US-12616526-B2 - Systems and methods for operative microscope tracking for technical guidance

Abstract

A system provides a computer-implemented rendered visualization of a surgeon's path or “roadmap” to a particular target region during a surgical case are disclosed herein. The system includes an approach library in communication with an operating microscope that includes data related to various surgical approach sequences, or “roadmaps” to various target regions. The approach library can be populated by the system and analyzed for variance and trends, as well as provide direct or indirect instruction and guidance through a display member during a surgical case.

Inventors

• Benjamin Hendricks
• Michael Lawton

Assignees

• DIGNITY HEALTH

Dates

Publication Date

20260505

Application Date

20210928

Claims (20)

1. 1 . A system, comprising: a computer-implemented system including a processor in communication with a display member and a memory, the memory including instructions, which, when executed, cause the processor to: define a stereotactic Cartesian coordinate system with respect to patient anatomy using imaging data acquired through cross-sectional imaging; receive a target region and a starting position with respect to patient anatomy; select an approach sequence from an approach library, wherein the approach sequence dictates a plurality of landmark regions associated with a plurality of steps along a sequential path between the starting position and the target region, wherein each landmark region of the plurality of landmark regions is associated with an estimated Cartesian zone defined within the approach library; iteratively determine a real-time Cartesian position of a focal point of an operative microscope relative to the stereotactic Cartesian coordinate system; display, by the display member, a landmark identifier at the estimated Cartesian zone of a landmark region within a field of view captured by the operative microscope based on the real-time Cartesian position of the focal point of the operative microscope; and display, by the display member, a directional identifier indicating a direction leading to an estimated Cartesian zone of a future landmark region associated with a future step of the plurality of steps of the approach sequence relative to the real-time Cartesian position of the focal point of the operative microscope, wherein the approach library includes: a landmark index including landmark region data associated with a plurality of landmark regions, wherein the landmark region data for a landmark region of the plurality of landmark regions includes: a plurality of recorded landmark positions within the stereotactic Cartesian coordinate system; and the estimated Cartesian zone associated with the landmark region, wherein the estimated Cartesian zone is representative of a three-dimensional region within the stereotactic Cartesian coordinate system based on the plurality of recorded landmark positions.
2. 2 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: associate the target region and the starting position with a respective Cartesian coordinate value with respect to the stereotactic Cartesian coordinate system.
3. 3 . The system of claim 1 , wherein the approach library includes: an approach sequence index including a plurality of approach sequences, wherein the plurality of approach sequences is categorically organized within the approach sequence index.
4. 4 . The system of claim 1 , wherein one or more recorded landmark positions of the plurality of recorded landmark positions are associated with a respective Cartesian datapoint instance denoting a Cartesian position of a focal point of an operative microscope at a time step during a surgical case.
5. 5 . The system of claim 1 , wherein one or more recorded landmark positions of the plurality of recorded landmark positions are associated with a recorded Cartesian location of a landmark region obtained using cross-sectional imaging.
6. 6 . The system of claim 1 , wherein the approach library includes: a set of Cartesian datapoints including a plurality of Cartesian datapoint instances associated with a Cartesian position of a focal point of an operative microscope recorded throughout a previously-recorded surgical case of a plurality of previously-recorded surgical cases, wherein the set of Cartesian datapoints is recorded at each time step of a plurality of time steps throughout the previously-recorded surgical case.
7. 7 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: associate a landmark region with a respective Cartesian zone of the stereotactic Cartesian coordinate system.
8. 8 . The system of claim 7 , wherein the Cartesian zone of the landmark region corresponds to an estimated position of the landmark region based on one or more recorded landmark positions within the stereotactic Cartesian coordinate system.
9. 9 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: associate each step of the approach sequence with a respective landmark region.
10. 10 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: display, by the display member, a video image including the field-of-view captured by the operative microscope on a display member.
11. 11 . The system of claim 10 , wherein the display member is a heads-up-display of the operative microscope or an external display in communication with the operative microscope.
12. 12 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: receive a real-time Cartesian position of the operative microscope relative to the stereotactic Cartesian coordinate system.
13. 13 . The system of claim 12 , wherein the memory further includes instructions, which, when executed, further cause the processor to: determine a real-time Cartesian position of a focal point of the operative microscope based on the real-time Cartesian position of the operative microscope.
14. 14 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: query the approach library to identify an approach sequence of a plurality of approach sequences indicative of the sequential path between the starting position and the target region.
15. 15 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: provide one or more starting positions associated with a target region based on one or more approach sequences associated with the target region.
16. 16 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: display a landmark identifier associated with the future landmark region associated with the future step of the plurality of steps of the approach sequence.
17. 17 . The system of claim 1 , wherein the landmark identifier associated with the landmark region is displayed when the real-time Cartesian position of the focal point of an operative microscope lies within estimated Cartesian zone of the landmark region as dictated by the approach library.
18. 18 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, further cause the processor to: align the operative microscope with a previously-recorded focal point and hind point combination associated with a landmark region.
19. 19 . The system of claim 1 , wherein the memory further includes instructions, which, when executed, cause the processor to: receive a selection of a landmark region from the plurality of landmark regions within the approach library; and display, by the display member, a directional indicator or laser guidance indicator to indicate a direction towards an estimated Cartesian zone associated with the landmark region.
20. 20 . A system comprising: a computer-implemented system including a processor in communication with a display member and a memory, the memory including instructions, which, when executed, cause the processor to: define a stereotactic Cartesian coordinate system with respect to patient anatomy using imaging data acquired through cross-sectional imaging; receive a target region and a starting position with respect to patient anatomy; select an approach sequence from an approach library, wherein the approach sequence dictates a plurality of landmark regions associated with a plurality of steps along a sequential path between the starting position and the target region, wherein each landmark region of the plurality of landmark regions is associated with an estimated Cartesian zone defined within the approach library; iteratively determine a real-time Cartesian position of a focal point of an operative microscope relative to the stereotactic Cartesian coordinate system; display, by the display member, a landmark identifier at the estimated Cartesian zone of a landmark region within a field of view captured by the operative microscope based on the real-time Cartesian position of the focal point of the operative microscope; and display, by the display member, a directional identifier indicating a direction leading to an estimated Cartesian zone of a future landmark region associated with a future step of the plurality of steps of the approach sequence relative to the real-time Cartesian position of the focal point of the operative microscope, wherein the landmark identifier associated with the landmark region is displayed when the real-time Cartesian position of the focal point of the operative microscope lies within the estimated Cartesian zone of the landmark region as dictated by the approach library.

Description

FIELD The present disclosure generally relates to surgical guidance provided by a system educated through a library of stereotactic data attained throughout a multitude of duplicable surgical approach techniques, applicable to all cranial and spinal pathologies. BACKGROUND Cranial surgery possesses a unique anatomical feature that permits a stereotactic approach to the intracranial anatomy. This is facilitated by the rigid skull that permits mechanical fixation and subsequent external optical or magnetic sensory based registration of an individual patient's cross-sectional imaging (ex. Magnetic resonance imaging (MRI) or computed tomography (CT) scan). Following registration of the optical or magnetic tracking sensor, an instrument with a 3-dimensional optical tracking frame can be manipulated relative to the individual patient's cranial or spinal anatomy, permitting this instrument to appear in digital cartesian space and be represented relative to a digital display of the patient's anatomy. This technique, formally referred to as stereotactic navigation, has permitted surgeons to conduct anatomically precise techniques for years within cranial and spinal surgeries. It is with these observations in mind, among others, that various aspects of the present disclosure were conceived and developed. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a cross-sectional image of a cranium indicating a surgical approach between a target region and a starting position; FIG. 2 is a simplified diagram showing a system for operating microscope (OM) tracking; FIG. 3 is a simplified diagram showing a data collection setup for the system of FIG. 2; FIG. 4 is a simplified diagram showing a field of view of an operating microscope of the system of FIG. 2; FIG. 5 is a simplified diagram showing generation of an approach log and derived approach sequence of the system of FIG. 2; FIG. 6 is a simplified diagram showing population of the approach library based on the approach log and derived approach sequence of the system of FIG. 2; FIG. 7 is a simplified diagram showing identification of a detected landmark based on the focal point of the OM of FIG. 2; FIG. 8 is a simplified diagram showing an approach library of the system of FIG. 2; FIG. 9 is a database diagram showing components of the approach library of FIG. 5 and the selected target region and starting position of FIG. 8; FIGS. 10A and 10B are each a diagram showing part of an approach log of the approach library of FIG. 5 for a particular surgical case; FIG. 11 is a simplified diagram showing retrieval of approach results based on a selected target region and starting position from the approach library of FIG. 7; FIG. 12 is a diagram showing a display member and an associated video image captured by an operative microscope of the system of FIG. 2 including landmark identifiers and directional identifiers of an approach sequence; FIG. 13 is an illustration showing a user interface of the system of FIG. 2; FIG. 14 is an illustration showing an approach selection process by the user interface of FIG. 13; FIGS. 15 and 16 are illustrations showing a surgeon's view using the operative microscope with the system of FIG. 2 FIG. 17 is a process flow illustrating a process for providing technical guidance during a surgical case by the system of FIG. 2; FIG. 18 is a process flow illustrating a process for populating an approach library of the system of FIG. 2; FIG. 19 is a process flow illustrating a process for populating and accessing approach library content from the system of FIG. 2; FIG. 20 is a simplified diagram showing an implementation of components of an Operating Microscope Guidance application of the system of FIG. 2; and FIG. 21 is a simplified diagram showing an exemplary computing system for implementation of the system of FIG. 2. Corresponding reference characters indicate corresponding elements among the view of the drawings. The headings used in the figures do not limit the scope of the claims. DETAILED DESCRIPTION The present disclosure includes a computer-implemented system that utilizes operating microscope focal point data defined within cartesian space for the purposes of surgical technical guidance, education, analytical evaluation, quality improvement, efficiency testing, and patient outcome assessment. Introduction The operating microscope has been a staple for microsurgical procedures and therefore frameless stereotactic navigation has been adopted to implement this instrument as a trackable device in Cartesian space relative to a patient's anatomy. To permit surgeon recognition of a focal point (i.e. convergence point of a left and right ocular vision within an operating microscope) the operating microscope outputs a focal point depth value relative to the tracked optical position of the operating room microscope's stereotactic registration frame. This permits a surgeon to view the focal point relative to the patient's anatomy. Given the surgeon is conducting a