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EP-3970640-B1 - SURGICAL DEVICE WITH A MOVABLE TRACKER

EP3970640B1EP 3970640 B1EP3970640 B1EP 3970640B1EP-3970640-B1

Inventors

  • HERRMANN, FLORIAN
  • Schöpp, Hans
  • PULEVA, Nikolina

Dates

Publication Date
20260513
Application Date
20200918

Claims (19)

  1. A surgical device (10) comprising: a shaft (210) defining a longitudinal axis (A L ), the shaft (210) having a first shaft portion (212) configured to be inserted into a patient and a second shaft portion (214) configured to be located outside the patient when the first shaft portion (212) is inserted in the patient; an actuation member (120) actuatable relative to the first shaft portion (212); an operation member (110) operable relative to the second shaft portion (214), the operation member (110) being configured to actuate the actuation member (120) when being operated; and a first optical tracker (140) coupled with the operation member (110) so that operation of the operation member (110) causes the first optical tracker (140) to rotate relative to the longitudinal axis (A L ), wherein the first optical tracker (140) comprises a body (150) arranged or configured to be arranged co-axially to the longitudinal axis (A L ) of the shaft (210) and having a substantially cylindrical shape with a cylinder axis; and a plurality of optically detectable markers (152) located on or within the body and arranged in a pattern that defines, from a given viewing direction, distinctive arrangements of the markers (152) in different rotational states of the first optical tracker (140) relative to the longitudinal axis (A L ), wherein at least some of the markers are spaced apart from each other in a circumferential direction around the longitudinal axis.
  2. The surgical device according to any preceding claim, wherein there exists a predefined relationship between a movement of the first optical tracker (140) on the one hand and an actuation movement of one of the actuation member (120) and an actuatable implant (300) detachably couplable to the actuation member (120) on the other hand.
  3. The surgical device (10) according to claim 2, wherein the predefined relationship associates a change of a rotational state of the first optical tracker (140) resulting from its rotation with a change of a dimension or state of one of the actuation member (120) and the actuatable implant (300) detachably couplable to the actuation member (120) resulting from the actuation movement.
  4. The surgical device (10) according to any preceding claim, wherein the operation member (110) is rotatable around the longitudinal axis (A L ).
  5. The surgical device (10) according to any preceding claim, wherein the first optical tracker (140) is rigidly coupled or configured to be rigidly coupled to the operation member (110).
  6. The surgical device (10) according to any preceding claim, comprising a second tracker (220) rigidly coupled or configured to be rigidly coupled to the shaft (210).
  7. The surgical device (10) according to claim 6, wherein the operation member (110) is movable relative to the shaft (210) in an axial direction relative to the longitudinal axis (A L ) from a predefined first axial position to at least a predefined second axial position, wherein the surgical device (10) is configured such that an axial movement of the operation member (110) relative to the shaft (210) leads to an axial movement of the first optical tracker (140) relative to the second tracker (220).
  8. The surgical device (10) according to any preceding claims, wherein operation of the operation member (110) causes a rotation of the actuation member (120) relative to the first shaft portion (212).
  9. The surgical device (10) according to any of the preceding claims, wherein the shaft (210) defines a passage; and the operation member (110) is coupled to the actuation member (120) via a coupling section (130) extending into the passage defined by the shaft (210).
  10. The surgical device (10) according to any preceding claim, wherein the first shaft portion (212) is configured to cooperate with a first portion of an implant (300) and the actuation member (120) is configured to cooperate with a second portion of the implant (300), wherein the second portion of the implant is movable relative to the first portion of the implant for a change of an actuation state of the implant (300).
  11. The surgical device (10) according to claim 10, wherein the shaft (210) is configured to detachably receive the implant (300) for placement of the implant (300) in the body of the patient.
  12. The surgical device (10) according to any preceding claim, wherein the first optical tracker (140) comprises a cover layer (154) for the body (150); and one or more optically-detectable markers (152) arranged between the body (150) and the cover layer (154), wherein the cover layer is optically transparent at least in one or more regions where the one or more optically-detectable markers (152) are located.
  13. A system comprising the surgical device (10) of any of claims 1 to 12 and an implant (300) configured to be actuated by the actuation member (120) from a first actuation state to a second actuation state.
  14. The system according to claim 13, wherein the implant (300) is configured to change at least one dimension when being actuated from the first actuation state to the second actuation state.
  15. The system according to claim 13 or 14, wherein at least a part of the implant (300) is configured to extend relative to the first shaft portion (212) when the implant (300) is actuated from the first actuation state to the second actuation state; or at least a part of the implant (300) is configure to retract when the implant (300) is actuated from the second actuation state to the first actuation state.
  16. A computer program product (500) with program code (510) for carrying out a computer-implemented method (400) for determining actuation performed with a surgical device (10), the surgical device (10) comprising: a shaft (210) defining a longitudinal axis (A L ), the shaft (210) having a first shaft portion (212) configured to be inserted into a patient and a second shaft portion (214) configured to be located outside the patient when the first shaft portion (212) is inserted in the patient; an actuation member (120) actuatable relative to the first shaft portion (212); an operation member (110) operable relative to the second shaft portion (214), the operation member (110) being configured to actuate the actuation member (120) when being operated; and a first optical tracker (140) coupled with the operation member (110) so that operation of the operation member (110) causes the first optical tracker (140) to rotate relative to the longitudinal axis (A L ), wherein the first optical tracker (140) comprises a plurality of markers (152) arranged in a pattern that defines, from a given viewing direction, distinctive arrangements of the markers (152) in different rotational states of the first optical tracker (140) relative to the longitudinal axis (A L ); the method (400) comprising: determining (410) a rotational state of the first optical tracker (140); determining (420), from at least the rotational state of the first optical tracker (140), an actuation of at least one of the actuation member (120) and an implant (300) detachably couplable to the actuation member (120).
  17. The computer program product (500) according to claim 16, wherein the method (400) further comprises: determining an actuation state of the actuation member (120) resulting from the actuation relative to a known initial state prior to the actuation.
  18. The computer program product (500) according to claim 16 or 17, wherein the position of the first optical tracker (140) is determined relative to a second tracker (220) having a fixed relationship relative to the shaft (210) by tracking the first and second trackers (140; 220).
  19. The computer program product (500) according to any one of claims 16 to 18, wherein the method (400) further comprises: visualizing the actuation of the actuation member (120) on a display (600), wherein, optionally, visualizing of the actuation of the actuation member (120) is performed in real-time relative to an image of the patient.

Description

Technical Field The present disclosure generally relates to the field of computer-assisted surgical navigation using optical or non-optical tracking technologies. In particular, a surgical device with a movable tracker, a system comprising the surgical device, a computer-implemented method involving the surgical device, and a computer program product are presented. Background Many surgical procedures benefit from determination of a state, a position, or an orientation of a surgical device in an operating room. To this end, surgical devices are equipped with trackers trackable by a surgical navigation system with tracking capabilities (e.g., a navigation camera). A result of the tracking may then be visualized by the surgical navigation system, for example relative to image data of a patient treated by the surgical device. In a typical application of a surgical navigation system, the surgical device and the patient are each associated with a tracker, wherein image data previously obtained by, for example, a computer tomography (CT) scan are initially registered with a pose of a patient tracker. By then continuously tracking the patient and the surgical device, the surgical navigation system can determine a spatial relationship between the surgical device and the three dimensional image data. The determined spatial relationship can, for example, be displayed on a screen, helping the surgeon operate the surgical device relative to the patient. Typical surgical devices that rely on optical trackers for navigation comprise a distal end configured to enter the body of a patient and a proximally arranged optical tracker configured for line of sight tracking by the navigation camera. Some of those surgical devices further comprise an operation member that is operable by a surgeon to actuate a mechanism provided in a region of the distal end. Evidently, actuation of this mechanism is difficult to track because line of sight tracking cannot be employed during a surgical intervention when the distal end has entered the patient body. Document US 2019/038366 A1 discloses techniques for determining the shape of a surgical implant and navigating the surgical implant during surgery. The shape of the surgical implant is determined during surgery and a graphical representation of the surgical implant accurately depicting its shape are displayed and overlaid on graphical depiction of a target anatomy of a patient. Document US 2013/023994 A1 discloses an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. In one embodiment, the fusion device includes a body portion, a first endplate, and a second endplate, the first and second endplates capable of being moved in a direction away from the body portion into an expanded configuration or capable of being moved towards the body portion into an unexpanded configuration. The fusion device is capable of being deployed and installed in both configurations. Document US 2012/059472 A1 discloses an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. In one embodiment, the fusion device includes a central ramp, a first endplate, and a second endplate, the central ramp capable of being moved in a first direction to move the first and second endplates outwardly and into an expanded configuration. Document US 2018/085233 A1 discloses a spinal implant defining an axis. A first image guide is connected with a member and oriented relative to a sensor to communicate a signal representative of a position of the member. A second image guide is connected with the member and oriented to represent an angle measuring a second orientation of the axis relative to a first orientation. Document EP 1 415 609 A1 disclose an optical tracking system. The tracking system comprises a camera system including at least two spatially separated cameras capable of viewing the clinical field of view to provide camera data in a first coordinate system defined by the camera system; an instrument comprising an optically detectable object that is detectable by the camera system to provide instrument data representative of the position of the instrument in the first coordinate system; a headband positionable on the head of a surgeon, the headband including a display viewable by the surgeon and an optically detectable array and that is detectable by the camera system to provide headband data representative of the position of the headband in the first coordinate system; data storage comprising one of CT and MRI image data representative of the anatomy of the patient received from one of a CT and MRI imaging machine; and a computer to accept the camera data, the instrument data, the headband data, and the image data, and being programmed to t