensional bone model; the type and type of the three-dimensional bone prosthesis model are determined based on the key parameters of the bone Model; implant the selected three-dimensional bone prosthesis model into the three-dimensional bone model; adjust the placement position and placement angle of the three-dimensional bone prosthesis model based on the key parameters of the bone and the type and model of the three-dimensional bone prosthesis model.
  • Each module in the above surgical robot navigation and positioning system can be fully or partially realized by software, hardware and combinations thereof.
  • the above-mentioned modules can be embedded in or independent of the processor in the computer device in the form of hardware, and can also be stored in the memory of the computer device in the form of software, so that the processor can invoke and execute the corresponding operations of the above-mentioned modules.
  • FIG. 6 illustrates a schematic diagram of the physical structure of an electronic device.
  • the electronic device may include: a processor (processor) 610, a communication interface (Communications Interface) 620, a memory (memory) 630 and a communication bus 640, Wherein, the processor 610 , the communication interface 620 , and the memory 630 communicate with each other through the communication bus 640 .
  • the processor 610 can call the logic instructions in the memory 630 to execute the navigation and positioning method of the surgical robot, the method includes:
  • the three-dimensional bone model is registered to obtain a registration result; wherein, the first spatial position is the operation in the three-dimensional bone model of the target position The spatial position of the pre-planning point in the three-dimensional model coordinate system, the second spatial position is the spatial position of the intraoperative marker point on the bone of the entity target position in the world coordinate system, and the third spatial position is the bone of the entity target position The spatial position of the dashed point set on the world coordinate system;
  • the spatial position under the coordinate system, the fifth spatial position is the spatial position of the surgical actuator and the skeleton under the three-dimensional model coordinate system;
  • the cut-in position of the surgical implement is adjusted according to the fifth spatial position.
  • the logic instructions in the above-mentioned memory 630 may be implemented in the form of software functional units and when sold or used as an independent product, may be stored in a computer-readable storage medium.
  • the technical solution of the present application is essentially or the part that contributes to the prior art or the part of the technical solution can be embodied in the form of a software product, and the computer software product is stored in a storage medium, including Several instructions are used to make a computer device (which may be a personal computer, a server, or a network device, etc.) execute all or part of the steps of the methods described in the various embodiments of the present application.
  • the aforementioned storage media include: U disk, mobile hard disk, read-only memory (ROM, Read-Only Memory), random access memory (RAM, Random Access Memory), magnetic disk or optical disc, etc., which can store program codes. .
  • the present application also provides a computer program product, the computer program product includes a computer program, the computer program can be stored on a non-transitory computer-readable storage medium, and when the computer program is executed by a processor, the computer can Performing the surgical robot navigation and positioning method provided by the above methods, the method includes:
  • the three-dimensional bone model is registered to obtain a registration result; wherein, the first spatial position is the operation in the three-dimensional bone model of the target position The spatial position of the pre-planning point in the three-dimensional model coordinate system, the second spatial position is the spatial position of the intraoperative marker point on the bone of the entity target position in the world coordinate system, and the third spatial position is the bone of the entity target position The spatial position of the dashed point set on the world coordinate system;
  • the spatial position under the coordinate system, the fifth spatial position is the spatial position of the surgical actuator and the skeleton under the three-dimensional model coordinate system;
  • the cut-in position of the surgical implement is adjusted according to the fifth spatial position.
  • the present application also provides a non-transitory computer-readable storage medium, on which a computer program is stored, and when the computer program is executed by a processor, it is implemented to perform the surgical robot navigation and positioning method provided by the above-mentioned methods, the method include:
  • the three-dimensional bone model is registered to obtain a registration result; wherein, the first spatial position is the operation in the three-dimensional bone model of the target position The spatial position of the pre-planning point in the three-dimensional model coordinate system, the second spatial position is the spatial position of the intraoperative marker point on the bone of the entity target position in the world coordinate system, and the third spatial position is the bone of the entity target position The spatial position of the dashed point set on the world coordinate system;
  • the spatial position under the coordinate system, the fifth spatial position is the spatial position of the surgical actuator and the skeleton under the three-dimensional model coordinate system;
  • the cut-in position of the surgical implement is adjusted according to the fifth spatial position.
  • the device embodiments described above are only illustrative, and the units described as separate components may or may not be physically separated, and the components shown as units may or may not be physical units, that is, they may be located in One place, or it can be distributed to multiple network elements. Part or all of the modules can be selected according to actual needs to achieve the purpose of the solution of this embodiment. It can be understood and implemented by those skilled in the art without any creative effort.
  • each implementation can be implemented by means of software plus a necessary general hardware platform, and of course also by hardware.
  • the essence of the above technical solution or the part that contributes to the prior art can be embodied in the form of software products, and the computer software products can be stored in computer-readable storage media, such as ROM/RAM, magnetic discs, optical discs, etc., including several instructions to make a computer device (which may be a personal computer, server, or network device, etc.) execute the methods described in various embodiments or some parts of the embodiments.

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Abstract

本申请提供一种手术机器人导航定位系统及方法，涉及医疗器械技术领域，该系统包括：配准模块，被配置为根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；追踪模块，被配置为获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；位置调节模块，被配置为根据所述第五空间位置调整手术执行器的切入位置。本申请能够确保手术执行器的切入位置的准确性，以及提高手术过程中的导航精度。

Description

一种手术机器人导航定位系统及方法
相关申请的交叉引用
本申请要求于2021年09月03日提交的申请号为202111035796.0，发明名称为“手术机器人导航定位系统及方法”的中国专利申请的优先权，其通过引用方式全部并入本文。
技术领域
本申请涉及医疗器械技术领域，尤其涉及一种手术机器人导航定位系统及方法。
背景技术
现有的手术，如全膝关节置换术、髋关节置换术、脊柱治疗手术等主要是参考患者术前的影像学X线片，根据手术医生的临床经验进行局部分析和诊断，通过传统的手术工具与器械进行假体的安放与植入，导致手术精准性较低。
发明内容
本申请提供一种术机器人导航定位系统及方法，用以解决现有技术中手术精准性较低的缺陷，实现确保手术执行器的切入位置的准确性，以及提高手术过程中的导航精度。
本申请提供一种手术机器人导航定位系统，包括：
配准模块，被配置为根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
追踪模块，被配置为获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置；
位置调节模块，被配置为根据所述第五空间位置调整手术执行器的切入位置。
根据本申请提供的手术机器人导航定位系统，所述追踪模块还被配置为对手术执行器在世界坐标系下的空间位置进行360°的角度范围的光学跟踪。
根据本申请提供的手术机器人导航定位系统，所述配准模块包括：
第一配准模块，被配置为将所述第一空间位置与所述第二空间位置进行配准，得 到配准矩阵；
第二配准模块，被配置为根据所述配准矩阵，将所述第三空间位置与所述三维模型进行配准，得到配准结果。
根据本申请提供的手术机器人导航定位系统，所述手术执行器安装于手持动力设备上；
所述位置调节模块包括：
手持控制模块，被配置为根据所述第五空间位置确定手术执行器的调节路径，以使操作者根据所述调节路径对手持动力设备进行控制，手动调节手术执行器的切入位置。
根据本申请提供的手术机器人导航定位系统，所述手术执行器安装于机械臂末端；
所述位置调节模块包括：
机械臂控制模块，被配置为根据所述第五空间位置确定手术执行器的调节路径，以使操作者根据所述调节路径操作机械臂，以调节机械臂末端的手术执行器的切入位置。
根据本申请提供的手术机器人导航定位系统，所述位置调节模块还被配置为在手术操作中，运行手术执行器时，确定三维模型坐标系中规划的目标位置的骨骼的当前操作区域的空间位置。
根据本申请提供的手术机器人导航定位系统，所述追踪模块通过手术执行器的多个追踪球，以及骨骼上的多个追踪球，获取所述第四空间位置。
根据本申请提供的手术机器人导航定位系统，该系统还包括：
术前规划模块，被配置为在获取到目标位置的医学图像后，对所述医学图像进行分割和三维重建，得到目标位置的三维骨骼模型。
根据本申请提供的手术机器人导航定位系统，所述术前规划模块还被配置为在三维骨骼模型上标记术前规划点，基于三维骨骼模型确定骨骼假体模型，基于骨骼假体模型确定操作区域。
本申请还提供一种手术机器人导航定位方法，包括以下步骤：
根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空 间位置；
根据所述第五空间位置调整手术执行器的切入位置。
本申请还提供一种电子设备，包括存储器、处理器及存储在存储器上并可在处理器上运行的计算机程序，所述处理器执行所述程序时实现如上述任一种所述手术机器人导航定位方法的步骤。
本申请还提供一种非暂态计算机可读存储介质，其上存储有计算机程序，该计算机程序被处理器执行时实现如上述任一种所述手术机器人导航定位方法的步骤。
本申请还提供一种计算机程序产品，包括计算机程序，所述计算机程序被处理器执行时实现如上述任一种所述手术机器人导航定位方法的步骤。
本申请提供的手术机器人导航定位系统及方法，通过划线操作获取实体的膝关节的骨骼上的划线点集在世界坐标系下的空间位置，从而根据配准矩阵将划线点集在世界坐标系下的空间位置与三维骨骼模型进行配准，与传统的取点配准算法相比，提高了配准效率和配准精准度；通过手术执行器上的多个追踪球，以及骨骼上的多个追踪球实时获取手术执行器、骨骼在三维模型坐标系下的空间位置，能够提升导航系统对手术执行器、骨骼的跟踪精度；根据手术执行器、骨骼在三维模型坐标系下的空间位置调整手术执行器的切入位置，以控制手术执行器进行手术操作。本申请提供的手术机器人导航定位系统及方法，能够确保手术执行器的切入位置的准确性，以及提高手术过程中的导航精度。
附图说明
为了更清楚地说明本申请或现有技术中的技术方案，下面将对实施例或现有技术描述中所需要使用的附图作一简单地介绍，显而易见地，下面描述中的附图是本申请的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他的附图。
图1是本申请提供的手术机器人导航定位系统的结构示意图；
图2是本申请提供的手术机器人导航定位系统中手持动力设备的结构示意图；
图3为是本申请提供的手术机器人导航定位系统其中一个应用场景示意图；
图4为是本申请提供的手术机器人导航定位系统另一个应用场景示意图；
图5是本申请提供的手术机器人导航定位方法的流程示意图；
图6是本申请提供的电子设备的结构示意图。
具体实施方式
为使本申请的目的、技术方案和优点更加清楚，下面将结合本申请中的附图，对本申请中的技术方案进行清楚、完整地描述，显然，所描述的实施例是本申请一部分实施例，而不是全部的实施例。基于本申请中的实施例，本领域普通技术人员在没有 作出创造性劳动前提下所获得的所有其他实施例，都属于本申请保护的范围。
本申请提供的手术机器人导航定位系统既可以应用于关节置换手术或脊柱手术中，关节置换手术可以为膝关节置换手术，或髋关节置换手术。
手术机器人导航定位系统可包括上位机主控系统11和光学导航仪系统13，上位机主控系统11主要包括上位机和显示屏。其中，上位机用于对图像进行各种运算处理。光学导航仪系统13包括追踪相机(例如，双目红外相机)和显示屏，上位机主控系统11的显示屏和光学导航仪系统13的显示屏可同步显示三维骨骼模型。
在手术前，医生可以分别在患者的目标位置的骨骼上植入固定钉，并在骨骼上安装示踪器。示踪器上设置有多个追踪球(光学小球)，可以通过追踪相机(追踪到追踪球的位置，以便根据追踪相机追踪到的追踪球的位置，确定术中标记点、划线点集分别在世界坐标系下的空间位置，以调节手术执行器的切入位置。
如图1所示，为一个实施例中手术机器人导航定位系统的结构示意图，包括：配准模块102、追踪模块104和位置调节模块106，配准模块102、追踪模块104均可位于上位机中，其中：
配准模块102，被配置为根据第一空间位置、第二空间位置和第三空间位置，对三维骨骼模型进行配准，得到配准结果。该系统中，第一空间位置为目标位置的三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置。
追踪模块104，被配置为获取第四空间位置，根据配准结果将其转换到三维模型坐标系下，得到第五空间位置。在该系统中，第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置。
在本实施例中，追踪模块104通过手术执行器的多个追踪球，以及骨骼上的多个追踪球，实时地获取第四空间位置。
位置调节模块106，被配置为根据第五空间位置调整手术执行器的切入位置，以控制手术执行器进行手术操作。
目标位置可以是膝关节、髋关节或脊柱等。三维骨骼模型是膝关节、髋关节或者脊柱的三维数字化骨骼模型。当目标位置为膝关节时，三维股骨模型在一些可能的实施例中可以包括三维股骨模型和三维胫骨模型。当目标位置为髋关节时，三维骨骼模型在一些可能的实施例中可以包括三维髋臼模型和三维股骨模型。术前规划点为预先在三维骨骼模型中规划的用于配准的点。术中标记点为医生在术中通过手术探针在关节的骨骼上标记的多个点。划线点集为医生在术中利用手术探针在骨骼上进行划线操作确定的多个点。
本实施例中，可以通过追踪相机追踪到追踪球的位置，以便根据追踪相机追踪到 的追踪球的位置，确定术中标记点、划线点集分别在世界坐标系下的空间位置。同时还会获取目标位置的三维骨骼模型中的术前规划点在三维模型坐标系下的空间位置。之后根据上述获取的位置信息依次对目标位置的骨骼进行注册配准。配准是指将实体目标位置所在的世界坐标系配准到预先获取的目标位置的三维骨骼模型所在的三维模型坐标系。
本实施例中，配准模块102，还包括：
第一配准模块，被配置为将第一空间位置与第二空间位置进行粗配准，得到配准矩阵。
第二配准模块，被配置为根据配准矩阵将第三空间位置与三维模型进行精配准，得到配准结果。
可选的，在粗配准阶段，通过追踪相机追踪手术探针上的追踪球在世界坐标系的空间位置，从而根据追踪球在世界坐标系的空间位置，确定手术探针在实体的目标位置的骨骼上进行采点操作时的术中标记点在世界坐标系的空间位置。同时，还需要在获取到目标位置的三维模型中骨骼上的术前规划点在三维模型坐标系的空间位置后，再将术前规划点在三维模型坐标系下的空间位置与术中标记点在世界坐标系下的空间位置进行粗配准，得到配准矩阵。通过将三维模型坐标下的术中标记点与世界坐标系下的术前规划点进行粗配准，实现将医生的术中操作与三维模型进行对齐，得到世界坐标系与三维模型坐标系的初始转换关系，即配准矩阵。
作为本实施例一种可选的实现方式，第一配准模块的粗配准过程，用于通过预设三维空间点云搜索方式，根据术前规划点在三维模型坐标系下的空间位置将术前规划点进行三角化处理，以及根据术中标记点在世界坐标系下的空间位置对术中标记点进行三角化处理，得到术中标记点对应的实操三角形序列和术前规划点对应的规划三角形序列；通过预设三维空间点云搜索方式，根据规划三角形序列对术前规划点在三维模型坐标系下的空间位置进行修正，得到修正后的术前规划点；通过配准算法将实操三角形序列对应的术中标记点与修正后的术前规划点进行配准，得到配准矩阵。
示例性的，对于术前规划点，假设术前规划点中的点云排列顺序为P1、P2、P3...Pn，则前三个点自动组成三角形，从第四个点开始需要从之前的点中挑选出两个点与当前点组成三角形，挑选原则为挑选过后所组成的三角形周长最大。根据这一原则得到若干三角形序列。术中标记点生成三角形序列的方式与术前规划点的方式是相同的。
在本可选的实现方式中，粗配置模块在前规划点的修正过程中，用于通过预设三维空间点云搜索方式，确定三维模型坐标下系的术前规划点在三维模型上的邻域空间点集。该邻域空间点集中包括大量的点。规划三角形序列中包括多个三角形，每个三角形包括三个三角点，对于当前三角形，根据预设筛选策略在该邻域空间点集中筛选当前三角形的每个三角点对应的目标点，得到第一目标点集。预设筛选策略为筛选出的三个目标点组成的三角形与实操三角形序列中的三角形为全等三角形。由于全等三 角形误差极小，可以当前三角形的三个三角点在三维模型坐标下的空间位置分别修正至对应目标点的位置，重复该修正过程，实现通过规划三角形序列中的大量三角形不断对术前规划点在三维模型坐标下的空间位置进行修正，进而得到与术中标记点最相近的修正后的术前规划点。
本实施例中的配准算法可以是ICP(Iterative Closest Point，迭代最近点算法)。当配准完成后，术前规划点可以变为透明。在本实施例中，通过对术中标记点以及术前规划点进行三角化处理，根据规划三角形序列对术前规划点进行修正，得到修正后的术前规划点，由于三角形具有唯一性和足够的稳定性，且预先对术前规划点进行了修正，有效提高了配准的准确性。
在粗配准的基础上，可以进行第二阶段的精配准。在精配准阶段，不需要进行术前规划，在术中可以利用手术探针等标定设备在实体目标位置的骨骼表面进行划线操作。划线操作的划线区域是骨骼表面的关键骨骼区域，即包含关键骨骼点的区域。通过追踪相机追踪手术探针上的追踪球在世界坐标系的空间位置，从而根据追踪球在世界坐标系的空间位置，确定手术探针在实体的目标位置的骨骼上进行划线操作时的划线点集在世界坐标系下的空间位置。
示例性的，在划线操作中，可以通过手术探针以频率S进行采样，在线上进行采点操作，将整条线段细分为若干点集，从而得到划线点集。
在精配准阶段，第二配准模块，被配置为根据配准矩阵将划线点集在世界坐标系下的空间位置反射回三维模型坐标系中，得到划线点集在三维模型坐标系下的位置；根据划线点集在三维模型坐标系下的位置在三维模型上搜索邻域空间点集；根据搜索到的邻域空间点集以及划线点集在世界坐标系下的空间位置对划线点集在三维模型坐标系下的空间位置进行修正，得到修正后的划线点集；将修正后的划线点集与划线点集在世界坐标系下的空间位置进行配准。
第二配准模块还被配置为：根据划线点集在世界坐标系下的空间位置将划线点集中的点进行三角形配对，得到配对三角形序列；根据搜索到的邻域空间点集以及配对三角形序列对划线点集在三维模型坐标系下的空间位置进行修正。划线点集是由多条线段上的点所组成的，例如，可以包括三条线段中的点。将划线点集中的点进行三角形配对，分别在每条线段中选取一个点，每三个点组成一个三角形，组成原则为三角形周长最大，按照该三角形配对方式，得到配对三角形序列。配对三角形序列包括多个三角形。
其中，第二配准模块的划线点集的修正方式与第一配准模块中的术前规划点的修正方式是相同的。可选的，第二配准模块在划线点集的修正过程中，还被配置为：在搜索到的邻域空间点集中筛选出第一目标点集；根据配对三角形序列将划线点集在三维模型坐标系下的空间位置修正至第一目标点集的位置。搜索到的邻域空间点集中包括大量的点。配对三角形序列中包括多个三角形，每个三角形包括三个三角点，对于 当前三角形，可以根据配对三角形序列在第二邻域空间点集中筛选当前三角形的每个三角点对应的目标点，得到第一目标点集。预设筛选策略为筛选出的三个目标点组成的三角形与配对三角形序列中的三角形为全等三角形。由于全等三角形误差极小，可以当前三角形的三个三角点在三维模型坐标下的空间位置分别修正至第一目标点集中对应目标点的位置，重复该修正过程，实现通过配对三角形序列中的大量三角形不断对划线点集在三维模型坐标下的空间位置进行修正，使得划线点集反射到三维模型坐标系中的空间位置更为准确。
例如，可以通过ICP(Iterative Closest Point，迭代最近点算法)配准算法将修正后的划线点集与划线点集在世界坐标系下的空间位置进行配准。配准结果可以是最终得到的世界坐标系与三维坐标下的转换关系，通过配准结果可以提高术中操作的精准性。在本实施方式中，通过划线操作获取实体的膝关节的骨骼上的划线点集在世界坐标系下的空间位置，从而根据配准矩阵将划线点集在世界坐标系下的空间位置与三维骨骼模型进行精配准，与传统的取点配准算法相比，配准效率有利极大的提高，配准精准度也有较大提高。
本实施例中，通过追踪相机(双目红外相机)实时追踪手术执行器的多个追踪球的位置、目标位置的骨骼区域上的追踪球的位置，可以确定手术执行器的当前空间位置、操作区域的当前空间位置，根据配准结果将其转换至三维模型坐标系下，从而可以实时确定手术执行器在三维模型坐标系下的空间位置、操作区域在三维模型坐标系下的空间位置。
可选的，追踪模块104还被配置为通过手术执行器的多个追踪球对手术执行器在世界坐标系下的空间位置进行360°的角度范围的光学跟踪，可以理解的是，也可以通过骨骼上的多个追踪球对骨骼在世界坐标系下的空间位置进行360°的角度范围的光学跟踪。示例性的，手术执行器、以及目标位置的骨骼上的示踪器上设置的追踪球的数量可以为8个。通过设置多个追踪球可以构建多个在空间上互不相同的定位面，让各个定位面之间产生明显的互异性，便于导航定位系统准确识别和区分各个定位面，提高定位面的配准精度，从而可以提升导航系统对手术执行器、骨骼的跟踪精度。
手术执行器可以包括磨挫杆15或锯片，当手术机器人导航定位系统应用于髋关节置换手术中时，手术执行器可包括磨挫杆15，以对髋臼杯进行磨挫。当手术机器人导航定位系统应用于膝关节置换手术中时，手术执行器可包括锯片，以进行截骨。图3示出了手术机器人导航定位系统应用于髋关节置换的一个应用场景，图4示出了手术机器人导航定位系统应用于膝关节置换的一个应用场景。
在其中一个实施例中，手术机器人导航定位系统还可包括手持动力设备14。如图2、图3所示，图2示出了一个实施例的手持动力设备14的结构示意图，手术执行器安装于手持动力设备14的末端。
在本实施例的其中一个实施方式中，如图2所示，手术执行器安装在手持动力设 备14的连接器1前端的安装口100上，连接器1上可拆卸地安装有导航支架3，导航支架3上设置有多个用于为光学导航仪系统13构建定位面的追踪球2(也即是说，在本实施例中，前述的手术执行器的多个追踪球为设置于手持动力设备14上的追踪球2)，导航支架3上形成有环状支撑面4，环状支撑面4的轨迹能周向延伸，多个追踪球2环绕分布在环状支撑面4的表面。追踪相机通过多个追踪球2对手术执行器的空间位置进行360°的角度范围的光学跟踪。
在手术执行器运行前，通过手术执行器上的多个追踪球，以及骨骼上的多个追踪球，对手术执行器、骨骼的空间位置进行360°的角度范围的光学跟踪，得到准确的手术执行器、骨骼的空间位置，从而根据得到的手术执行器、骨骼的空间位置对手术执行器的切入位置进行调整。
作为本实施例的一种可选的实现方式，位置调节模块包括手持控制模块，手持控制模块可位于主位机内，手持控制模块被配置为根据手术执行器、骨骼在三维模型坐标系下的空间位置确定手术执行器的调节路径，以使操作者根据调节路径对手持动力设备14进行控制，手动调节手术执行器的切入位置。
在该实现方式中，手术执行器预先安装于手持动力设备上，在执行器运行前，当手持动力设备被操作至目标位置处时，手持控制模块被配置为根据手术执行器、骨骼在三维模型坐标系下的空间位置，确定手术执行器在三维模型坐标系下的空间位置、当前操作区域在三维模型坐标系下的空间位置。根据手术执行器、当前操作区域的空间位置确定当前操作区域的空间位置与手术执行器的当前空间位置之间的位置差量，根据位置差量确定手持动力设备14被操作的位移量，从而根据该位移量确定手术执行器的调节路径。在三维骨骼模型中显示调节路径，以引导医生手握手持动力设备14，使手持动力设备14带动手术执行器运动至操作区域附近。
在可替换实施例中，手术机器人导航定位系统还可包括机械臂系统12，机械臂系统12包括机械臂控制装置和机械臂，手术执行器可连接于机械臂的末端。在本实施例中，前述的手术执行器的多个追踪球可以为安装在机械臂的末端上的示踪器上的追踪球，或者，可以为手术执行器自身上安装的示踪器上的追踪球。
作为本实施例的一种可选的实现方式，位置调节模块106还包括机械臂控制模块，机械臂控制模块位于机械臂控制装置内，被配置为根据手术执行器、骨骼在三维模型坐标系下的空间位置确定手术执行器的调节路径，以使操作者根据调节路径操作机械臂，以调节机械臂末端的手术执行器的切入位置。
针对机械臂控制模块，在确定手术执行的调节路径后，会在三维骨骼模型中显示调节路径，以引导医生拖着机械臂，使机械臂带动手术执行器运动至操作区域内，以调节机械臂末端的手术执行器的切入位置。
作为本实施例的一种可选的实现方式，位置调节模块106还被配置为在手术操作中，运行手术执行器时，确定三维模型坐标系中规划的目标位置的骨骼的当前操作区 域的空间位置，以将手术执行器的运动限定在当前操作区域内。
当位置调节模块106通过手持控制模块控制手术执行器时，确定手术执行器的安全操作范围，即三维模型坐标系中规划的目标位置的骨骼的当前操作区域的空间位置，以使操作者操作手持动力设备，以控制手术执行器在当前操作区域内运动。
当位置调节模块106通过机械臂控制模块控制手术执行器时，根据手术执行器的空间位置与目标位置的当前操作区域的空间位置确定手术执行器相对于当前操作区域的偏移量；根据偏移量，对机械臂进行控制，以将手术执行器的运动限定在当前操作区域内。
当手术机器人导航定位系统应用于髋关节置换手术中时，目标位置的操作区域可以为髋关节的操作区域，手术执行器的切入位置可以为预先规划的的髋关节的特定位置。
当手术机器人导航定位系统应用于膝关节置换手术中时，目标位置的操作区域可以为膝关节的各个截骨平面，手术执行器的切入位置可以为当前操作区域(当前截骨平面)的外缘并与当前操作区域对齐的位置。
三维模型中会显示预先规划的多个目标区域被操作的顺序，为术中的医生提供参考，便于医生选择其中一个目标区域作为当前被操作的当前目标区域。在手术执行器安装与机械臂末端的实施例中，在运行手术执行器时，启动以虚拟弹簧和阻尼器为模型的笛卡尔阻尼控制模式，机械臂基于多个自由度方向上的各个虚拟弹簧的预设刚度值C和多个自由度方向上手术执行器相对于当前操作区域的偏移量Δx，输出与被操作方向相反的反馈力F，F＝Δx*C，从而将手术执行器的运动限定在当前操作区域内。
在本实现方式中，虚拟弹簧的刚度-阻尼模型，也称为笛卡尔阻尼控制模式(Cartesian Impedance Control Mode，CICM)。在阻尼控制模式下，机器人的行为是顺从敏感的，并能对外部影响作出反应，外部影响比如，可以为障碍物或过程力。施加外力可使机器人离开计划的轨道路径。
在一个实施例中，上述系统还包括：
术前规划模块，被配置为在获取到目标位置的医学图像后，对医学图像进行分割和三维重建，得到目标位置的三维骨骼模型；在三维骨骼模型上标记术前规划点；基于三维骨骼模型确定骨骼假体模型，基于骨骼假体模型确定操作区域。
其中，术前规划模块可在三维骨骼模型上选择骨性标志点作为术前规划点。
其中，基于三维骨骼模型确定骨骼假体模型的步骤可包括：基于三维骨骼模型，确定骨骼关键参数；基于骨骼关键参数确定三维骨骼假体模型的类型和型号。
术前规划模块还可被配置为：将选择的三维骨骼假体模型植入三维骨骼模型；基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度。
目标位置的医学图像可以是膝关节的CT或者核磁图像数据、髋关节的CT或者 核磁图像数据、脊柱的CT或者核磁图像数据。在获取到目标用户的目标位置的CT或者核磁图像数据后，可以通过神经网络模型对医学图像进行图像分割，可以按需分割成不同粒度的区域，例如，当目标位置的医学图像为膝关节的CT或者核磁图像数据时，可以分割为股骨区域和胫骨区域，或者还可以按需分割成股骨区域、胫骨区域、腓骨区域和髌骨区域；当目标位置的医学图像为髋关节的CT或者核磁图像数据时，可以分割为股骨区域和髋臼区域。而后可以对分割后各个区域图像进行三维重建，得到各个骨骼区域的三维骨骼模型。
针对膝关节，其骨骼关键参数可包括骨骼关键解剖点、骨骼关键轴线和骨骼尺寸参数，骨骼关键解剖点可基于深度学习算法，例如神经网络模型，进行识别，并在三维骨骼模型上将识别的骨骼关键解剖点进行标记。其中，骨骼尺寸参数可包括股骨左右径、股骨前后径、胫骨左右径和胫骨前后径。股骨左右径根据股骨内外侧缘连线，股骨前后径根据股骨前皮质切线和股骨后髁切线确定，胫骨左右径根据胫骨内外侧缘连线确定，胫骨前后径根据胫骨前后缘连线确定。
骨骼关键轴线基于骨骼关键解剖点确定，基于骨骼关键轴线确定骨骼关键角度。而基于骨骼关键轴线、骨骼关键角度有助于确定三维骨骼假体模型的类型和型号。膝关节的三维骨骼假体模型一般性地包括三维股骨假体模型、三维胫骨假体和连接三维胫骨假体模型和三维股骨假体模型的垫片模型。
膝关节的三维骨骼假体模型可为目前市场上已有的全膝关节置换用的假体模型，该三维骨骼假体模型有多种类型，每种类型的三维骨骼假体模型有多种型号。例如，三维股骨假体模型的类型有ATTUNE-PS、ATTUNE-CR、SIGMA-PS150等，ATTUNE-PS的型号有1、2、3、3N、4、4N、5、5N、6、6N。
将选择的膝关节的三维骨骼假体模型植入对应的膝关节的三维骨骼模型，基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度。在本实施例中，实现了三维可视化显示骨骼与假体的匹配调节过程、匹配效果。在得到植入三维骨骼假体模型后的三维模型后，可以基于股骨外翻角、股骨内翻角、股骨外旋角、股骨内旋角、股骨左右径、股骨前后径确定股骨假体模型是否与三维股骨模型已安装适配。可以基于胫骨内翻角、股骨外翻角、胫骨左右径、胫骨前后径确定胫骨假体模型是否与三维胫骨模型已安装适配。
作为本实施例一种可选的实现方式，三维模型包括三维股骨模型，三维骨骼假体模型包括三维股骨假体模型，骨骼关键参数包括股骨关键参数，股骨关键参数包括股骨机械轴、股骨通髁线、后髁连线、股骨左右径和股骨前后径；基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度的步骤包括：基于股骨左右径和股骨前后径，调整三维股骨假体模型的放置位置；调整三维股骨假体模型的内翻角或外翻角，使三维股骨假体模型的横截面与股骨机械轴垂直；调整三维股骨假体的内旋角或外旋角，使股骨后髁角PCA(股骨通髁线与后髁连 线在横断面的投影线之间的夹角)在预设范围内。
在本可选的实现方式中，当股骨假体模型的放置位置满足股骨假体模型能覆盖股骨左右、股骨前后，则安装位置合适。
可以基于股骨假体模型的当前位置，根据股骨假体模型在冠状面上下方向上的中轴线与股骨力线的相对角度确定股骨外翻角和股骨内翻角，根据股骨假体模型的横轴和通髁线的相对角度确定外旋角和内旋角；通过股骨机械轴和股骨假体模型在矢状面前后方向上的中轴线的角度确定股骨屈曲角。通过调整上述角度，可以确定三维股骨假体模型的安装角度是否合适，例如，当内/外翻角被调整为0°时，PCA被调整为3°时，则可认定为股骨假体模型的安放位置和安放角度调整到合适的位置。
作为本实施例一种可选的实现方式，三维骨骼模型还包括三维胫骨模型，三维股骨假体模型还包括三维胫骨假体模型；骨骼关键参数还包括胫骨关键参数，胫骨关键参数包括胫骨机械轴、胫骨左右径和胫骨前后径；基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度的步骤包括：基于胫骨左右径和胫骨前后径，调整三维胫骨假体模型的安放位置；调整三维胫骨假体的内翻角或外翻角，使胫骨机械轴与三维胫骨假体的横截面垂直。
在本可选的实现方式中，除通过上述方式确定安装位置和角度外，还可以根据胫骨假体的设计原则确定胫骨假体的后倾角，胫骨假体的屈曲角的调整大小可以基于患者生理特性确定，调整为0°或其他，避免出现notch(缺口)、Over。
作为本实施例一种可选的实现方式，在调整三维骨骼假体模型的安放位置和安放角度的步骤之后，方法还包括：基于三维骨骼假体模型与三维骨骼假体模型的匹配关系进行模拟截骨，得到三维骨骼术后模拟模型；对三维股骨术后模拟模型进行包括伸直位和屈曲位的运动模拟；在伸直位状态确定伸直间隙，在屈曲状态确定屈曲间隙；对比伸直间隙与屈曲间隙，对三维骨骼假体模型进行匹配性验证。
在本可选的实现方式中，根据股骨假体设计原则确定股骨截骨厚度，不同的股骨假体可能对应不同的截骨厚度；基于假体确定截骨厚度、假体与骨骼匹配后，便可确定截骨平面。
截骨平面可以包括股骨截骨平面和胫骨截骨平面，对于胫骨截骨平面，其数量可以是1个平面区域。对于股骨截骨平面，其数量可以包括5个平面区域，该5个平面区域分别包括股骨前端截骨平面、股骨前斜截骨平面、股骨后髁截骨平面、股骨后斜截骨平面、股骨远端截骨平面。
在调整好三维骨骼假体模型的安放位置和安放角度之后，基于三维骨骼假体模型与三维模型的匹配关系进行模拟截骨，得到三维骨骼术后模拟模型。
在得到三维骨骼术后模拟模型后，进行运动模拟，可以通过伸直位模拟图、屈曲位模拟图，确定伸直间隙、屈曲间隙。基于伸直间隙和屈曲间隙，确定三维骨骼假体模型是否与截骨后的三维模型适配。通过对假体的安装效果进行模拟可从不同角度观 察假体大小、位置是否合适，是否出现假体碰撞、异位，进而能够精确地确定假体与骨骼是否适配。用户可通过该最终的模拟图像，确定是否需要对三维骨骼假体模型进行调整，如果更换骨骼假体的类型和型号，则可重新调用假体库，基于新的骨骼假体模型生成置换后的三维骨骼术后模拟模型。通过对术后的预期效果进行模拟，可以使最终得到的三维骨骼假体模型与患者的膝关节更加匹配。在一种实施方式中，术前规划方法还包括：基于所述三维股骨模型确定股骨髓腔中心点的三维坐标；通过圆形拟合法创建髓内定位模拟杆；由所述髓内定位模拟杆确定股骨开髓点。
在可选的实现方式中，在膝关节置换术中还需要确定股骨髓内定位模拟杆入针点的位置，其中髁间窝的顶点可作为髓内定位模拟杆的入针点位置，入针点的位置即可作为股骨开髓点。在术中，三维骨骼模型上可视化显示髓内定位模拟杆和股骨开髓点，引导医生开髓。
针对髋关节，可以根据髋关节的三维骨骼模型确定骨骼关键参数，髋关节的三维骨骼模型包括三维髋臼模型和三维股骨模型。骨骼关键参数可以包括髋臼旋转中心、髋臼直径、髋臼前倾角、髋臼外展角、股骨头旋转中心、股骨髓腔形态、股骨髓腔解剖轴以及股骨颈干角。根据髋臼旋转中心、髋臼直径、髋臼前倾角、髋臼外展角，综合考虑髋臼杯覆盖率，确定三维髋臼假体模型的类型以及型号。根据股骨头旋转中心、股骨髓腔形态、股骨髓腔解剖轴以及股骨颈干角确定三维股骨假体模型的类型及型号，同时考虑腿长差和股骨联合偏心距。
作为本实施例一种可选的实现方式，三维骨骼模型还包括三维髋臼模型，骨骼关键参数还包括髋臼旋转中心、髋臼直径、髋臼前倾角、髋臼外展角、综合考虑髋臼杯覆盖率；三维骨骼假体模型还包括三维髋臼假体模型；基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度包括：基于髋臼旋转中心、髋臼直径、髋臼前倾角、髋臼外展角以及髋臼杯覆盖率，调整三维髋臼假体模型的安放位置，使髋臼杯安放在安全区。
作为本实施例一种可选的实现方式，三维骨骼模型还包括三维股骨模型，骨骼关键参数还包括股骨头旋转中心、股骨髓腔形态、股骨髓腔解剖轴以及股骨颈干角；三维骨骼假体模型还包括三维股骨假体模型；基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度包括：基于根据股骨头旋转中心、股骨髓腔形态、股骨髓腔解剖轴以及股骨颈干角，调整三维股骨假体模型的安放位置，使三维股骨假体模型与股骨贴合。
在本实施例中，基于三维骨骼模型确定骨骼关键参数，基于骨骼关键参数确定三维骨骼假体模型的类型和型号，从而将选择的三维骨骼假体模型植入三维骨骼模型，基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度。能够提高假体安放位置的准确性，有利于提高关节置换手术的精准性。
在一个实施例中，如图5所示，提供了一种手术机器人导航定位方法，包括如下的步骤502至步骤506：
步骤502，根据第一空间位置、第二空间位置和第三空间位置，对三维骨骼模型进行配准，得到配准结果。在该方法中，第一空间位置为目标位置的三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置。
步骤504，获取第四空间位置，根据配准结果将其转换到三维模型坐标系下，得到第五空间位置。在该方法中，第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置。
步骤506，根据第五空间位置调整手术执行器的切入位置，以控制手术执行器进行手术操作。
在一个实施例中，上述方法还包括：通过手术执行器上的多个追踪球对手术执行器在世界坐标系下的空间位置进行360°的角度范围的光学跟踪。
在一个实施例中，步骤502包括：
将第一空间位置与第二空间位置进行粗配准，得到配准矩阵；根据配准矩阵将第三空间位置与三维模型进行精配准，得到配准结果。
在一个实施例中，手术执行器安装于手持动力设备上；根据第五空间位置调整手术执行器的切入位置包括：
根据第五空间位置确定手术执行器的调节路径，以使操作者根据调节路径对手持动力设备进行控制，手动调节手术执行器的切入位置。
在一个实施例中，手术执行器安装于机械臂末端；根据第五空间位置调整手术执行器的切入位置包括：
根据第五空间位置确定手术执行器的调节路径，以使操作者根据调节路径操作机械臂，以调节机械臂末端的手术执行器的切入位置。
在一个实施例中，上述方法还包括：
在手术操作中，运行手术执行器时，确定三维模型坐标系中规划的目标位置的骨骼的当前操作区域的空间位置，以将手术执行器的运动限定在当前操作区域内。
在一个实施例中，上述方法还包括：
在获取到目标位置的医学图像后，对医学图像进行分割和三维重建，得到目标位置的三维骨骼模型；基于三维骨骼模型，确定骨骼关键参数；基于骨骼关键参数确定三维骨骼假体模型的类型和型号；将选择的三维骨骼假体模型植入三维骨骼模型；基于骨骼关键参数和三维骨骼假体模型的类型和型号调整三维骨骼假体模型的安放位置和安放角度。
需要说明的是，在附图的流程图示出的步骤可以在诸如一组计算机可执行指令的 计算机系统中执行，并且，虽然在流程图中示出了逻辑顺序，但是在某些情况下，可以以不同于此处的顺序执行所示出或描述的步骤。
关于手术机器人导航定位方法的在一些可能的实施例中的限定可以参见上文中对于手术机器人导航定位系统的限定，在此不再赘述。上述手术机器人导航定位系统中的各个模块可全部或部分通过软件、硬件及其组合来实现。上述各模块可以硬件形式内嵌于或独立于计算机设备中的处理器中，也可以以软件形式存储于计算机设备中的存储器中，以便于处理器调用执行以上各个模块对应的操作。
图6示例了一种电子设备的实体结构示意图，如图6所示，该电子设备可以包括：处理器(processor)610、通信接口(Communications Interface)620、存储器(memory)630和通信总线640，其中，处理器610，通信接口620，存储器630通过通信总线640完成相互间的通信。处理器610可以调用存储器630中的逻辑指令，以执行手术机器人导航定位方法，该方法包括：
根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置；
根据所述第五空间位置调整手术执行器的切入位置。
此外，上述的存储器630中的逻辑指令可以通过软件功能单元的形式实现并作为独立的产品销售或使用时，可以存储在一个计算机可读取存储介质中。基于这样的理解，本申请的技术方案本质上或者说对现有技术做出贡献的部分或者该技术方案的部分可以以软件产品的形式体现出来，该计算机软件产品存储在一个存储介质中，包括若干指令用以使得一台计算机设备(可以是个人计算机，服务器，或者网络设备等)执行本申请各个实施例所述方法的全部或部分步骤。而前述的存储介质包括：U盘、移动硬盘、只读存储器(ROM，Read-Only Memory)、随机存取存储器(RAM，Random Access Memory)、磁碟或者光盘等各种可以存储程序代码的介质。
另一方面，本申请还提供一种计算机程序产品，所述计算机程序产品包括计算机程序，计算机程序可存储在非暂态计算机可读存储介质上，所述计算机程序被处理器执行时，计算机能够执行上述各方法所提供的手术机器人导航定位方法，该方法包括：
根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前 规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置；
根据所述第五空间位置调整手术执行器的切入位置。
又一方面，本申请还提供一种非暂态计算机可读存储介质，其上存储有计算机程序，该计算机程序被处理器执行时实现以执行上述各方法提供的手术机器人导航定位方法，该方法包括：
根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置；
根据所述第五空间位置调整手术执行器的切入位置。
以上所描述的装置实施例仅仅是示意性的，其中所述作为分离部件说明的单元可以是或者也可以不是物理上分开的，作为单元显示的部件可以是或者也可以不是物理单元，即可以位于一个地方，或者也可以分布到多个网络单元上。可以根据实际的需要选择其中的部分或者全部模块来实现本实施例方案的目的。本领域普通技术人员在不付出创造性的劳动的情况下，即可以理解并实施。
通过以上的实施方式的描述，本领域的技术人员可以清楚地了解到各实施方式可借助软件加必需的通用硬件平台的方式来实现，当然也可以通过硬件。基于这样的理解，上述技术方案本质上或者说对现有技术做出贡献的部分可以以软件产品的形式体现出来，该计算机软件产品可以存储在计算机可读存储介质中，如ROM/RAM、磁碟、光盘等，包括若干指令用以使得一台计算机设备(可以是个人计算机，服务器，或者网络设备等)执行各个实施例或者实施例的某些部分所述的方法。
最后应说明的是：以上实施例仅用以说明本申请的技术方案，而非对其限制；尽管参照前述实施例对本申请进行了详细的说明，本领域的普通技术人员应当理解：其依然可以对前述各实施例所记载的技术方案进行修改，或者对其中部分技术特征进行 等同替换；而这些修改或者替换，并不使相应技术方案的本质脱离本申请各实施例技术方案的精神和范围。

Claims (10)

  1. 一种手术机器人导航定位系统，包括：
    配准模块，被配置为根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
    追踪模块，被配置为获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置；
    位置调节模块，被配置为根据所述第五空间位置调整手术执行器的切入位置。
  2. 根据权利要求1所述的手术机器人导航定位系统，其中，所述追踪模块还被配置为对手术执行器在世界坐标系下的空间位置进行360°的角度范围的光学跟踪。
  3. 根据权利要求1所述的手术机器人导航定位系统，其中，所述配准模块包括：
    第一配准模块，被配置为将所述第一空间位置与所述第二空间位置进行配准，得到配准矩阵；
    第二配准模块，被配置为根据所述配准矩阵，将所述第三空间位置与所述三维模型进行配准，得到配准结果。
  4. 根据权利要求1所述的手术机器人导航定位系统，其中，所述手术执行器安装于手持动力设备上；
    所述位置调节模块包括：
    手持控制模块，被配置为根据所述第五空间位置确定手术执行器的调节路径，以使操作者根据所述调节路径对手持动力设备进行控制，手动调节手术执行器的切入位置。
  5. 根据权利要求1所述的手术机器人导航定位系统，其中，所述手术执行器安装于机械臂末端；
    所述位置调节模块包括：
    机械臂控制模块，被配置为根据所述第五空间位置确定手术执行器的调节路径，以使操作者根据所述调节路径操作机械臂，以调节机械臂末端的手术执行器的切入位置。
  6. 根据权利要求1所述的手术机器人导航定位系统，其中，所述位置调节模块还被配置为在手术操作中，运行手术执行器时，确定三维模型坐标系中规划的目标位置的骨骼的当前操作区域的空间位置。
  7. 根据权利要求1所述的手术机器人导航定位系统，其中，所述追踪模块通过 手术执行器的多个追踪球，以及骨骼上的多个追踪球，获取所述第四空间位置。
  8. 根据权利要求1所述的手术机器人导航定位系统，该系统还包括：
    术前规划模块，被配置为在获取到目标位置的医学图像后，对所述医学图像进行分割和三维重建，得到目标位置的三维骨骼模型。
  9. 根据权利要求8所述的手术机器人导航定位系统，其中，所述术前规划模块还被配置为在三维骨骼模型上标记术前规划点，基于三维骨骼模型确定骨骼假体模型，基于骨骼假体模型确定操作区域。
  10. 一种基于权利要求1-9任一项所述的手术机器人导航定位系统所实现的手术机器人导航定位方法，包括以下步骤：
    根据第一空间位置、第二空间位置和第三空间位置，对所述三维骨骼模型进行配准，得到配准结果；其中，所述第一空间位置为目标位置的所述三维骨骼模型中术前规划点在三维模型坐标系下的空间位置，所述第二空间位置为实体目标位置的骨骼上的术中标记点在世界坐标系下的空间位置，第三空间位置为实体目标位置的骨骼上的划线点集在世界坐标系下的空间位置；
    获取第四空间位置，并根据所述配准结果将所述第四空间位置转换到三维模型坐标系下，得到第五空间位置；其中，所述第四空间位置为手术执行器、骨骼在世界坐标系下的空间位置，所述第五空间位置为手术执行器、骨骼在三维模型坐标系下的空间位置；
    根据所述第五空间位置调整手术执行器的切入位置。
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