EP0359773B1 — Process and device for optical representation of …

Claim 1

Independent Claim 355 words

Method for the reproducible optical representation of an operation to be carried out with the aid of a surgical instrument (31), in which method tomographic information of a body part in which the surgical operation is to be carried out is stored in the data memory of a data processing system (21), positional data of an operating site are determined from the tomographic information, the surgical instrument (31) is mounted on a three-dimensionally freely movable carrier (16), attitude data of the surgical instrument (31) are determined with the aid of a coordinate measuring device (1; 50) and fed to the data processing system (21), which relates the attitude data of the surgical instrument (31) to the positional data of the operating site, and the surgical instrument (31) is aligned with respect to the operating site on the basis of this relationship, characterised by the following steps: at least three measuring points (42) accessible from outside are determined or arranged as reference points on the body part, tomograms (41) of the body part which contain the measuring points (42) are produced and filed in the data memory, the spatial position of the measuring points (42) is measured with the aid of the coordinate measuring device (1; 50), and the measurement data are filed in the data memory, the data processing system (21) produces a relationship between the image data, contained in the tomograms (41), of the measurement points (42) and the data, determined by the coordinate measuring device (1; 50), of the measurement points (42), the spatial attitude of the three-dimensionally freely movable surgical instrument (31) is continuously measured with the aid of the coordinate measuring device (1; 50), and the attitude data are fed to the data processing system (21), the data processing system (21) superimposes the attitude data of the surgical instrument (31) on the image information of the tomograms (41), and the data processing system (21) generates on an output device, in particular a display screen (22), superimposition images (43) in which the image contents of the tomograms (41) and the respective attitudes of the surgical instrument (31) are superimposed on one another.

Claim 2

Dependent Claim 355 words

Method for the reproducible optical representation of an operation to be carried out with the aid of a surgical instrument (31), in which method tomographic information of a body part in which the surgical operation is to be carried out is stored in the data memory of a data processing system (21), positional data of an operating site are determined from the tomographic information, the surgical instrument (31) is mounted on a three-dimensionally freely movable carrier (16), attitude data of the surgical instrument (31) are determined with the aid of a coordinate measuring device (1; 50) and fed to the data processing system (21), which relates the attitude data of the surgical instrument (31) to the positional data of the operating site, and the surgical instrument (31) is aligned with respect to the operating site on the basis of this relationship, characterised by the following steps: at least three measuring points (42) accessible from outside are determined or arranged as reference points on the body part, tomograms (41) of the body part which contain the measuring points (42) are produced and filed in the data memory, the spatial position of the measuring points (42) is measured with the aid of the coordinate measuring device (1; 50), and the measurement data are filed in the data memory, the data processing system (21) produces a relationship between the image data, contained in the tomograms (41), of the measurement points (42) and the data, determined by the coordinate measuring device (1; 50), of the measurement points (42), the spatial attitude of the three-dimensionally freely movable surgical instrument (31) is continuously measured with the aid of the coordinate measuring device (1; 50), and the attitude data are fed to the data processing system (21), the data processing system (21) superimposes the attitude data of the surgical instrument (31) on the image information of the tomograms (41), and the data processing system (21) generates on an output device, in particular a display screen (22), superimposition images (43) in which the image contents of the tomograms (41) and the respective attitudes of the surgical instrument (31) are superimposed on one another.

Claim 3

Dependent Claim 56 words

Method according to Claim 1, characterised in that the carrier (16) of the surgical instrument (31) is mounted on a three-dimensionally freely movable articulated arm (20; 72), and the attitude data of the surgical instrument (31) are determined by synchros of the coordinate measuring device (1; 50) which are connected to the articulated arm (20; 72).

Claim 4

Dependent Claim 31 words

Method according to Claim 1, characterised in that the attitude data of the surgical instrument (31) are determined in a contactless fashion by a coordinate measuring device constructed as a locator.

Claim 5

Dependent Claim 46 words

Method according to one of Claims 1 to 3, characterised in that superimposition images (43), which are formed by tomograms (41) extending longitudinally and transversely in the vertical plane as well as by horizontal ones (41), are simultaneously represented in various windows of the output device.

Claim 6

Dependent Claim 30 words

Method according to one of Claims 1 to 4, characterised in that the superimposition images (43) are filed in a data memory for the purpose of documenting the surgical operation.

Claim 7

Dependent Claim 45 words

Method according to one or more of Claims 1 to 5, characterised in that use is made for the production of the superimposition images (43) always of those tomograms (41) which correspond to the respective attitude of the surgical instrument (31) inside the body part.

Claim 8

Dependent Claim 87 words

Method according to one or more of Claims 1 to 6, characterised in that the spatial position of the body part is checked by the coordinate measuring device (1; 50) by repeated scanning of the measuring points (42) at temporal intervals, the measurement data obtained in the process are input into the data processing system (21) and compared by the latter with the original measurement data, and in the event of deviations a positional correction of the tomograms (41) represented on the output device is carried out.

Claim 9

Dependent Claim 124 words

Method according to one or more of Claims 1 to 7, characterised in that the regions of the body part that are to be removed are traced in the manner of an envelope by means of a probe connected to the coordinate measuring device (1; 50) or of the surgical instrument (31), in that the positional data of the region of the body part that are obtained in the process are compared by the data processing system (21) with the corresponding image information of the tomograms (41), and in that in the event of a deviation in the data caused by a change in volume or position of the region of the body part corrected images are produced and filed in the data memory.

Claim 10

Dependent Claim 98 words

Method according to one or more of Claims 1 to 8, characterised in that the cavity produced during a surgical operation by the removal of a specific region of the body part is scanned by means of a probe connected to the coordinate measuring device (1; 50) or of the surgical instrument (31) in the manner of an envelope, the positional data of the cavity that are obtained in the process are superimposed with the image information of the corresponding tomograms (41), and the data, produced in the process, of post-operative tomograms are filed in the data memory.

Claim 11

Dependent Claim 28 words

Method according to one or more of Claims 1 to 9, characterised in that the superimposition images (43) and post-operative tomograms are comparable with the original tomograms (41).

Claim 12

Dependent Claim 305 words

Device for executing the method according to one of the preceding claims, containing a data processing system (2), a data memory in the data processing system (21), in which tomographic information of a body part is stored in the form of a sequence of tomograms (41), a display screen (22), connected to the data processing system (21), for reproducing selected tomograms (41) from the tomographic information, a three-dimensionally freely movable carrier (16), which carries a surgical instrument (31), a coordinate measuring device (1; 50), coupled to the carrier (16) and the data processing system (21), for determining the attitude data of the surgical instrument (31), which can be related by the data processing system (21) to positional data in the tomographic information, characterised by at least three measuring points (42) specified on the body part and accessible from outside, tomographic information in which the measurement points (42) are contained, means in the data processing system (21) for producing a relationship between the positional data, scanned by the coordinate measuring device (1; 50), of the measuring points (42) and the positional data of the measuring points (42) in the tomographic information, and thus in general between positional data of the tomographic information and the attitude data, determined by the coordinate measuring device (1; 50), of the surgical instrument (31), means in the data processing system (21) for superimposing attitude data, determined during a surgical operation in the body part on the basis of the said relationship, of the surgical instrument (31) with the tomographic information, and for generating superimposition images (43), and means, connected to the data processing system (21), for continuous reproduction of the superimposition images (43) on the display screen (22), which continuously display the attitudes of the surgical instrument (31) in the tomograms (42) and thus in the body part during the operation.

Claim 13

Dependent Claim 43 words

Device according to Claim 11, characterised in that the carrier (16) of the surgical instrument (31) is mounted on a three-dimensionally freely movable articulated arm (20; 72), and the coordinate measuring device (1; 50) has synchros connected to the articulated arm (20; 72).

Claim 14

Dependent Claim 29 words

Device according to Claim 11, characterised in that the coordinate measuring device is constructed as a locator with contactless determination of the attitude data of the surgical instrument (31

Claim 15

Dependent Claim 18 words

Device according to Claim 12, characterised in that the articulated arm (20; 72) contains six axes of rotation.

Claim 16

Dependent Claim 17 words

Device according to Claim 14, characterised in that the articulated arm (72) has a balancing mechanism (73).

Claim 17

Dependent Claim 48 words

Device according to Claim 15, characterised in that two members (61; 65, 68, 69) of the articulated arm (72) that can be pivoted about horizontal axes (62; 66) are connected via toothed belt drives (85, 86; 87, 88, 90) to their own counterweights (79, 81) in each case.

Claim 18

Dependent Claim 76 words

Device according to one or more of Claims 11 to 16, characterised in that the surgical instruments (31) and/or the probe can be connected via a coupling (32) to the coordinate measuring device (1; 50) and are provided with an identification code (34) and in that a code scanner (36) which is connected for the purpose of reproducing the code information to the data processing system (21) is arranged in the region of the coupling (32).

Claim 19

Dependent Claim 48 words

Device according to one or more of Claims 11 to 17, characterised in that the measuring instruments of the coordinate measuring device (1; 50) that are assigned to the individual articulations are arranged in a central housing and connected to the articulations by flexible drives and gear trains.

Process and device for optical representation of surgical operations

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