WO2023065495A1

WO2023065495A1 - Intracranial hematoma puncture and drainage operation system using robotic arm for puncture

Info

Publication number: WO2023065495A1
Application number: PCT/CN2021/137593
Authority: WO
Inventors: 王琳; 邵天琪; 王烨; 姜鹏; 杜世伟; 李光林
Original assignee: 深圳先进技术研究院
Priority date: 2021-10-20
Filing date: 2021-12-13
Publication date: 2023-04-27
Also published as: CN113974786A

Abstract

An intracranial hematoma puncture and drainage operation system using a robotic arm for puncture, comprising a navigation system and a console. The console comprises a PC module and a robotic arm control module. The robotic arm control module comprises a robotic arm end connection device and a pushing device. The robotic arm end connection device is connected to the pushing device. The navigation system is used for obtaining real-time posture information of a patient's head and transmitting same to the PC module. The PC module calculates real-time posture information of an intracranial puncture path of the patient in combination with a CT image and the real-time posture information of the patient's head; then a robotic arm module controls the posture of the robotic arm end connection device to be consistent in three-axis angles with the real-time posture of the intracranial puncture path, and then enables the pushing device to push a surgical needle. The system can provide accurate intracranial puncture path navigation, has the advantages of higher operation convenience and lower price, and can realize real-time navigation and thus allow for movement of the patient's head during the operation.

Description

A puncture and drainage operation system for intracranial hematoma with mechanical arm puncture

technical field

The invention relates to an intracranial hematoma puncture and drainage operation system for mechanical arm puncture.

Background technique

Surgical navigation has a wide range of applications in neurosurgery. In the field of cerebral hematoma treatment surgery, minimally invasive puncture and drainage (MIPD) is the best surgical treatment. During minimally invasive puncture and drainage, in order to improve the accuracy, doctors need to combine multiple key factors and fix the patient's head, and then insert The surgical needle is guided by the surgical navigation system and inserted precisely at a specific spatial angle. However, patients often cannot maintain a posture for a long time, so that the navigation route is misaligned, which leads to inaccurate insertion in the puncture operation.

Current navigation systems include optical navigation systems, electromagnetic navigation systems, and stereotactic navigation systems.

The optical navigation system is to scan the patient with MRI or CT before surgery, mark the lesion and its important structures according to the scan results, and then perform three-dimensional reconstruction to design the best surgical approach. The surgery is then guided by an optical tracking machine during surgery. The equipment of this method is very expensive, and the operation is complicated and time-consuming, so it is difficult to popularize in clinic. Assisted by a high-precision brain stereotaxic instrument connected by CT or MR, the base ring needs to be installed first, and then CT or MRI scans are performed, and then the coordinates of the target point are calculated by professional software. The preoperative preparation of this method takes a lot of time, the operation process is very complicated, and it is not easy for doctors with insufficient surgical experience to master it. At the same time, it is necessary to avoid the light source being blocked at all times during the operation, which limits the operation of the doctor, and the equipment is expensive.

Electromagnetic navigation also uses MRI or CT to make a surgical plan before surgery, find the location of the lesion, and choose the best surgical approach. However, the metal in the surgical environment will generate electromagnetic interference, which requires high use of surrounding instruments and affects the execution of the surgery. Secondly, this method also requires a lot of preparation time, the operation is cumbersome, difficult to master, and the cost of the equipment is high.

Stereotaxic navigation utilizes the principle of stereotaxic positioning at one point in space. The coordinates of a certain target point at the lesion in the cranial cavity are planned by MRI or CT scan before operation, and its precise position is determined. Instruments and devices are introduced into the skull so that the puncture needle reaches the target point. But stereotaxy requires that the patient's head be fixed by a brain stereotaxic instrument during the operation (a rigid mechanical structure fixes the head to ensure that the patient's head does not move during the operation). This method not only causes certain physical discomfort to the patient, but also the space occupation of the patient's head fixation device will also cause certain limitations to the doctor's operation.

Contents of the invention

In order to overcome the problems existing in the above-mentioned prior art, the present invention proposes a surgical system for puncture and drainage of intracranial hematoma with mechanical arm puncture. The advantages of low cost, and real-time navigation can be realized, and the patient's head can move during the operation. The invention of this system can assist doctors to complete the puncture and drainage operation of intracranial hematoma more efficiently and conveniently.

The technical solution of the present invention to solve the above problems is: a puncture and drainage operation system for intracranial hematoma with mechanical arm puncture, which is special in that:

Includes navigation system and console;

The console includes a PC module and a robotic arm control module; the robotic arm control module includes a connecting device at the end of the mechanical arm and a propulsion device; the connecting device at the end of the mechanical arm is connected to the propulsion device,

The navigation system is used to obtain the real-time posture information of the patient's head and transmit it to the PC module;

The PC module obtains the angle between the intracranial puncture path relative to the cross section and the sagittal plane after processing the CT image of the patient's head, and combines the real-time posture information of the patient's head to calculate the real-time position of the patient's intracranial puncture path. Attitude information: the attitude of the connecting device at the end of the manipulator is controlled by the manipulator module to the real-time attitude three-axis angle of the intracranial puncture path, and then the propulsion device is started to advance the surgical needle.

Further, the above-mentioned navigation system includes a navigation element IMU, which is used to establish a positional relationship with the patient's head, and indirectly navigate the three-axis Euler angles in the ground coordinate system of the intracranial puncture path.

Further, the above PC module includes a processor and a display. The processor is used for calculating the real-time attitude information of the intracranial puncture path of the patient, and the display is used for displaying the image of the intracranial puncture path.

Further, the above-mentioned manipulator control module further includes a teaching pendant, which respectively controls the position movement and attitude change of the connection device at the end of the manipulator.

Further, the above-mentioned navigation system includes a head-mounted navigation device module, and a navigation element IMU is arranged in the head-mounted navigation device module.

Advantages of the present invention:

The present invention uses the IMU as a navigation element to realize the purpose of determining the attitude information of the intracranial puncture path in real time through the method of coordinate system conversion; at the same time, the present invention integrates the mechanical arm to implement the puncture. This method is convenient, easy to operate, reduces the patient's surgical pain experience, and can assist doctors to complete precise puncture at low cost. At the same time, in the present invention, the IMU worn on the head is used to directly navigate the angle information of the intracranial puncture path relative to the ground coordinate system, and the mechanical arm performing the puncture is guided by the angle information of the intracranial puncture path provided by the IMU. posture, the surgical needle is pushed forward by the propulsion device, and the puncture is implemented. Compared with the previous traditional method, the present invention has simpler operation, less restrictive conditions, and greatly reduced cost while ensuring that the accuracy meets medical conditions, and greatly improves the efficiency of clinical use.

Description of drawings

Fig. 1 is an overview of the system of the present invention;

Fig. 2 is a flow chart of the method of the present invention;

Fig. 3 is an example of the manner in which the 3DSlicer software provided by the present invention calculates the angle between the puncture path and the reference plane;

Fig. 4 is a schematic diagram of a skull model wearing a wearable device provided by the present invention;

Fig. 5 is an explanatory diagram of the calculation method of the three-axis Euler angle in the ground coordinates of the intracranial puncture path provided by the present invention.

Detailed ways

In order to make the purpose, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments It is some embodiments of the present invention, but not all of them. Based on the implementation manners in the present invention, all other implementation manners obtained by persons of ordinary skill in the art without making creative efforts belong to the scope of protection of the present invention. Accordingly, the following detailed description of the embodiments of the invention provided in the accompanying drawings is not intended to limit the scope of the claimed invention, but merely represents selected embodiments of the invention.

An embodiment of the present invention provides a surgical system for puncture and drainage of intracranial hematoma with robotic arm puncture, including a navigation system and a console.

The console includes a PC module and a mechanical arm control module; the mechanical arm control module includes a connecting device at the end of the mechanical arm and a propulsion device; the connecting device at the end of the mechanical arm is connected to the propulsion device. The navigation system is used to obtain the real-time posture information of the patient's head and transmit it to the PC module; the PC module obtains the angle between the intracranial puncture path relative to the cross section and the sagittal plane after processing the CT image of the patient's head , and combined with the real-time posture information of the patient's head, the real-time posture information of the patient's intracranial puncture path is calculated; the three-axis angles of the real-time posture of the intracranial puncture path from the posture of the connecting device at the end of the robotic arm to the intracranial puncture path are controlled one by one by the manipulator module, and then Activate the advancer to advance the surgical needle.

As a preferred embodiment of the present invention, the navigation system includes a navigation element IMU, which is used to establish a positional relationship with the patient's head, and indirectly navigate the three-axis Euler angles in the ground coordinate system of the intracranial puncture path.

As a preferred embodiment of the present invention, the PC module includes a processor and a display. The processor is used for calculating the real-time attitude information of the intracranial puncture path of the patient, and the display is used for displaying the image of the intracranial puncture path.

As a preferred embodiment of the present invention, the manipulator control module further includes a teaching pendant, and the teaching pendant respectively controls the position movement and attitude change of the connecting device at the end of the manipulator.

As a preferred embodiment of the present invention, the navigation system includes a head-mounted navigation device module, and a navigation element IMU is arranged in the head-mounted navigation device module.

Example

A surgical system for puncture and drainage of intracranial hematoma with mechanical arm puncture, as shown in Figure 1, includes an operating table part and a console part.

The operating table includes a navigation system, specifically, the navigation system includes a head-mounted navigation device module, and the head-mounted navigation device module is provided with a navigation element IMU.

The console includes a PC module, specifically, the PC module includes a processor and a display.

The control module of the manipulator includes a control cabinet, a teaching pendant, a manipulator, a connecting device at the end of the manipulator, and a propulsion device. The PC module receives the real-time posture information of the patient's head (three-axis Euler angle in ground coordinates) transmitted by the head-mounted navigation device module. At the same time, the PC module stores the patient's preoperative CT image. Combining the two data, the PC module calculates the patient's cranial The real-time attitude information of the internal puncture path (ground coordinate three-axis Euler angle), the PC module controls the attitude of the connecting device at the end of the manipulator to the real-time attitude three-axis angle of the intracranial puncture path through the manipulator module, and then starts the propulsion device to advance Surgical needles for surgery.

Referring to Fig. 2, the detailed method flow process of the present invention is:

Step 1: Take the first CT scan of the patient's head. Based on the results of this CT scan, plan the intracranial puncture target and cranial surface puncture point in 3DSlicer, determine the puncture path, and automatically generate the puncture path through the Gyroguide extension plug-in of 3DSlicer The angle relative to the CT cross-section and the sagittal plane.

Step 2: Place the navigation component IMU on the horizontal plane for calibration (acceleration 8g, gyroscope 1000deg/s, bandwidth 98Hz, communication return rate 50Hz). After the calibration is completed, fix the navigation element IMU at the end of the connection device at the end of the robotic arm. The robot arm is adjusted to the initial pose state. At this time, the pose of the connecting device at the end of the robot arm is (x:180, y:0, z:0). Set the z-axis of the navigation component IMU to zero. At this time, the position of the navigation component IMU is The pose is (x:0,y:0,z:0).

Step 3: Place the navigation element IMU on the robotic arm on the head-mounted navigation device module on the patient's head and fix it. According to the three-axis value of the IMU at this time, and according to the coordinate system conversion method, combined with the angle between the puncture path and the cross-section and sagittal plane calculated in the previous step, the attitude value in the coordinate system of the puncture path is calculated, so that the IMU can indirectly measure in real time The posture (yaw, pitch, roll) of the intracranial puncture path is displayed in real time through the monitor of the PC module.

Step 4: According to the real-time display of the three-axis angle guidance of the puncture path by the PC module, the position and posture of the connecting device at the end of the manipulator is operated through the teaching panel of the manipulator, and the three-axis angle of the puncture needle and the three-axis angle of the puncture path indirectly measured by the IMU are one by one. Consistent, the propelling device implements propelling puncture.

In the present invention, the three-axis angle of the coordinate system measured by the navigation element IMU is specifically:

The navigation component IMU is an IMU inertial sensing unit, including an accelerometer and a gyroscope. The IMU is installed on the head wearable device, the purpose is to establish a positional relationship with the patient's head, so as to calculate the real-time posture changes of the patient's intracranial puncture path through the relevant coordinate system conversion method.

In order to calculate the Euler angle change during the IMU rotation, we define the three-axis rotation matrix of the IMU as:

Where θ is the roll angle roll, that is, the rotation angle around the x-axis of the IMU;

Pitch is the pitch angle, which is the rotation angle around the y-axis of the IMU; ψ is the heading angle yaw, which is the rotation angle around the z-axis of the IMU. The attitude angle of the IMU at the n+1 moment is θ,

ψ, which means that the IMU coordinate system is from the initial position at time n, through the rotation angle ψ around Z, and the rotation angle around Y

Rotate the angle θ around X to get the final pose.

Multiply the above three rotation matrices in the order of zyx rotation to obtain a rotation matrix C that can represent one Euler rotation, which is also called a Direction Cosine Matrix (DCM for short). We define this as the rotation from the reference frame (m frame) to the own coordinate system (b frame), with

express:

Accelerometer to calculate attitude angle

The accelerometer measures the acceleration of the component itself, using

Indicates that during the rotation of the IMU:

Solving the equation gives:

Gyroscope to calculate attitude angle

For gyroscope

express. The three-axis attitude angle at the n+1th moment is: θ+Δθ,

ψ+Δψ, where the change in attitude angle Δθ,

Δψ can be integrated by the angular velocity with the adopted time period, i.e.

Find the inversion matrix to get:

So far, we can obtain the three-axis Euler angle of the component in the ground coordinate system through the six-axis IMU. At the same time, there are various algorithms for the accelerometer and gyroscope of the IMU, which can obtain more accurate three-axis Euler angles, such as Kalman wave algorithm, Madgwick algorithm, etc., which are not limited in the present invention.

In the present invention, the real-time posture calculation method of the intracranial puncture path is specifically:

CT scan processing

In medicine, the skull is divided into three basic planes: sagittal plane, coronal plane and cross section. A CT scan scans a cross-section of the skull.

Import the CT image (DICOM file) into 3DSlicer software, determine the intracranial target point and cranial surface puncture point through the CT image, and design the transcranial puncture path. Then use the extension module GyroGuide in the 3DSlicer software to automatically calculate the angle between the puncture path and the cross-section and sagittal plane. As shown in Figure 3, the part framed by the red line is the calculation result, where RedPlane is the cross section, GreenPlane is the sagittal plane, and the angle between the puncture path and the two planes is the angle information we need to obtain.

How to obtain the attitude value in the ground coordinate system of the puncture path

In order to obtain the attitude value of the puncture path, first place the IMU at a position where the xy-axis plane is parallel to the cross-section, and its xz-axis plane is parallel to the sagittal plane, so as to clarify the positional relationship between the puncture path and the IMU, and then solve Calculate the three-axis angle information of the intracranial puncture trajectory. We do this with a headset. This study designs a head-mounted device that can basically realize the requirements, and uses 3D printing. The 3D printer brand is Stratasy, the printing accuracy is ±0.02—±0.05mm, and the construction resolution: X-axis: 600dpi; Y-axis: 600dpi; Z-axis: 1600dpi, Molding thickness: 0.016/0.03mm optional, printing material rigid resin (Resin). A schematic diagram of the headset is shown in Figure 4.

Therefore, the relationship between the puncture path and the position of the IMU is shown in Figure 5. Point A is the puncture insertion point, point O is the target point, and the large plane is the cross section. Then calculate the theoretical x, y-axis angle x _b , y _b of the puncture path as:

x _b = x _a -(90°-θ)

Where x _a is the x-axis angle of the IMU, and y _a is the y-axis angle of the IMU. The z-axis angle of the puncture point does not need to be calculated, but in the calibration process of the subsequent surgical puncture, ensure that the x-axis angle of the needle = x _b , the y-axis angle = y _b , and the z-axis angle = z _a . Axis angle = triaxial angle of the puncture path. So far, we have completed the pose calculation of the intracranial puncture path.

The above process is completed in the processor of the pc module.

Robotic Arm Control

The control part of the mechanical arm of the present invention includes five parts: a control cabinet, a teaching pendant, a mechanical arm, a connection device at the end of the mechanical arm, and a propulsion device. The teaching pendant controls the position parameters and attitude control, and controls the position movement and attitude change of the end of the mechanical arm respectively. The attitude parameters are RX, RY, RZ, which represent the angle value of the rotation relative to the selected initial coordinate system, which is a description of the orientation obtained by rotating three times around the selected initial coordinate system in a certain order. In the preceding steps, the initial postures of the IMU and the connection device at the end of the robotic arm are adjusted to be consistent (that is, the initial coordinate systems of the two are consistent). Afterwards, when the posture (three-axis angle) of the intracranial puncture path measured by the IMU is (x, y, z), the posture of the connecting device at the end of the robotic arm is moved to (180-x, y, z) through the teach pendant. The posture of the connecting device at the end of the arm is consistent with the posture of the intracranial puncture path, and then the terminal propulsion device is activated to insert the needle, and the operation is performed.

Compared with the existing optical navigation system, mechanical navigation system, and electromagnetic navigation system, the system of the present invention can provide accurate intracranial puncture path navigation, and has the advantages of more convenient operation and lower price, and can realize real-time navigation. The patient's head can move during the procedure. In summary, the system of the present invention can assist doctors to complete the puncture and drainage operation of intracranial hematoma more efficiently and conveniently.

The above description is only an embodiment of the present invention, and is not intended to limit the protection scope of the present invention. Any equivalent structure or equivalent process conversion made by using the description of the present invention and the contents of the accompanying drawings, or directly or indirectly used in other related The system field is equally included in the scope of protection of the present invention.

Claims

A puncture and drainage operation system for intracranial hematoma with mechanical arm puncture, characterized in that:

Includes navigation system and console;

The console includes a PC module and a robotic arm control module; the robotic arm control module includes a connecting device at the end of the mechanical arm and a propulsion device; the connecting device at the end of the mechanical arm is connected to the propulsion device,

The navigation system is used to obtain the real-time posture information of the patient's head and transmit it to the PC module;

The PC module obtains the angle between the intracranial puncture path relative to the cross section and the sagittal plane after processing the CT image of the patient's head, and combines the real-time posture information of the patient's head to calculate the real-time position of the patient's intracranial puncture path. Attitude information: the attitude of the connecting device at the end of the manipulator is controlled by the manipulator module to the real-time attitude three-axis angle of the intracranial puncture path, and then the propulsion device is started to advance the surgical needle.
A puncture and drainage operation system for intracranial hematoma with mechanical arm puncture according to claim 1, characterized in that:

The navigation system includes a navigation element IMU, which is used to establish a positional relationship with the patient's head, and indirectly navigate the three-axis Euler angles in the ground coordinate system of the intracranial puncture path.
A puncture and drainage operation system for intracranial hematoma with mechanical arm puncture according to claim 2, characterized in that:

The PC module includes a processor and a display; the processor is used for calculating the real-time attitude information of the patient's intracranial puncture path, and the display is used for displaying the image of the intracranial puncture path.
A puncture and drainage operation system for intracranial hematoma with mechanical arm puncture according to claim 3, characterized in that:

The manipulator control module further includes a teaching pendant, which respectively controls the position movement and attitude change of the connecting device at the end of the manipulator.
A puncture and drainage operation system for intracranial hematoma with mechanical arm puncture according to any one of claims 2-4, characterized in that:

The navigation system includes a head-mounted navigation device module, and a navigation element IMU is arranged in the head-mounted navigation device module.