US-12616527-B2 - Surgical tracking system for tracking an instrument with respect to a reference body

US12616527B2US 12616527 B2US12616527 B2US 12616527B2US-12616527-B2

Abstract

Surgical guiding device, a surgical reference body ( 50 ) and a surgical tracking system ( 2 ), and in particular to a surgical guiding device, a surgical reference body and a surgical tracking system allowing an improved localization of surgical components.

Inventors

Jakob Kemper
Lars Metz
Ulrich Hoffmann
Fabian Huegle
Sabrina Horstmann
Peter Sterrantino

Assignees

STRYKER EUROPEAN OPERATIONS LIMITED

Dates

Publication Date: 20260505
Application Date: 20210608

Claims (19)

1 . A surgical tracking system for tracking a surgical instrument with respect to a surgical reference body, the surgical tracking system comprising: an optical imaging device representing a position and orientation of the surgical instrument, the optical imaging device having a predetermined viewing direction, an optical pattern representing a position and orientation of the surgical reference body, the optical pattern having at least one unique optical sub-pattern, which allows determination of a relative position and orientation of said surgical reference body with respect to the position and orientation of said surgical instrument, an image processing device ( 30 ) configured to: recognize the position and orientation of the at least one sub-pattern of the optical pattern with respect to a position and viewing direction of the imaging device based on an image taken from the optical imaging device and a stored representation of the optical pattern, and virtually visualize the surgical instrument represented by the optical imaging device and virtually visualize a surgical reference body represented by the optical pattern, wherein the surgical reference body includes: a radio dense geometry having a first radio dense sub-geometry and a second radio dense sub-geometry each being fixedly and spatially reproducibly connected to the surgical reference body, a first reference body portion having an anatomically adapted surface for a patient's anatomy, a second reference body portion having an anatomically adapted surface for a patient's anatomy, wherein each of the first radio dense sub-geometry and the second radio dense sub-geometry has a unique radio projection for each proximal to distal orientation of the surgical reference body, so that each of the first radio dense sub-geometry and the second radio dense sub-geometry alone allows determination of the spatial position and orientation of the surgical reference body based on a two dimensional radio projection of at least a part of the surgical reference body, wherein the first radio dense sub-geometry is allocated to the first reference body portion, and the second radio dense sub-geometry is allocated to the second reference body portion.
2 . The surgical tracking system of claim 1 , wherein the image processing device is further configured to: augment a predetermined operating trajectory of the surgical instrument onto the virtual visualization of the surgical instrument, based on a recognized position and orientation of the at least one sub-pattern of the optical pattern with respect to the position and predetermined viewing direction of the imaging device, so as to visualize an operating path of the surgical instrument relative to a surgical reference body represented by the optical pattern.
3 . The surgical tracking system of claim 1 , wherein the optical imaging device comprises a mechanical interface configured to be coupled to a positive fit receptacle of one of the surgical instrument and the surgical reference body for forming a unit having a reproducible relation between a geometry of said one of the surgical instrument and the surgical reference body, and the position and predetermined viewing direction of the optical imaging device, wherein the surgical instrument includes a mechanical interface for the mechanical interface of the optical imaging device so as to form a reproducible relation between the geometry of the surgical instrument and the position and predetermined viewing direction of the optical imaging device.
4 . The surgical tracking system of claim 3 , wherein the radio dense geometry has a unique radio projection for each proximal to distal orientation of the surgical reference body, so that the radio dense geometry allows determination of the spatial position and orientation of the surgical reference body based on a two dimensional radio projection of at least a part of the surgical reference body.
5 . The surgical tracking system of claim 3 , wherein the radio dense geometry has the first radio dense sub-geometry, the second radio dense sub-geometry, and a third radio dense sub-geometry each being fixedly and spatially reproducibly connected to the surgical reference body, a first leg having an anatomically adapted surface for a patient's anatomy, a second leg having an anatomically adapted surface for a patient's anatomy, wherein the first leg with a first end is connected to a first end of the second leg at a leg joining portion, wherein each of the first radio dense sub-geometry, the second radio dense sub-geometry, and the third radio dense sub-geometry has a unique radio projection for each proximal to distal orientation of the surgical reference body, so that each of the first radio dense sub-geometry, the second radio dense sub-geometry, and the third radio dense sub-geometry alone allows determination of the spatial position and orientation of the surgical reference body based on a two dimensional radio projection of at least a part of the surgical reference body, and wherein the first radio dense sub-geometry is allocated to a second end of the first leg, the second radio dense sub-geometry is allocated to a second end of the second leg, and the third radio dense sub-geometry is allocated to the leg joining portion of the first leg and the second leg.
6 . The surgical tracking system of claim 3 , wherein the surgical instrument is a surgical cutting guide device including: a guiding body having a planar cutting extension from a proximal end of the surgical cutting guide device to a distal end of the surgical cutting guide device, and being adapted for guiding a surgical cutting tool, and having a cutting plane trajectory extending along the guiding body and succeeding in distal direction along a traveling path of a surgical cutting tool to be inserted and guided, the radio dense geometry being located in a predetermined spatial position and orientation with respect to the guiding body, and being adapted for providing a unique radio projection for each proximal to distal orientation of the guiding body, wherein the surgical reference body includes: the radio dense geometry being fixedly and spatially reproducibly connected to the surgical reference body, wherein the radio dense geometry has a unique radio projection for each proximal to distal orientation of the surgical reference body, so that the radio dense geometry allows determination of the spatial position and orientation of the surgical reference body based on a two dimensional radio projection of at least a part of the surgical reference body.
7 . The surgical tracking system of claim 1 , wherein the optical imaging device comprises a mechanical interface configured to be coupled to a positive fit receptacle of the surgical instrument for forming a unit having a reproducible relation between a geometry of the surgical instrument, and the position and predetermined viewing direction of the optical imaging device, wherein the surgical reference body includes a mechanical interface for the mechanical interface of the optical imaging device so as to form a reproducible relation between the geometry of the surgical reference body and the position and predetermined viewing direction of the optical imaging device.
8 . The surgical tracking system of claim 1 , wherein the optical pattern comprises a mechanical interface configured to be coupled to a positive fit mechanical interface of the surgical instrument for forming a unit having a reproducible relation between a geometry of the surgical instrument, and the position and orientation of the optical pattern ( 80 ), wherein the surgical instrument includes the mechanical interface for the mechanical interface of the optical pattern so as to form a reproducible relation between the geometry of the surgical instrument and the position and orientation of the optical pattern.
9 . The surgical tracking system of claim 1 , wherein the optical pattern comprises a mechanical interface configured to be coupled to a positive fit mechanical interface of one of the surgical instrument and the surgical reference body for forming a unit having a reproducible relation between a geometry of said one of the surgical instrument and the surgical reference body, and the position and orientation of the optical pattern, wherein the surgical reference body includes the mechanical interface for the mechanical interface of the optical pattern so as to form a reproducible relation between the geometry of the surgical reference body and the position and orientation of the optical pattern.
10 . The surgical tracking system of claim 1 , wherein the optical imaging device is inseparably connected to the surgical instrument so as to form a reproducible relation between the geometry of the surgical instrument and the position and orientation of the optical imaging device, and wherein the optical pattern is inseparably connected to the surgical reference body so as to form a reproducible relation between the geometry of the surgical reference body and the position and orientation of the optical pattern.
11 . The surgical tracking system of claim 1 , wherein the optical pattern is inseparably connected to the surgical instrument so as to form a reproducible relation between the geometry of the surgical instrument and the position and orientation of the optical pattern.
12 . The surgical tracking system of claim 1 , wherein the optical pattern is composed of at least one of: a geometrically even raster of light and dark fields, which includes a raster of squared light and dark fields, which includes a raster of light and black fields, and/or a geometrically even raster of fields of different colors, which includes a raster of squared colored fields, which includes a raster of color gradient fields.
13 . The surgical tracking system of claim 1 , wherein the optical pattern is composed of a honeycomb raster of light and dark fields, which includes a raster of light and dark circles or hexagons in a honeycomb raster, which includes a raster of light and black circles or hexagons.
14 . The surgical tracking system of claim 13 , wherein the guiding body is a first guiding body releasably mountable to the surgical cutting guide device and including adhering means for adhering the first guiding body to a patient's anatomy so that a first cutting plane trajectory extending along the first guiding body and succeeding in a distal direction along a traveling path of a surgical cutting tool to be inserted and guided aligns with a first intended cutting plane at the patient's anatomy, the surgical cutting guide device further including a second first guiding body releasably mountable to the surgical cutting guide device and including adhering means for adhering the second guiding body to a patient's anatomy so that a second cutting plane trajectory extending along the second guiding body and succeeding in a distal direction along a traveling path of a surgical cutting tool to be inserted and guided aligns with a second intended cutting plane at the patient's anatomy, wherein the second cutting plane trajectory is inclined with respect to the first cutting plane trajectory, the surgical tracking system configured to augment at least one of the first cutting plane trajectory and the second cutting plane trajectory with respect to at least one of the first intended cutting plane and the second intended cutting plane at the patient's anatomy, based on at least one of the optical pattern and the radio dense geometry having a unique radio projection, provided on each of the surgical reference body, the first guiding body and the second guiding body, and wherein the surgical tracking system is adapted for instructing a surgeon on how to align at least one of the first cutting plane trajectory and the second cutting plane trajectory with respect to at least one of the first intended cutting plane and the second intended cutting plane.
15 . The surgical tracking system of claim 1 , wherein the optical pattern is composed of a honeycomb raster of fields of different colors, which includes a raster of colored circles or hexagons in a honeycomb raster, which includes a raster of color gradient circles or hexagons.
16 . A method for visualizing tracking of a surgical instrument with respect to a surgical reference body, the method comprising: taking an optical image toward a predetermined viewing direction by an imaging device mounted with the predetermined viewing direction onto the surgical instrument, of an optical pattern mounted with a predetermined relative position and orientation to the surgical reference body, wherein the optical pattern has at least one unique optical sub-pattern, which allows determination of a relative position and orientation of said surgical reference body with respect to the position and orientation of said surgical instrument, processing a taken optical image of the optical pattern by recognizing the at least one sub-pattern of the optical pattern, comparing the recognized optical sub-pattern with a stored representation of the optical pattern, and determining from a size, an orientation and a distortion of the recognized sub-pattern compared to the stored representation of the optical pattern the position and orientation of the surgical instrument with respect to the orientation and position of the surgical reference body, wherein the surgical reference body includes: a radio dense geometry having a first radio dense sub-geometry and a second radio dense sub-geometry each being fixedly and spatially reproducibly connected to the surgical reference body, a first reference body portion having an anatomically adapted surface for a patient's anatomy, a second reference body portion having an anatomically adapted surface for a patient's anatomy, wherein each of the first radio dense sub-geometry and the second radio dense sub-geometry has a unique radio projection for each proximal to distal orientation of the surgical reference body, so that each of the first radio dense sub-geometry and the second radio dense sub-geometry alone allows determination of the spatial position and orientation of the surgical reference body based on a two dimensional radio projection of at least a part of the surgical reference body, wherein the first radio dense sub-geometry is allocated to the first reference body portion, and the second radio dense sub-geometry is allocated to the second reference body portion.
17 . The method of claim 16 , further comprising: visualizing the surgical instrument represented by the optical imaging device and visualizing the surgical reference body represented by the optical pattern.
18 . The method of claim 17 , further comprising: augmenting a predetermined operating trajectory of the surgical instrument onto a virtual visualization of the surgical instrument, based on a recognized position and orientation of the at least one sub-pattern of the optical pattern with respect to a position and viewing direction of the imaging device, so as to visualize an operating path of the surgical instrument relative to the surgical reference body represented by the optical pattern.
19 . A surgical tracking system for tracking a surgical instrument with respect to a surgical reference body, the surgical tracking system comprising: an optical imaging device representing a position and orientation the surgical instrument, the optical imaging device having a predetermined viewing direction; an optical pattern representing a position and orientation of the surgical reference body, the optical pattern having at least one unique optical sub-pattern, which allows determination of a relative position and orientation of said surgical instrument with respect to the position and orientation of said surgical reference body; an image processing device configured to recognize the position and orientation of the at least one sub-pattern of the optical pattern with respect to a position and viewing direction of the imaging device based on an image taken from the optical imaging device and a stored representation of the optical pattern, and configured to determine the relative position and orientation of said surgical instrument with respect to the position and orientation of said surgical reference body, wherein the surgical reference body includes: a radio dense geometry having a first radio dense sub-geometry and a second radio dense sub-geometry each being fixedly and spatially reproducibly connected to the surgical reference body, a first reference body portion having an anatomically adapted surface for a patient's anatomy, a second reference body portion having an anatomically adapted surface for a patient's anatomy, wherein each of the first radio dense sub-geometry and the second radio dense sub-geometry has a unique radio projection for each proximal to distal orientation of the surgical reference body, so that each of the first radio dense sub-geometry and the second radio dense sub-geometry alone allows determination of the spatial position and orientation of the surgical reference body based on a two dimensional radio projection of at least a part of the surgical reference body, wherein the first radio dense sub-geometry is allocated to the first reference body portion, and the second radio dense sub-geometry is allocated to the second reference body portion.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS The present application is a national phase entry under 35 U.S.C. § 371 of International Application No. PCT/IB2021/055020, filed Jun. 8, 2021, published in English, the disclosures of which are incorporated herein by reference. FIELD OF THE INVENTION The present invention relates to a surgical guiding device, a surgical reference body and a surgical tracking system, and in particular to a surgical guiding device, a surgical reference body and a surgical tracking system allowing an improved localization of surgical components, and a corresponding method, computer program product and storage medium having stored thereon the computer program product. BACKGROUND OF THE INVENTION Surgical procedures have improved over the recent years. Significant improvements have been achieved by supporting systems for supporting the clinical personal in particular surgeons during surgeries. In particular bone fractures benefit from supporting systems for surgeons, which provide the surgeon with equipment, which allows the surgeon to improve exactness of repositioning of bone parts and positioning of implants, like screws, nails and bone plates, as well as tools and targeting and guiding devices. As traumatized bones, i.e. fractures, have only a limited visual access, monitoring is usually based on radiating principles, like X-ray imaging or computer tomography CT images, or magnet resonance tomography MRT images. All these principles and methods involve at least one of the drawbacks of being radiation intensive, requiring large devices and requiring a considerable amount of time. Each monitoring step during a surgery prolongs the surgery duration and thus the duration of narcotic impact and increases costs and radiation impact. Therefore, there is a need for surgical guiding devices, surgical reference bodies and surgical tracking systems as well as corresponding methods, which reduce imaging effort and thus duration of the surgery, reduce radiation impact on the patient, but at the same time maintain or increase the level of exactness of the surgery. SUMMARY OF THE INVENTION The present invention provides a surgical guiding device, a surgical reference body and a surgical tracking system, allowing an improved localization and positioning of surgical components, and corresponding methods, computer program products and storage mediums having stored therein the computer program product(s) according the subject matter of the independent claims. Further embodiments are incorporated into the dependent claims. According to an embodiment of the invention there is provided a surgical tracking system for tracking a surgical instrument with respect to a surgical reference body, the surgical tracking system comprises an optical imaging device representing a position and orientation of one of a surgical instrument and a surgical reference body, the optical imaging device having a predetermined viewing direction; an optical pattern representing a position and orientation of the other of said surgical instrument and said surgical reference body, the optical pattern having at least one unique optical sub-pattern, which allows determination of a relative position and orientation of said surgical reference body with respect to the position and orientation of said surgical instrument; an image processing device comprising pattern recognition means being adapted for recognizing the position and orientation of the at least sub-pattern of the optical pattern with respect to a position and viewing direction of the imaging device based on an image taken from the optical imaging device and a stored representation of the optical pattern, and visualization means being adapted for virtually visualizing a surgical instrument represented by the respective one of the optical imaging device and the optical pattern and virtually visualizing a surgical reference body represented by the respective other of the optical pattern and the optical imaging device. Thus, the relative position of an optical imaging device and an optical pattern can be determined. If the optical pattern is known with respect to its structure and size, an image thereof allows to determine from where the image was taken. It is not required to take an image of the entire pattern, as long as the imaged portion of the pattern is unique in the entire pattern. Both, the optical imaging device and the optical pattern represent either a surgical instrument or a surgical reference body. It should be noted that the optical imaging device and the optical pattern may also represent other items for which it is required to determine their relative position with respect to each other. It is also possible that the entire surgical tracking system supports more than one optical imaging device and it also possible to support more than one optical pattern. The optical pattern may be printed onto a surgical instrument or a reference body. If printed onto, embedded in