Optical tracker and surgical device with optical tracker

Abstract

An optical tracker and a surgical device, the surgical device including a shaft defining a longitudinal axis, wherein the shaft has a first shaft portion configured to be inserted into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted in the patient. The surgical device further includes an actuation member actuatable relative to the first shaft portion and an operation member operable relative to the second shaft portion, the operation member configured to actuate the actuation member when operated. In addition, the surgical device includes a tracker coupled with the operation member such that operation of the operation member causes the tracker to move relative to the shaft (e.g., rotate about the longitudinal axis).

Description

Technical Field

[0001] This disclosure generally relates to the field of computer-aided surgical navigation using optical or non-optical tracking technologies. Specifically, it presents optical trackers, surgical apparatuses having movable (e.g., rotatable) trackers, systems including surgical apparatuses, computer-implemented methods relating to surgical apparatuses, and computer program products. Background Technology

[0002] Many surgical procedures benefit from the determination of the status, position, or orientation of surgical instruments in the operating room. For this purpose, surgical instruments are equipped with trackers that can be tracked by a surgical navigation system (e.g., a navigation camera) with tracking capabilities. The results of the tracking can then be visualized by the surgical navigation system, for example, relative to image data of the patient being treated by the surgical instrument.

[0003] In a typical application of a surgical navigation system, both the surgical apparatus and the patient are associated with a tracker, where image data previously acquired, for example, by computed tomography scans, is initially registered with the posture of the patient tracker. By then continuously tracking both the patient and the surgical apparatus, the surgical navigation system can determine the spatial relationship between the surgical apparatus and the three-dimensional image data. This determined spatial relationship can, for example, be displayed on a screen, thereby assisting the surgeon in manipulating the surgical apparatus relative to the patient.

[0004] Typical surgical devices relying on optical trackers for navigation include an optical tracker positioned proximally, with a distal end configured to enter the patient's body and a navigation camera configured for line-of-sight tracking. Some of these surgical devices further include an actuating element that can be operated by a surgeon to actuate a mechanism located in a region at the distal end. Obviously, actuation of this mechanism is difficult to track because line-of-sight tracking cannot be used during surgical intervention once the distal end has entered the patient's body. Summary of the Invention

[0005] There is a need for a trackable surgical device that extends the tracking capabilities of surgical navigation systems known to date.

[0006] According to a first aspect, a surgical device is presented, the surgical device including a shaft defining a longitudinal axis, wherein the shaft has a first shaft portion configured to be inserted into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted into the patient. The surgical device further includes an actuating member actuable relative to the first shaft portion and an operating member operable relative to the second shaft portion, the operating member being configured to actuate the actuating member when operated. Furthermore, the surgical device includes a first tracker coupled to the operating member, such that operation of the operating member causes the first tracker to move relative to the shaft.

[0007] According to one variation, the operation of the operating member can cause the first tracker to rotate relative to the longitudinal axis. In another variation, the operation of the operating member can cause a translational movement of the first tracker relative to the axis (e.g., along the longitudinal axis) or a movement of the first tracker that combines rotation and translation.

[0008] According to one variation, a predefined relationship may exist between, on the one hand, the movement of the first tracker and, on the other hand, the actuated movement of the actuating member and one of the actuable implants coupled to the actuating member. The movement of the first tracker may be a rotational movement. The actuated movement of the actuating member and one of the actuable implants coupled to the actuating member may be a movement relative to the first axis portion. For example, the actuated movement of the actuating member may be a rotational movement about the longitudinal axis. The rotational movement may occur clockwise or counterclockwise.

[0009] The predefined relationship can associate a change in the position of the first tracker caused by movement of the first tracker with a change in size or state caused by the actuated movement. The associated change in the position of the first tracker can be a change in the angular position of the first tracker about the longitudinal axis caused by rotational movement. The change in size or state can involve either the actuating member or the actuable implant coupled to the actuating member. The change in size can include a change in the height, length, or width of at least a portion of the actuating member and / or the actuable implant coupled to the actuating member, or any combination of these changes. The change in state can be discrete in nature (e.g., extension / contraction or opening / closing).

[0010] The predefined relationship can be a functional relationship. Using such a functional relationship, the surgical navigation system can calculate and convert detected rotational movement (e.g., rotational angle caused by the change in angular position) into associated changes in size or state. These changes in size or state of the actuating member or the actuable implant can, for example, be visually presented to the surgeon relative to image data of the patient.

[0011] In one variation, the operating member can rotate about the longitudinal axis. In other variations, the operating member can translate or rotate about an axis other than the longitudinal axis.

[0012] The actuating member may be a handle (e.g., implemented as a rotatable knob or lever). The actuating member may be operated manually or automatically. The actuating member may be configured to interact with a gear mechanism, which is configured to convert the actuating movement applied to the actuating member into an actuating movement of the actuating member or the actuable implant coupled to the actuating member. This conversion may occur between rotational actuating movements and translational actuating movements, or vice versa, or between different rotational or translational movements.

[0013] The first tracker can be rigidly coupled or configured to be rigidly coupled to the actuating member. In this variant, rotational movement of the actuating member about the longitudinal axis causes a corresponding rotational movement of the first tracker. The rigid coupling between the first tracker and the actuating member allows the first tracker to be detached from the surgical apparatus.

[0014] Furthermore, the first tracker can be an optical tracker (e.g., for tracking in the infrared and / or visible spectrum) or a non-optical tracker. The first tracker may include multiple markers (e.g., at least 3, 4, 5, or 6 markers, and up to 10, 14, or more markers). These markers can be optically detectable markers, such as optically passive markers (e.g., reflectors) or optically active markers (e.g., light-emitting diodes, LEDs). The optically passive markers may have a generally flat shape that can optionally bend around the longitudinal axis. In other variations, the optically passive markers may have a spherical shape.

[0015] The markers of the first tracker can be arranged in a pattern that defines different arrangements of the markers as observed from a given viewing direction in different rotational states of the first tracker relative to the longitudinal axis. Thus, at least some of the markers can be spaced apart from each other in a circumferential direction around the longitudinal axis. The markers can be tracked by sensors of a surgical navigation system. In the case of optically detectable markers, the sensor can be an optical sensor. The optical sensor can be a monocular camera or a stereo camera.

[0016] The surgical device may include a second tracker rigidly coupled to or configured to be rigidly coupled to the axis. The second tracker may be an optical tracker (e.g., for tracking in the infrared and / or visible spectrum). The second tracker may include multiple optical tracking elements, such as reflective spheres or active LEDs. The second tracker may include 3, 4, or 5 optical tracking elements (optionally, all optical tracking elements need to be tracked simultaneously for proper navigation). The optical tracking elements may be tracked by an optical sensor of the surgical navigation system. When the first tracker is configured as an optical tracker with optically detectable markers, the optical sensor may be further configured to track the markers of the first tracker.

[0017] According to one variation, the actuating member can be moved relative to the axis from a predefined first axial position to a predefined second axial position in an axial direction relative to the longitudinal axis. In one example, the movement of the actuating member between the predefined axial positions can be translated into rotational movement of the actuating member. The predefined axial positions may relate to different predefined actuation states of the actuable implant (e.g., withdrawal or retraction).

[0018] The surgical apparatus can be configured such that axial movement of the actuating member relative to the axis causes axial movement of the first tracker relative to the second tracker. In one example, this axial movement can be converted into rotational movement of the actuating member. This rotational movement of the actuating member can be derived based on tracking changes in the distance between the first and second trackers.

[0019] Operation of the operating member can cause the actuating member to rotate relative to the first shaft portion. When the first shaft portion is rigidly coupled to the second shaft portion, the actuating member will also rotate relative to the second shaft portion. In particular, when the operating member is rigidly coupled to the actuating member, the rotation of the actuating member can correspond to the rotation of the operating member about the longitudinal axis (e.g., in terms of angular change).

[0020] According to one variation, the shaft defines a channel, and the actuating member is coupled to the actuating member via a coupling section extending into the channel defined by the shaft. The channel may be defined by a cylindrical cavity within the shaft, configured to removably receive the coupling section and optionally the actuating member. The channel may extend coaxially with the longitudinal axis of the shaft. In some variations, the shaft is in the form of a tube, wherein the distal portion of the tube forms the first shaft portion, and the proximal portion of the tube forms the second shaft portion.

[0021] The connection section may include an internal driver and an external driver, which are configured to move relative to each other from a predefined first axial position to at least a predefined second axial position in the axial direction relative to the longitudinal axis. The relationship between the internal driver and the external driver may be defined as a radially inner position and a radially outer position in the radial direction relative to the longitudinal axis.

[0022] At least one of the internal driver and the external driver can be configured to include or cooperate with the actuating member. For example, the actuating member may include an internal portion and an external portion respectively (e.g., integrally) coupled to the internal driver and the external driver and corresponding to the movement of the internal driver and the external driver. This implementation can achieve different actuation modes based on the positions of the internal driver and the external driver relative to each other in the coupled segment (e.g., only the internal portion acts as an actuator, only the external portion acts as an actuator, or both portions act as actuators).

[0023] The surgical apparatus may further include a drive member coupled to at least one of the internal drive and the external drive. The drive member may be configured to move relative to the axis in an axial direction relative to the longitudinal axis from a predefined first axial position to at least a predefined second axial position, such that movement of the drive member from the predefined first axial position to the at least predefined second axial position causes a change in the position of the internal drive relative to the external drive (e.g., movement of the drive member from a distal to a more lateral position causes movement of the internal drive relative to the external drive to a more lateral position, and vice versa). Specifically, the drive member may have three predefined positions along the longitudinal axis (e.g., to implement the three actuation modes mentioned above).

[0024] In some embodiments, the drive member may be rigidly coupled to the first tracker. In other embodiments, the first tracker may constitute the drive member or a portion thereof. In still other embodiments, a dedicated third tracker may be provided for the drive member (e.g., the third tracker may be rigidly coupled to the drive member). The third tracker may be an optical tracker (e.g., for tracking in the infrared and / or visible spectrum). In these cases, the operation of the drive member may also be tracked (e.g., relative to the second tracker).

[0025] The first shaft portion can be configured to cooperate with a first portion of the implant. The actuating member can be configured to cooperate with a second portion of the implant, wherein the second portion is movable relative to the first portion for changing the actuated state of the implant. The shaft can be configured to detachably receive the implant for placing the implant in the patient's body. The implant can be specifically removed from the patient's body after the actuated movement.

[0026] The first tracker may be an optical tracker and includes a body. The first tracker may include a cover layer for the body and one or more optically detectable markers disposed between the body and the cover layer. The cover layer may be optically transparent (e.g., in the infrared and / or visible spectrum) at least in one or more regions where the one or more markers are located. The one or more optically detectable markers may be located on or within the body. The cover layer may be configured for the transmission of light of a specific wavelength, which may be reflected or emitted by the markers and tracked by an optical sensor. The cover layer may be detachably (e.g., for cleaning, disinfection, or maintenance purposes) or non-detachably attached to the body.

[0027] The body of the first tracker can be arranged or configured to be coaxial with respect to the longitudinal axis of the shaft. The body can have a substantially cylindrical shape with a cylindrical axis. Specifically, the body can have a roller shape with a central opening. In other variations, the body can have a number of different sides, for example, four in the case of a cube. The first tracker can be detached from the surgical device (e.g., for cleaning or sterilization purposes).

[0028] According to a second aspect, a system is provided comprising a surgical apparatus according to a first aspect and an implant configured to be actuated from a first actuated state to a second actuated state by an actuating member. The actuation may be discrete or continuous.

[0029] According to one variation, the implant is configured to change at least one dimension when actuated from the first actuation state to the second actuation state. The change in the at least one dimension may be an increase or decrease in the at least one dimension (e.g., height, width, or length).

[0030] Furthermore, at least a portion of the implant may be configured to extend relative to the first axis portion when the implant is actuated from the first actuation state to the second actuation state. Alternatively, or additionally, at least a portion of the implant may be configured to retract when the implant is actuated from the second actuation state to the first actuation state.

[0031] According to a third aspect, a computer-implemented method is provided for determining an actuation performed by means of a surgical device. The surgical device includes: a shaft defining a longitudinal axis, the shaft having a first shaft portion configured for insertion into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted into the patient; an actuating member actuable relative to the first shaft portion; an operating member operable relative to the second shaft portion, the operating member being configured to actuate the actuating member when operated; and a first tracker coupled to the operating member such that operation of the operating member causes the first tracker to move relative to the shaft. The method includes: determining the position of the first tracker; and determining, at least based on the position of the first tracker, at least one of the actuating member and an implant coupled to the actuating member.

[0032] The position of the first tracker determined according to the third aspect can be the position of the first tracker around the longitudinal axis defined by the axis of the surgical device.

[0033] Determining the actuation of the actuating member may include determining an actuation movement or its actuation state. The actuation state may be determined from a predefined set of two or more actuation states (e.g., on / off or extension / contraction). The actuation movement may be determined as an angle or translational distance (e.g., in the form of a continuous parameter).

[0034] The position of the first tracker can be determined by tracking different arrangements of the markers on the first tracker from a given viewpoint, the different arrangements representing a state of rotation relative to the longitudinal axis. The determined actuation of the actuating member can be further used to determine a change in the size of one of the actuating member and the actuable implant connected to the actuating member.

[0035] According to one variation, the method may include: determining an actuation state of the actuating member caused by the actuation relative to a known initial state prior to the actuation. The initial state may be determined manually or automatically, or otherwise known, before the implant is inserted into the patient's body. This similarly applies to the actuation state of an actuable implant.

[0036] The position of the first tracker relative to the second tracker, which has a fixed relationship with respect to the axis, can be determined by tracking the first and second trackers (e.g., by means of an optical sensor if the tracker is an optical tracker). The second tracker may have a fixed angular relationship with respect to the longitudinal axis. Therefore, two trackers can be tracked simultaneously.

[0037] Furthermore, the method may include visualizing the actuation of the actuating member on a display. Visualizing the actuation of the actuating member may be performed in real time relative to an image of the patient. The image of the patient may be generated based on computed tomography (CT) image data.

[0038] According to a fourth aspect, a computer program product is provided having program code, when executed by a processor, for implementing the method according to a third aspect. The processor may be part of a computing system commonly used in computer-aided surgery.

[0039] According to a fifth aspect, a tracker is provided, particularly for use with the surgical apparatus described herein. The optical tracker includes a body, a cover layer for the body, and one or more optically detectable markers disposed between the body and the cover layer. The cover layer is optically transparent at least in one or more areas where the one or more optically detectable markers are located.

[0040] In one variant, the tracker is an optical tracker and includes a body on which one or more optically detectable markers are disposed, or within the body. The body and markers are covered by a cover layer that is optically transparent at least in areas of the one or more markers. The cover layer may be configured for the transmission of light of a specific wavelength (e.g., infrared and / or visible light), which may be reflected by the optical elements and tracked by the optical sensor.

[0041] The cover layer may include an elastic material, allowing it to be easily positioned around or removed from the body. The cover layer may include at least two distinct material layers, with an inner layer being relatively soft and an outer layer being relatively hard. In this example, the cover layer will not damage the optically detectable marker located on or within the tracker body, while simultaneously being robust against damage to its outer surface (e.g., mechanical damage such as scratches). The cover layer may be smooth on its exterior, allowing for easy cleaning and disinfection.

[0042] According to a sixth aspect, a surgical device is provided. The surgical device includes a shaft defining a longitudinal axis. The shaft has a first shaft portion configured to be inserted into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted into the patient. The surgical device further includes an actuating member actuable relative to the first shaft portion and an operating member operable relative to the second shaft portion. The operating member is configured to actuate the actuating member when operated. The surgical device further includes an optical tracker coupled to the operating member, such that operation of the operating member causes the optical tracker to rotate relative to the shaft.

[0043] According to a seventh aspect, a system is provided comprising a surgical apparatus according to a sixth aspect and an implant configured to be actuated from a first actuated state to a second actuated state by an actuating member. The actuation may be discrete or continuous.

[0044] According to an eighth aspect, a computer-implemented method is provided for determining an actuation performed by means of a surgical device. The surgical device includes: a shaft defining a longitudinal axis, the shaft having a first shaft portion configured for insertion into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted into the patient; an actuating member actuable relative to the first shaft portion; an operating member operable relative to the second shaft portion, the operating member being configured to actuate the actuating member when operated; and an optical tracker coupled to the operating member such that operation of the operating member causes the optical tracker to rotate relative to the axis. The optical tracker includes a plurality of marks arranged in a pattern defining different arrangements of the marks in different rotational states of the optical tracker relative to its longitudinal axis, as observed from a given viewing direction. The method includes: determining the rotational state of the optical tracker; and determining, at least based on the rotational state of the optical tracker, at least one of the actuating member and an implant coupled to the actuating member.

[0045] According to a ninth aspect, a computer program product is provided having program code, when executed by a processor, for implementing the method according to a fourth aspect. The processor may be part of a computing system commonly used in computer-aided surgery. Attached Figure Description

[0046] Other details, advantages, and aspects of this disclosure will become apparent from the following embodiments, taken in conjunction with the accompanying drawings, in which:

[0047] Figure 1A A perspective view of an embodiment of a surgical apparatus according to the present disclosure is shown, including first and second portions of the apparatus in a disconnected state;

[0048] Figure 1B It shows Figure 1A A perspective view of an embodiment, wherein the two parts are in a connected state;

[0049] Figure 2A It shows Figure 1A and Figure 1B The first device portion of the embodiment;

[0050] Figure 2B An embodiment of an optical tracker, including a body and a cover layer, is shown in an exploded view;

[0051] Figure 2C It shows the assembly state. Figure 2B Optical tracker;

[0052] Figure 2D An embodiment of a first device portion with an alternative arrangement of operating components and an optical tracker is shown;

[0053] Figure 2E An embodiment of a first device portion having a drive member and a connecting section including internal and external drives is shown;

[0054] Figure 3A A front view of the external actuator of the connecting section of the first part of the surgical apparatus presented herein is shown;

[0055] Figure 3B A front view of the external and internal drives of the connecting section of the first part of the surgical apparatus is shown;

[0056] Figure 4 It shows Figure 1A and Figure 1B A perspective view of the second device portion of an embodiment;

[0057] Figure 5A , Figure 5B It shows including, for example Figure 1B Perspective and side views of a system embodiment of a surgical device and an actuable implant in their coupled state, as shown;

[0058] Figures 6A to 6C These are different views of an actuable implant;

[0059] Figure 6D A schematic representation of the drive member in a first position and the implant actuated for posterior expansion or contraction is shown;

[0060] Figure 6E A schematic representation of the drive member in the second position and the implant actuated for anterior expansion or contraction is shown;

[0061] Figure 6F A schematic representation of the drive member in the third position and the implant actuated for expansion or contraction at a symmetrical height is shown.

[0062] Figure 7 A flowchart illustrating an embodiment of a method for determining the actuation of an actuating member of a surgical apparatus is shown;

[0063] Figure 8 A schematic representation of a computer program product having code that can be executed by a processor is shown;

[0064] Figure 9 A schematic representation of an embodiment of a surgical navigation system having optical sensors used to track the actuation of actuating components and implants is shown;

[0065] Figure 10 An exemplary visualization of a portion of the surgical device and implant during spinal treatment surgery is shown; and

[0066] Figure 11A , Figure 11B A schematic representation of a portion of the surgical apparatus and an actuable implant is shown during spinal surgery. Detailed Implementation

[0067] In the following description, exemplary embodiments will be explained with reference to the accompanying drawings. The same reference numerals will be used to designate the same or similar structural features.

[0068] Figure 1A and Figure 1B An embodiment of a surgical device 10 according to the present disclosure is shown. The surgical device 10 includes two device parts 100, 102 that can be connected to each other. Figure 1A The two device parts 100 and 102 are shown in a disconnected state, and Figure 1B Two device parts 100 and 102 are shown in a connected state. Each of the two device parts 100 and 102 has a longitudinal axis A. L The longitudinal extension portion. The second device portion 102 has a generally tubular configuration and is configured to coaxially receive the first device portion 100. (See below for reference.) Figures 2A to 2E Figure 3 describes the individual components of the surgical device 10 and their functions in more detail.

[0069] Figure 2A The diagram shows... Figure 1A and Figure 1B The first device portion 100 of the embodiment shown is a rod-shaped part and includes an operating member 110 at its proximal end. In this embodiment, the operating member 110 is exemplary, having a handle with a knob-like configuration.

[0070] The operating member 110 is rigidly connected to the actuating member 120 disposed at the distal end of the first device portion 100. More specifically, a rigid connection section 130 extends between and interconnects the operating member 110 and the actuating member 120. The operating member 110 is operable to actuate the actuating member 120. The operating member 110 is positioned about a longitudinal axis A. L The rotation of [the component] causes a corresponding rotation of the actuating member 120. This occurs around the longitudinal axis A. L The rotation can be clockwise or counterclockwise.

[0071] In other examples, a gear mechanism may be functionally disposed between the operating member 110 and the actuating member 120. The gear mechanism allows a given rotational speed of the operating member 110 to result in a different rotational speed of the actuating member 120. In one example, the gear mechanism may serve as a reduction gear for fine adjustment. For instance, the rotational speeds of the operating member 110 and the actuating member 120 may have a 2:1 ratio (e.g., a 2° rotation of the operating member 110 results in a 1° rotation of the actuating member).

[0072] The first device portion 100 of the surgical apparatus 10 further includes a first tracker 140. The first tracker is an optical tracker 140 that can be tracked in the infrared or visible spectrum by a suitable optical tracking system. Furthermore, other trackers described herein are also configured as such optical trackers. It will be understood that this disclosure is not limited to optical trackers and optical tracking systems. Instead, one or more of the trackers described herein may also be configured as electromagnetic trackers (each including, for example, one or more tracking coils) or ultrasonic trackers tracked by a suitable electromagnetic or ultrasonic tracking system.

[0073] Continue to refer to Figure 2A The optical tracker 140 is detachably coupled to the first device portion 100 in a rotatably fixed manner (e.g., via a plug-in connection). In other examples, the optical tracker 140 may be clamped to the first device portion 100. The optical tracker 140 is rigidly (but detachably) coupled to the operating member 110 such that the operating member 110 about the longitudinal axis A L The rotation of the optical tracker 140 causes a corresponding rotation of the optical tracker 140. Referring to an example in which the coupling section 130 includes a gear, the optical tracker 140 may be located on either functional side of the gear.

[0074] Also there Figure 2B and Figure 2C It shows more details in the middle. Figure 2A The optical tracker 140 shown is illustrated. As shown, the optical tracker 140 includes a body 150 having a longitudinal axis A when attached to the coupling section 130. L The cylindrical shape is substantially hollow, with coaxially arranged cylindrical axes. The body 150 includes a plurality of optically detectable marks 152 on its outer surface. The optically detectable marks 152 are located on the body 150 and are arranged circumferentially in a pattern that defines the optically detectable marks 152 as seen from a given viewing direction, relative to the longitudinal axis A. L Different arrangements in different rotational states. The optically detectable mark 152 is a flat, passive mark and includes a reflective coating configured to reflect light of a specific wavelength (e.g., infrared (IR)).

[0075] The optical tracker 140 further includes a cover layer 154. (As...) Figure 2C As shown, the overlay 154 is transparent (e.g., in the infrared and / or visible spectrum) to protect the optically detectable mark 152 from damage while remaining optically detectable when the tracker body 150 is covered by the overlay 154. In other examples, the overlay 152 is transparent only in the area where the optically detectable mark is located. Figure 2B The cover layer 154 shown is configured to be detachably attached to the tracker body 150. The detachable cover layer 154 enables, for example, cleaning, disinfection, and maintenance of the body and the optically detectable marker 152 located on the body 150. In other examples, the cover layer 154 is fixedly attached to the body 150.

[0076] In another variation not shown in the accompanying drawings, the optically detectable mark 152 may be located on the inner surface of the cover layer 152. For example, the cover layer 154 may have a recess on its inner surface, in which the optically detectable mark 152 is located.

[0077] Figure 2D An embodiment of a first device portion 100 with an alternative arrangement of an operating member 110 and a first optical tracker 140 is shown. In this embodiment, the operating member 110 is perpendicular to the longitudinal axis A. L Extended, and the first optical tracker 140 is rigidly attached to the first device portion 100 and relative to the longitudinal axis A L Positioned opposite to the operating components. The first optical tracker 140 includes four optical tracking elements 144 arranged on a cross-shaped mount 146 at the end of each arm. The optical tracking elements 144 are implemented as passive tracking elements in the form of spheres with a reflective coating. Optical sensors (e.g., monocular cameras or stereo cameras, in...) Figure 2D (Not shown in the image) can track the movement of the optical tracking element 144, and can calculate and derive the corresponding rotation of the surgical device 10 based on the tracked movement.

[0078] Figure 2E A variation of an embodiment of a first device portion 100 having a drive member 160 and a coupling section 130 is shown. The coupling section 130 includes a radially inner drive 170 and a radially outer drive 180 (see also...). Figure 3B The radial direction is relative to the longitudinal axis A. LDefined. Drive member 160 is coupled to radial inner driver 170 and is movable relative to radial outer driver 180 such that movement of drive member 160 causes corresponding movement of inner driver 170 relative to outer driver 180. Actuating member 110 is rotatably fixed to inner driver 170 and outer driver 180. It should be noted that in some embodiments, the axial positions of drive member 160 and optical tracker 140 can be switched such that drive member 160 is closer to actuating member 110 than optical tracker 140.

[0079] Drive component 160 along longitudinal axis A L It has at least two, specifically three, predefined positions. Therefore, the internal driver 170 also has at least two, specifically three, predefined positions relative to the external driver 180. In this embodiment, the actuating member 120 is provided by a combination of the end regions of the internal driver 170 and the end regions of the external driver 180.

[0080] like Figure 3A and Figure 3B As schematically shown, axial movement of the internal actuator 170 selectively controls engagement of the implant portion via the actuating member 120. For example, in a first or contracted axial position (e.g. Figure 3A As shown in the diagram, the internal actuator 170 can disengage from the implant portion. In this first position, operation of the actuating member 110 can cause the implant, including the implant portion, to expand rearward. In a second or extended axial position (not shown), the external actuator 180 can disengage from the implant portion. In this second position, operation of the actuating member 110 can cause the implant, including the implant portion, to expand forward. In the retracted axial position, the actuator 160 can be closer to the actuating member 110 than in the extended axial position. In a third predefined position (e.g., ... Figure 3B As shown in the diagram, both the internal actuator 170 and the external actuator 170 can engage with the implant portion. In this third position, operation of the operating member 110 can cause the implant, including the implant portion, to symmetrically expand its height.

[0081] In one embodiment, the functions of the drive member 160 and the first optical tracker 140 can be integrated into a single component (not shown) to reduce the number of components in the surgical device 100 while maintaining the functionality described herein. For example, the drive member 160 can be configured to additionally function as the first optical tracker 140. In this embodiment, the drive member 160 may include a body, a cover for the body, and one or more optically detectable markers disposed between the body and the cover. Furthermore, the drive member 160 can be coupled to the actuation member 110 such that operation of the actuation member 110 causes the drive member 160 to revolve around a longitudinal axis A relative to the axis. L Rotate.

[0082] Figure 3A A front view of the external actuator 180 is shown. The tip of the external actuator 180 is configured as an external portion of the actuating member 120 to cooperate with an implant capable of being actuated by the surgical device 10. Reference will be made below. Figures 6A to 6C Describe the implant in more detail.

[0083] Figure 3A The tip of the external actuator 180 shown has a generally cylindrical shape, wherein the inner surface of the tip has an actuation profile configured to cooperate with a first portion of the implant in a torque-resistant manner (i.e., such that the first implant portion cannot rotate relative to the external actuator 180). More specifically, although the inner tip surface has an undulating profile in the circumferential direction, other profiles (e.g., an inner square) will serve the same purpose.

[0084] Figure 3B A front view of the external drive 180 and the internal drive 170 is shown. (As shown from...) Figure 3B It becomes apparent that the tip of the internal actuator 170 is configured as an internal portion of the actuating member 120 and includes an actuation profile configured to cooperate with a second portion of the implant in a torque-resistant manner (i.e., such that the second implant portion can rotate relative to the external actuator 180 when the actuating member 120 is rotated). More specifically, while the tip of the internal actuator 170 has an outer surface with an undulating profile in the circumferential direction, other profiles (e.g., an outer square) will serve the same purpose.

[0085] Figure 4 It shows Figure 1A and Figure 1BThe second device portion 102 of the surgical device 10. The second device portion 102 includes a shaft 210 having a distal first shaft portion 212 configured for insertion into a patient and a proximal second shaft portion 214 configured to be located outside the patient when the first shaft portion 212 is inserted into the patient. The shaft 210 has a generally tubular configuration such that it defines a channel through the first shaft portion 212 and the second shaft portion 214 to coaxially receive the first device portion 100 (see [link to original text]). Figure 1B ).

[0086] The first shaft portion 212 includes two actuated claws 216 located on opposite sides of the distal tip of the first shaft portion 212 and configured to detachably grasp the implant. Figure 4 Not shown in the text, see below. Figures 6A to 6C A claw 216 is configured to temporarily attach the implant to the first axial portion 212. The claw 216 is configured to be relative to the longitudinal axis A. L The movement is substantially perpendicular between a closed position in which the implant is grasped and an open position in which the implant is not grasped. The claw 216 can be coupled to an operating mechanism. Movement of the operating mechanism toward the implant opens the claw 216, and the grasped implant is released. Movement in the opposite direction closes the claw 216, and the implant is grasped by the claw 216.

[0087] The second device portion 102 further includes a handle portion located at its proximal end. A second optical tracker 220 is rigidly but detachably coupled to a second shaft portion 214 in the region of this handle portion. Due to the rigid coupling of the second optical tracker 220 to the second shaft portion 214 of the second devices 123, 102 and the rigid coupling of the first optical tracker 140 to the first device portion 100, the two trackers 140, 220 move relative to each other when the two device portions 100, 102 move relative to each other. Thus, the two trackers 140, 220 allow the relative movement between the two device portions 100, 102 to be determined by a surgical navigation system with optical tracking capabilities.

[0088] exist Figure 4 In the example, the optical tracker 220 includes four optical tracking elements 222 arranged on a cross-shaped mount 224 at the end of each arm. The optical tracking elements 222 are implemented as passive tracking elements in the form of spheres with a reflective coating.

[0089] Figure 5A and Figure 5B Two different views of the system are shown, the system comprising, as... Figure 1BThe surgical device 10 is shown in the connected state, along with an actuable implant 300 detachably connected to the surgical device. More specifically, the implant 300 is held by a claw 216 to the distal end of the second shaft portion 212. The implant 300 is configured to be actuated by an actuating member 120 when the operating member 110 is operated by one hand and the shaft 210 is held stationary by the other hand (as will be described in more detail below).

[0090] It will be understood that the operating component 110 revolves around the longitudinal axis A. L The rotation causes a corresponding rotation of the actuating member 120 and the first optical tracker 140. Because the shaft 210 with the second optical tracker 220 is kept stationary, the first optical tracker 140 rotates relative to the second optical tracker 220, making this relative rotation detectable by the optical sensors of the surgical navigation system. Because the actuating member 120 is about the longitudinal axis A... L The rotational actuation of the actuating member 120 is coupled to the actuating implant 300, and because the rotation of the actuating member 120 corresponds to the rotation of the first optical tracker 140, the rotational movement of the first optical tracker 140 has a predefined relationship with the actuating movement of the actuating implant 300. In one example, this predefined relationship is given by the change in the size of the actuating implant 300 with respect to the rotational angle covered by the rotational movement of the first optical tracker 140 (e.g., mm / °). The relationship can also be given with respect to the relationship between the discrete (e.g., binary) actuation state change of the implant 300 (e.g., contraction / extension) or any combination of changes in the size and state of the implant 300 and the rotational angle covered by the actuating member 110 and therefore the rotational movement of the first optical tracker 140.

[0091] In one example, if the covered rotation angle is greater than 359°, the number of full rotations can be counted automatically (e.g., by a computing system connected to the optical sensors of the surgical navigation system). In another example, the first optical tracker 140 is configured to change its position along the longitudinal axis A for each full rotation. L The position allows the number of complete laps to be measured (e.g., derived from the distance between the first optical tracker 140 and the second optical tracker 220).

[0092] Figures 6A to 6C A detailed view of the actuable implant 300 is shown. Figure 6A The rear view shows an actuable implant 300, with emphasis on the first portion 310 and the second portion 320 of the implant 300, which are configured to cooperate with the first shaft portion 212 and the actuation member 120, respectively.

[0093] The first portion 310 of the implant 300 includes two notches 312 on opposite sides of the first portion 310. The notches 312 are configured to correspond to the claws 216 of the surgical device 10. Figures 6A to 6C Not shown in the image; see examples. Figure 4 The first portion 310 of the implant 300 is rigidly and releasably coupled to the first axial portion 212.

[0094] The first portion 310 of the implant 300 has a centrally located, substantially cylindrical cavity configured to receive the substantially cylindrical tip of the first axial portion 212 and having a matching, undulating outer profile. A second portion 320 of the implant 300 is located at the center of the substantially cylindrical cavity of the first portion 310 and is configured to cooperate with the actuating member 120 via a matching, undulating inner profile. In this example, actuation of the actuating member 120 causes the second portion 320 to rotate relative to the first portion 310 of the implant 300. This rotation of the second portion 320 further results in a change in the actuated state of the implant 300, specifically a change in size (here: the height of the implant 300).

[0095] Figure 6B A side view of the implant 300 is shown, with emphasis on a mechanism configured to actuate (here: expand or contract) at least a portion of the implant 300 relative to the first axial portion 212 when the second portion 320 of the implant 300 is actuated by the actuating member 120. Figure 6B In the view, implant 300 includes an actuable upper implant portion 330 and an actuable lower implant portion 340, each including a guide portion, the guide portions being configured to define a direction of actuated movement of implant portions 330, 340 either away from each other (expansion) or toward each other (contraction). Each guide portion includes a slit-like guide opening 350, 360. The guide openings 350, 360 cooperate with a guide pin 370 extending into the guide openings 350, 360 for guiding movement of implant portions 330, 340.

[0096] Figures 6D to 6F Each shows the drive member 160 along the longitudinal axis A L A schematic side view of the implant 300 in the corresponding position. Each side view refers to a different engagement of the implant 300 with the actuating member 120, such as... Figure 3A and Figure 3B As exemplarily illustrated, the engagement of the implant 300 and the actuating member 120 depends in each case on the drive member 160 along the longitudinal axis A. L The location.

[0097] exist Figure 6D In the middle, the driving component 160 is located along the longitudinal axis A L In the first position, the implant 300 is configured to expand or contract backward. Figure 6E In the middle, the driving component 160 is located along the longitudinal axis A L In the second position, the implant 300 is configured for anterior expansion or contraction. Figure 6F In the middle, the driving component 160 is located along the longitudinal axis A L In the third position, the implant 300 is configured for symmetrical height expansion or contraction.

[0098] Figure 7 Block diagram 400 illustrates a computer-implemented method embodiment for determining the actuation of the actuating member 120 of the surgical apparatus 10 described above. (See also...) Figure 8 and Figure 9 Explanation of the method implementation examples.

[0099] Figure 8 A schematic representation of a computer program product 500 having code 510 executable by a processor of a computer 520 is shown. The code is configured to cause the processor to perform a method embodiment when executed by the processor. The computer 520 may belong to a surgical navigation system, such as those commonly used in computer-aided surgery.

[0100] Figure 9 It shows a device connected to a computer 520 (see...) Figure 8 A schematic representation of such a surgical navigation system, comprising an additional optical sensor 415 and a display 600 also connected to a computer 520. The surgical navigation system is configured to visualize at least an actuable implant 300 and optionally at least a portion of a first axis portion 212 on the display 600.

[0101] Now refer to it again Figure 7 In step 410, computer 520 determines the longitudinal axis A of the first optical tracker 140 about the axis 210 defined by the surgical device 10. I The position. In one example, determining the position can be performed automatically via optical sensor 415 and computer 520. Based on data from optical sensor 415, in some cases, computer 520 tracks changes in the arrangement of different optically detectable markers 152 of first optical tracker 140 from a given viewing direction (e.g., relative to second optical tracker 220). In this way, the position of first optical tracker 140 around longitudinal axis A is determined. L The position has changed.

[0102] In step 420, computer 520 determines the actuation of actuation member 120 based at least on the position of the first optical tracker 140 and optionally other information. As an example, based on data from optical sensor 415, computer 520 can continuously track different arrangements of the optically detectable markers 152 of the first optical tracker 140. Any newly received data is compared with previously received data. The comparison can be performed in real time. If a difference is determined between the data, the first optical tracker 140 rotates around the longitudinal axis A. L The first optical tracker 140 rotates, and thus the actuating member 120 is actuated. If the difference between the data cannot be determined, the first optical tracker 140 does not rotate or stops rotating, and therefore the actuating member 120 is not actuated or stops rotating. Thus, the continuous comparison of the received results makes it possible to determine the start and end of the actuation, and to determine the rotation angle covered by the first optical tracker 140 during the determined actuation period (e.g., relative to the second optical tracker 220).

[0103] Additionally, the computer 520 can determine the actuation state of the implant 300 caused by actuation based on the determined rotation angle. Specifically, the resulting actuation state can be determined relative to a known initial state prior to actuation. Therefore, the known initial actuation state can be combined with the determined rotation angle to determine the subsequent actuation state of the implant 300. Specifically, the dimensional change of the implant 300 can be determined based on a predefined (e.g., functional) relationship between the first optical tracker 140 and the actuable implant 300, as pre-stored by the computer 520.

[0104] For visualization, image data of the surgical device 10 and the implant 300 can be pre-stored by the computer 520. The optical sensor 415 can track the movement of the first optical tracker 140 and the second optical tracker 220 and send the tracking-related data to the computer 520. The computer 520 receives and processes this data and accordingly visualizes the model of the surgical device 10 and the implant 300 on the display 600.

[0105] exist Figure 10 In the exemplary display view shown, visualization includes visualizing the implant 300 with respect to registered 3D image data of the patient to assist the surgeon during surgery. The patient's image data may also be pre-stored by the computer 520. Additionally, the patient's position may be tracked via an attached optical patient tracker. Real-time visualization may include tracking the movement of both the patient and the surgical device 10 and translating the tracked movement into visualization on the display 600.

[0106] Figure 11A and Figure 11BA schematic representation of the visualization of a registered three-dimensional image data of an actuable implant 300 (and optionally at least a portion of the first axial portion 212) for spinal intervention on a display 600 is shown. Changes in the size of the actuable implant 300 are also visualized in real time. To visualize these changes in size, rotation of the optical tracker 140 is tracked by an optical sensor 415 and converted by a computer 520 according to the relationship between the rotational movement of the optical tracker 140 and the actuation of the implant 300, as described above.

[0107] Furthermore, assuming that the drive member 160 can also be tracked (e.g., because its function is assumed by the first optical tracker 140, or because the first optical tracker 140 is rigidly attached to the drive member 160, or because a separate third optical tracker is rigidly attached to the drive member 160), the drive member 160 along the longitudinal axis A L The position can be tracked, for example, by optical sensor 415 by tracking the axial distance between the first optical tracker 140 and the second optical tracker 220. The tracked position can be translated by computer 520 into a specific engagement of implant 300 and actuation member 120 to determine the type of expansion or contraction of implant 300 (e.g., posterior, anterior, or symmetrical expansion or contraction as described above) for subsequent visualization. As an alternative to tracking the position of actuation member 160 by means of optical sensor 415, the position of actuation member 160 can be, for example, manually entered into computer 520 via graphical user interface (GUI).

[0108] The conversion result is based on the rotation of the optical tracker 140, and optionally based on the drive member 160 along the longitudinal axis A. L The system determines and applies dimensional changes to the implant model visualized on the display 600 based on the location of the implant. All the visualizations described above can be performed in real time.

[0109] As will become apparent from the foregoing description of exemplary embodiments, the surgical apparatus presented herein includes an optical tracker that rotates relative to a longitudinal axis when the surgical apparatus is operated. This rotation can be translated into, for example, actuated movement of an implant. The actuated movement can also be visualized, although it is not observable in itself.

[0110] It will be understood that this disclosure is not limited to detecting actuated movement of an implant. Rather, the surgical device may have actuating components for collecting tissue or performing any other surgical task, and may also visualize the state of that task as described above.

Claims

1. A surgical device, comprising: A shaft defining a longitudinal axis and a channel, the shaft having a first shaft portion configured to be inserted into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted into the patient; An actuating member that can be actuated relative to the first shaft portion; An operating member, which can be operated relative to the second axis portion, is configured to actuate the actuating member when operated; and An optical tracker, connected to the operating member, such that operation of the operating member causes the optical tracker to rotate relative to the axis, wherein... The optical tracker includes: The body, which is arranged or configured to be coaxial with the longitudinal axis of the shaft, and has a substantially cylindrical shape with a cylindrical axis; and Multiple optically detectable marks are located on or within the body and are arranged in a pattern that defines different arrangements of the marks as observed from a given viewing direction in different rotational states of the optical tracker relative to its longitudinal axis, wherein at least some of the marks are spaced apart from each other in a circumferential direction around the longitudinal axis. The operating member is connected to the actuating member via a connecting section extending into the channel, the connecting section including an internal driver and an external driver, the internal driver and the external driver being configured to move relative to each other from a predefined first axial position to at least a predefined second axial position in an axial direction relative to the longitudinal axis. At least one of the internal driver and the external driver is configured to include or cooperate with the actuation member to achieve different actuation modes based on the positions of the internal driver and the external driver relative to each other in the connection segment.

2. The surgical device according to claim 1, wherein, The optical tracker is detachably attached to the surgical device.

3. The surgical device according to claim 1, wherein, The operation of the operating component causes the optical tracker to rotate relative to the longitudinal axis.

4. The surgical device according to claim 1, wherein, There is a predefined relationship between the movement of the optical tracker as one aspect and the actuation movement of one of the actuation components and the actuable implant (300) detachably connected to the actuation component as another aspect.

5. The surgical device according to claim 4, wherein, The predefined relationship associates a change in the position of the optical tracker caused by its movement with a change in the size or state of one of the actuating member and the actuable implant detachably connected to the actuating member caused by the actuating movement.

6. The surgical device according to claim 1, wherein, The operating component is capable of rotating around the longitudinal axis.

7. The surgical device according to claim 1, wherein, The optical tracker is rigidly coupled to the operating member or configured to be rigidly coupled to the operating member.

8. A system comprising: The surgical device according to claim 1; and An implant configured to be actuated by the actuating member from a first actuation state to a second actuation state.

9. A computer program product having program code for implementing, when executed by a processor, a computer-implemented method for determining actuation performed by means of a surgical apparatus, the surgical apparatus comprising: A shaft defining a longitudinal axis and a channel, the shaft having a first shaft portion configured to be inserted into a patient and a second shaft portion configured to be located outside the patient when the first shaft portion is inserted into the patient; An actuating member that can be actuated relative to the first shaft portion; An operating member, which can be operated relative to the second axis portion, is configured to actuate the actuating member when operated; and An optical tracker, connected to the operating member, such that operation of the operating member causes the optical tracker to rotate relative to the axis, wherein... The optical tracker includes a plurality of markers arranged in a pattern that defines different arrangements of the markers in different rotational states of the optical tracker relative to its longitudinal axis, as observed from a given viewing direction. The operating member is connected to the actuating member via a connecting section extending into the channel, the connecting section including an internal driver and an external driver, the internal driver and the external driver being configured to move relative to each other from a predefined first axial position to at least a predefined second axial position in an axial direction relative to the longitudinal axis. Wherein, at least one of the internal driver and the external driver is configured to include or cooperate with the actuation member to achieve different actuation modes based on the positions of the internal driver and the external driver relative to each other in the connection segment; The method includes: The actuation mode is determined based on the position of the internal driver and the external driver relative to each other in the connection segment; Determine the rotational state of the optical tracker; and Actuation of at least one of the actuating member and the implant detachably coupled to the actuating member is determined based at least on the rotational state and actuation mode of the optical tracker.

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