Positioning assistance system for positioning a medical technical device

Abstract

The invention relates to a positioning aid system for positioning a medical technical device on the basis of at least one medical image. Here, the at least one medical image is detected by means of a magnetic resonance tomography device. Here, the positioning aid system is designed for placement onto a surface. Here, the positioning aid system comprises at least one channel for the medical technical device. Here, the channel forms a first angle with the surface normal which is acute. Here, the channel is penetrable by means of the medical technical device. Here, the channel is filled with a water-containing medium. Here, the medical technical device in the water-containing medium can be shown in the medical image.

Description

Technical Field

[0001] This invention relates to a positioning assistance system for locating medical technology devices based on at least one medical image. The invention also relates to a method for locating medical technology devices using the positioning assistance system. Background Technology

[0002] It is known that minimally invasive surgery is performed in medicine using image support. This is achieved through imaging, particularly real-time imaging monitoring of the surgery. During imaging, at least one medical image is detected. It is known that imaging is performed using a magnetic resonance imaging (MRT) device. In other words, it is known that medical images are detected using an MRT device during minimally invasive surgery.

[0003] Minimally invasive procedures may include, for example, biopsies and / or ablation and / or catheter insertion and / or brachytherapy. In minimally invasive surgery, a suitable medical device for performing the procedure is introduced into the patient. The medical device is then guided along a path to the target area where the surgery will be performed. For this, precise positioning of the medical device is essential. Positioning here includes introduction at a predetermined, defined angle into a suitable surgical location. In particular, subsequent repositioning of the medical device should be avoided so that the procedure can be performed efficiently and as carefully and painlessly as possible for the patient.

[0004] It is known that medical technology devices are typically invisible in magnetic resonance imaging (MRT) without the addition of contrast agents or contrast agent solutions. Therefore, when a medical technology device has been introduced into a patient, it is typically only visible in medical images obtained using an MRT device. Within the patient's tissue, the medical technology device becomes visible in the medical images as an artifact due to the compression of tissue through it. Furthermore, when a medical technology device includes a magnetizable metal, it exhibits magnetic field distortion around the device. This magnetic field distortion is generated by a decrease in signal strength around the magnetizable metal. This magnetic field distortion is visible in the medical images as an artifact. In particular, the magnetic field distortion produces dark areas around the location of the medical technology device in the medical images.

[0005] For this reason, the location, especially position and / or angle, of medical technology devices cannot usually be examined using MRT imaging before they are introduced into patients.

[0006] It is known to mark locations and / or angles with a finger and examine them on medical images to determine if the marked locations or angles are suitable for minimally invasive surgery. However, this method is cumbersome and imprecise because fingers are typically significantly larger than medical technology equipment. Furthermore, it is troublesome for radiologists to simultaneously mark locations and / or angles with a finger and examine them on medical images. The additional personnel required for marking locations and / or angles imply additional personnel costs.

[0007] In an alternative approach, the planned location for introducing a medical technology device is marked or projected onto the patient using at least one laser. This location can then be marked using a marker visible in a medical image and examined within that image. The angle at which the medical technology device should be introduced must be estimated in this method. Examining the angle before introducing the medical technology device into the patient is not feasible.

[0008] Another alternative is to use a grid, which is positioned on the patient relative to the target area. The grid here comprises multiple channels, marked by markers visible in medical images. To perform the procedure, one of the grid's channels can be selected, and a medical device is introduced into the patient through the selected channel. The channels are typically configured such that the medical device is introduced perpendicularly into the patient. Thus, the position and angle of the medical device relative to the patient are constrained by the discrete grid. Furthermore, it is necessary to optimally position the grid relative to local coils to ensure that the grid is visible in the medical images. The positioning of the grid and local coils can sometimes be costly and time-intensive. Summary of the Invention

[0009] Therefore, the object of the present invention is to provide a system that enables flexible and monitorable positioning of medical technology devices used to perform minimally invasive surgery with respect to position and angle, using MRT imaging.

[0010] The objective is achieved by a positioning assistance system for locating a medical technology device based on at least one medical image and a method for locating the medical technology device by means of a positioning assistance unit. Advantageous improvements are set forth in the following description.

[0011] The solution according to the invention, relating to the claimed device and the claimed method, is described below. The features, advantages, or alternative embodiments mentioned herein are also applicable to other claimed subjects, and vice versa. In other words, embodiments of the object (e.g., those oriented towards the device) are also improved by incorporating the features described or claimed in conjunction with the method. The corresponding functional features of the method are constituted herein by corresponding modules of the object.

[0012] This invention relates to a positioning assistance system for locating a medical device based on at least one medical image. Here, the medical image is, in particular, a magnetic resonance imaging (MRI) scan image. Here, the positioning assistance system is configured for placement onto a surface. Here, the positioning assistance system includes at least one channel for the medical device. Here, the channel is formed at a first angle, acute, to the surface normal. Here, the channel can be pierced by the medical device. Here, the channel is filled with an aqueous medium. Here, the medical device in the aqueous medium is visible in the medical image.

[0013] In particular, the medical device is configured for introduction into an object. In other words, the medical device is configured for introduction into a material constituting the object. Here, the medical device is introduced into the material through a surface. In other words, the medical device pierces the surface when introduced into the material. The surface here constitutes the outer skin of the object. The material can be tissue, particularly human or animal tissue. The object can then be a patient. In other words, the medical device can be introduced into a patient. Here, the patient can be human or animal. The surface then corresponds to the patient's skin.

[0014] Medical technology devices are configured here for performing minimally invasive surgery. These devices may, in particular, include biopsy needles or catheters, endoscopes, ablation systems, or radiation sources for brachytherapy. They may, in particular, be at least partially constructed of metals, such as titanium, medical-grade stainless steel, and / or plastics. Specifically, they may be constructed of non-magnetic or only weakly magnetizable materials.

[0015] When a medical device is introduced into an object, the device must have a predetermined location or orientation. Location is defined here by the position of the medical device relative to the object and / or by the angle of the medical device relative to a surface. Optionally, location may also include angles that give the rotation of the medical device about the surface normal, which is the axis of rotation. In other words, the location of the medical device may optionally be given in spherical coordinates. Here, the rotation about the surface normal, which is the axis of rotation, is described by an azimuth angle. In other words, the azimuth angle describes the angle by which the medical device rotates about the surface normal, which is the axis of rotation. The angle relative to the surface gives the polar angle in spherical coordinates. Location can be optimally selected for minimally invasive surgery. In particular, location may be associated with a target area of ​​the object in which minimally invasive surgery should be performed. In particular, location may also be associated with one or more potentially critical areas through which the medical device traverses the path from the surface to the target area. Critical areas may be, for example, areas and / or organs with increased bleeding risk.

[0016] Medical images are detected using magnetic resonance imaging (MRT) equipment. In other words, medical images are magnetic resonance (MR) images or MRT images. Specifically, MRT images map nuclear spin density distribution, preferably protons in water. Medical images can particularly map at least a portion of an object. Specifically, medical images can map the following regions or portions of the object, into which medical technology equipment should be incorporated. Medical images can map at least a portion of the object in two dimensions or three dimensions. In other words, medical images can be three-dimensional medical images or two-dimensional medical slice images. Medical images can thus include multiple pixels or voxels. Multiple pixels can be arranged in a two-dimensional pixel matrix. Multiple voxels can be arranged in a three-dimensional voxel matrix.

[0017] Medical technology devices are either invisible or only very faintly visible in medical images. They are only indirectly visible, particularly when introduced into and extruded from materials visible in medical images.

[0018] A positioning assistance system is configured for placement onto a surface. For this purpose, the positioning assistance system may include a contact surface configured for contacting or placing onto the surface. In particular, the contact surface may conform to or fit a shape formed on the surface. In other words, the contact surface may be configured as a negative shape of the surface. For example, the contact surface may include a 4cm... 2 and 400cm 2 The area between them. In particular, the contact surface can include 4cm. 2 25cm 2 100cm 2 225cm 2 Or 400cm 2 The area. The positioning assistance system can be perpendicular to the contact surface and include a thickness between 0.5 cm and 5 cm. For example, the positioning assistance system perpendicular to the contact surface can include a thickness of 0.5 cm, 1 cm, 2 cm, 3 cm, 4 cm, or 5 cm.

[0019] Placement onto a surface is particularly describable, where the positioning aid system is placed onto a surface. In alternative embodiments, placement of the positioning aid system may additionally include securing the positioning aid system to the object using a strap. In alternative embodiments, placement of the positioning aid system may additionally include bonding the positioning aid system to the object or to the surface of the object. In alternative embodiments, placement of the positioning aid system may additionally include securing the positioning aid system to the surface using a suction system, particularly a suction cup.

[0020] The positioning assistance system includes at least one channel. The channel may have a circular, square, oval, elliptical, or rectangular cross-section. In other words, the channel may have a circular, square, oval, elliptical, or rectangular cross-section. Alternatively, the cross-section of the channel may form any polygon. The channel is particularly elongated or tubular. Preferably, the channel extends or stretches along the axis or centerline of a straight line. The centerline describes the orientation of the center of the channel. In other words, the orientation of the channel may be defined by the centerline of its straight line. The channel extends at a first acute angle about the surface normal. The surface normal is perpendicular to the surface. In particular, the surface normal is perpendicular to the contact surface of the positioning assistance system. The surface normal is also referred to below as the surface normal. The first acute angle is enclosed by the surface normal and the channel. The channel may be represented by the centerline passing through the center of the channel. In other words, the surface normal and the centerline enclose the first acute angle. The first acute angle is between 0° and 90°. Below, the first angle of the acute angle can also be 0°. Alternatively, the first angle of the acute angle can be, for example, 1°, 3°, 5°, 10°, 20°, 25°, or 50°. The orientation of the channel or centerline can also optionally be described by the rotation of the channel or centerline about the surface normal to the surface that serves as the axis of rotation. The rotation can here be given as an angle parallel to the surface. In this case, the orientation of the channel in spherical coordinates can be given. Here, the first angle of the acute angle describes the polar angle in spherical coordinates. The rotation about the surface normal that serves as the axis of rotation is described by the azimuth angle.

[0021] The channel is configured such that a medical device can penetrate or pierce the positioning aid system at a location within the channel. In other words, the medical device can reach or be guided to the surface through the channel. Conversely, the medical device can be guided through or pierce the channel before being introduced onto the surface or into the material bounded by the surface. The location of the medical device can be either the location where the medical device pierces the contact surface or the location where the medical device pierces the surface of the positioning aid system opposite to the contact surface. Here, the surface opposite to the contact surface can be oriented parallel to the contact surface. Alternatively, the surface opposite to the contact surface can be oriented at an angle to the contact surface.

[0022] The channel is filled with an aqueous medium. This aqueous medium can, in particular, have a gelatinous or jelly-like consistency. In other words, the aqueous medium can be configured such that it remains within the channel and does not flow out. Specifically, the consistency of the aqueous medium can be configured such that it can be punctured by a medical device. Furthermore, the consistency of the aqueous medium can be configured such that it stabilizes the positioning of the medical device after puncture. Positioning can then be changed only by applying force. The aqueous medium can, in particular, be a gel. In other words, the aqueous medium can have a gel-like consistency. Specifically, the gel can be a dispersion system. The gel can comprise at least two components. These two components can be a solid component and an aqueous component. The solid component can form a sponge-like three-dimensional network. The pores of the network can be filled by the aqueous component. This gel can be called a hydrogel. In other words, the aqueous medium can be a hydrogel. The aqueous medium can be shown in medical images. In other words, the aqueous medium can be shown using MRT imaging. In other words, the aqueous medium generates a signal in MRT imaging, which can be detected and displayed in medical images.

[0023] In this context, "puncture" means that the medical device can puncture a water-containing medium and guide it through a channel in such a way. In other words, the medical device can at least partially squeeze and / or compress the water-containing medium so that the medical device can guide it through the channel, traverse the channel, or puncture the channel.

[0024] The presence of an aqueous medium, compressed by the medical technology device, is visible or can be shown in the medical image. Furthermore, as described above, the magnetic field distortion around the medical technology device caused by signal degradation is visible in the medical image. Signal degradation occurs when the medical technology device includes a magnetizable metal. In this way, grounding of the medical technology device in at least one channel is visible in the medical image.

[0025] The inventors have recognized that, in this way, the medical device is visible in a medical image before puncturing the surface or before introducing material. The medical device can thus be introduced into the channel, and its positioning relative to the surface, i.e., particularly the position and angle of the medical device, can be examined or analyzed within the channel. Position and / or angle can thus be corrected without having to introduce the medical device into the material or object or into the patient. Repositioning is thus feasible without having to puncture the patient multiple times. This avoids the need for repeated sterilization of the medical device due to multiple introductions into the material. In medical applications, this leads to improved patient comfort and results in acceleration or time savings during minimally invasive procedures.

[0026] According to one aspect of the invention, the medical device is a biopsy needle.

[0027] A biopsy needle can be configured for tissue sampling. Here, the material can be tissue, particularly human or animal tissue. The biopsy needle can be, for example, a syringe. The biopsy needle can be rigid or flexible. The biopsy needle may include a sharp or blunt tip. In embodiments of the invention, the biopsy needle can be positioned at a guide wire.

[0028] The inventors have recognized that biopsy needles can be optimally positioned before being introduced into the patient through the surface, aided by a positioning assist system. They have also recognized that this method can particularly improve or optimize patient comfort. Furthermore, time can be saved because multiple punctures of the patient with the biopsy needle result in repeated sterilization of the needle due to repositioning. Additionally, material consumption can be reduced because a biopsy needle already introduced into the patient may not be reusable. By examining the positioning, particularly the position and / or angle of the biopsy needle within the channel, the need for multiple introductions into the patient can be avoided.

[0029] According to another aspect of the invention, the aqueous medium includes at least one of the following materials: pectin, galanthine, agarose, polyacrylamide, and polyurethane polymer.

[0030] The materials mentioned can be used to form an aqueous medium with the desired consistency.

[0031] In particular, the aforementioned solid component of the aqueous medium may include at least one of the aforementioned materials. Specifically, the material may be configured to bind the liquid component or to contain the liquid component within its pores as described above. The liquid component here may in particular be water, especially distilled water.

[0032] The inventors have recognized that the material is suitable for forming an aqueous medium with a desired consistency. The inventors have recognized that the material can incorporate liquid components. The inventors have also recognized that the material is suitable, and particularly permissible, for medical applications. The inventors have recognized that the material, alone or in combination with liquid components, is visible in medical images. In other words, the inventors have recognized that the material, alone or in combination with liquid components, can be shown through MRT imaging. Thus, medical technology devices are visible in MRT images when introduced into an aqueous medium comprising at least one of the aforementioned materials.

[0033] According to another aspect of the invention, a medical device is coated with a polymeric catalyst. Here, the aqueous medium comprises at least one polymerizable component. Here, the aqueous medium hardens after being punctured by the medical device.

[0034] Aqueous media harden through the polymerization of the aqueous medium itself or its polymerizable components. In other words, the aqueous medium polymerizes after being punctured by a medical device. Alternatively, the polymerizable components of the aqueous medium polymerize through contact with a polymerization catalyst. Specifically, puncturing the channel or the aqueous medium initiates the polymerization of the aqueous medium. In other words, contact between the aqueous medium and the polymerization catalyst initiates the polymerization of the aqueous medium.

[0035] The polymerization catalyst can be a free radical initiator or a free radical-forming initiator. For example, the polymerization catalyst can be polyacrylamide or ammonium persulfate (APS) or a peroxide or azo compound. Alternatively, the polymerization catalyst can be an ionic initiator.

[0036] The polymerizable components herein particularly include monomers of the polymer, which are polymerizable components or aqueous media that are hardened into said polymer. Monomers herein are characterized in particular by having at least one double bond. Polymerizable combinations may particularly include dicarboxylic acids and polyols (e.g., glycerol) or diphenyl carbonate and aromatic glycols or vinyl chloride or ethylene.

[0037] "After puncture" in this context means that polymerization occurs particularly slowly, allowing the medical device to puncture or be guided through the channel before it fully hardens. In other words, the medical device can still be positioned within the channel before it hardens.

[0038] In the hardened state, the aqueous medium can be configured such that at least the angle of the medical device in the channel is fixed. In other words, the angle is no longer variable. The angle of the medical device is described by the angle that the medical device occupies relative to the surface. In particular, the position of the medical device relative to the positioning aid system is also fixed or immutable in the fully hardened state. If the positioning aid system does not move relative to the surface, then the position of the medical device relative to the surface is also fixed in the fully hardened state. In other words, in the fully hardened state, the positioning of the medical device can be fixed. Thus, in the hardened state, the medical device can only move forward and backward. In particular, the medical device can then be introduced into the object through the surface at a fixed angle and a fixed position.

[0039] The inventors have recognized that hardening prevents the medical device from slipping again after it has been punctured and associatedly positioned in the channel. In other words, guidance of the medical device in the channel can be provided through hardening. This ensures that the medical device persistently maintains the desired positioning or desired location and / or desired angle. In other words, the inventors have recognized that the positioning assistance system provides the possibility of providing guidance for desired positioning after the medical device has been first positioned in the channel as flexibly as possible. Here, the guidance is personalized for positioning the medical device.

[0040] According to another aspect of the invention, the positioning assistance system includes a holding device for a medical technology device. Here, the holding device is configured to stabilize the medical technology device at a second angle relative to the surface normal.

[0041] The second angle, as described above regarding "angle," defines the orientation or positioning of the medical device relative to the surface. The second angle is enclosed by the surface normal and the medical device. The second angle can be, in particular, an acute angle. The second angle can also be, in particular, 0°.

[0042] The second angle can here be equal to the first angle of the acute angle. In other words, the value of the second angle is equal to the value of the first angle of the acute angle. Specifically, the medical device can then be oriented parallel to the centerline of the channel. Alternatively, the medical device can rotate parallel to the surface relative to the centerline at an angle between 0° and 360°. In other words, the medical device and the centerline can rotate relative to each other about the surface normal.

[0043] Alternatively, the second angle may differ from the first acute angle. In particular, if the medical device and the midline rotate in the same manner relative to the surface normal, the medical device is also tilted relative to the channel or within the channel in this case. Specifically, the channel has a larger diameter than the medical device.

[0044] The orientation or location of the medical device and the midline can be given in polar coordinates as described above. Here, the first and second acute angles correspond to the polar angles or polar distances of the orientation in spherical coordinates, respectively. Rotation about the surface normal to the surface that serves as the axis of rotation can be described by azimuth angles. If the medical device and the midline are oriented parallel to each other, the first acute angle is equal to the second acute angle, and the corresponding azimuth angles are also equal.

[0045] The retaining device is configured to stabilize the medical device at a second angle. For this purpose, the retaining device can be configured as a support between the medical device and the positioning assistance system. Specifically, the retaining device is configured as a support between the medical device and the surface opposite the contact surface of the positioning assistance system.

[0046] In particular, the retaining device can be configured such that a medical device can be placed on a support. Specifically, the support can be adjustable such that it supports the medical device relative to the positioning aid system at an angle corresponding to 90° minus a second angle. The retaining device can be adjustable, particularly by means of a tensioning system or a screwing system. By means of a screwing system, the support of the retaining device can be moved further or closer, thereby changing the angle relative to the positioning aid system. Alternatively, the support can be tensioned by means of a spring. The angle of support of the support can be adjusted by adjusting the stress of the spring. The spring can be, for example, a leaf spring or a coil spring. In embodiments of the invention, the retaining device can be automatically adjustable. Specifically, the retaining device can include a motor configured to automatically set a first acute angle using the retaining device. Specifically, for this purpose, the support can be automatically adjusted. Specifically, the support can be automatically moved further or closer to adjust the first acute angle. Specifically, the support can be moved further away by means of a motor.

[0047] The inventors have recognized that the orientation or positioning of medical technology devices in a passageway can be stabilized by using a holding device. The inventors have also recognized that orientation or positioning can be undesirably unstable when manually holding a medical technology device. Furthermore, the inventors have recognized that by using a holding device, the operator guiding the medical technology device can put the device down, thus freeing their hands. The operator in this case can be, in particular, a physician or medical assistant.

[0048] According to another aspect of the invention, the positioning assistance system includes a plate. Here, the channel is configured as a hole in the plate.

[0049] The board can be made of plastic. In other words, the board can be made of plastic.

[0050] A hole can have two openings in the plate. In other words, the hole can extend laterally through the plate once. The hole forms openings, particularly in the contact surface of the positioning aid system and in the surface opposite to the contact surface of the positioning aid system. The hole can extend at a first acute angle to the surface normal, as described above with respect to the channel. Specifically, the centerline of the hole can form a first acute angle with the surface normal. Alternatively, the orientation of the hole, as described above, can be described using spherical coordinates. In particular, the hole can extend parallel to the surface normal.

[0051] The inventors have realized that channels, as holes in a plate, can be easily implemented. The inventors have realized that the plate provides a stable framework for the channels or holes. The inventors have realized that the plate can be easily and quickly placed onto a surface.

[0052] According to another aspect of the invention, the channel has a wider width than that of a medical device. Here, the channel can be punctured at a second angle to the surface normal.

[0053] In particular, the width of the channel is defined by the cross-sectional area or cross-section of the channel.

[0054] In particular, the width of the medical device is defined by the cross-sectional area or the width of the cross-section of the medical device. Specifically, the width of the cross-section of a channel or aperture may be greater than the width of the cross-section of the medical device. The width herein specifically describes the net width of the corresponding cross-section. The width is defined by the shortest distance between two opposing walls of the cross-section. These walls constitute the channel or describe the surface of the medical device. If the channel or medical device comprises a circular cross-section, the width may be defined by the diameter of the cross-section. If the channel or medical device comprises a square cross-section, the width may be defined by the side length of the cross-section. In particular, the width of the channel is two, three, four, ten, or twenty times the width of the medical device.

[0055] The second angle is constructed here, in particular, as described above. This applies here: the greater the width of the channel or aperture relative to the width of the medical device, the larger the second angle can be.

[0056] In particular, the second angle can be equal to the first angle of the acute angle. In other words, the value of the second angle can be equal to the value of the first angle of the acute angle.

[0057] Alternatively, the second angle may be different from the first acute angle. In other words, the magnitude of the second angle is different from the magnitude of the first acute angle. In particular, the medical device can then be oriented at an angle within the channel. In other words, the medical device can then be oriented at an angle or at an angle to the centerline of the channel with any rotation about the surface normal to the surface that serves as the axis of rotation. The maximum possible difference between the second angle and the first acute angle is determined by the ratio of the width of the channel to the width of the medical device and by the thickness preset by the positioning aid system.

[0058] The inventors have recognized that the width of the aperture or channel allows for greater flexibility in positioning medical devices within the channel. The greater the width of the channel compared to the width of the medical device, the more flexibly the position and / or secondary angle of the medical device within the channel can be selected or set.

[0059] According to another aspect of the invention, the channel is sealed with a membrane at both openings. Here, the membrane can be punctured using a medical device.

[0060] The openings here, in particular, are formed by holes, as described above. Each opening is sealed or closed with a membrane.

[0061] The film can be, in particular, a plastic film. The film can be at least partially connected to the plate. The film can be, in particular, at least partially or sectionally fused to the plate. The film can, in particular, be at least partially connected to the plate at the edge of the opening.

[0062] The membrane can be configured so thin that it can be punctured by medical devices. The membrane can also be configured such that when punctured by a medical device, it only creates a hole at the insertion site. In other words, the membrane can be configured so that it does not tear when punctured by a medical device.

[0063] In particular, the membrane can be configured to seal tightly against the medical device when punctured, preventing the leakage of aqueous media at the puncture site. Specifically, the membrane can be rubber-like and / or flexible.

[0064] The thin film of the opening of the channel in the contact surface of the sealing positioning aid system constitutes at least a portion of the contact surface between the positioning aid system and the surface.

[0065] The membrane is configured to prevent aqueous media from spilling or flowing out of the channel. Alternatively or additionally, the membrane prevents contamination and / or fouling by aqueous media.

[0066] The film can be made of polyester (PET), polycarbonate (PC), polyvinyl chloride (PVC), or polyethylene (PE).

[0067] The inventors have recognized that a membrane can prevent contamination and / or soiling and / or leakage from aqueous media in the channel. The inventors have also recognized that this method ensures the sterility of the positioning assistance system.

[0068] According to another aspect of the invention, the positioning assistance system includes multiple channels. Here, the multiple channels are arranged in a grid pattern on the board.

[0069] Each of the multiple channels can be configured as described above or according to the aspects described above.

[0070] The term "grid pattern" here can specifically refer to a checkerboard or honeycomb pattern.

[0071] In particular, each of the two channels is separated from the other by a wall. The wall is made of a plate. The wall can be of any thickness. The wall can be thicker or stronger than 0.1 mm. The wall can be thinner than 2 cm. For example, the wall can be 0.1 mm, 0.5 mm, 1 mm, 1.5 mm, 2 mm, 5 mm, 1 cm, or 2 cm thick.

[0072] The channels can all form the same acute angle about the surface normal. Alternatively, at least two of the multiple channels can form different acute angles about the surface normal. In particular, channels at the edge of the plate form a larger acute angle about the surface normal compared to channels more centrally located on the plate. In particular, the orientation of the different channels can differ at least partially in their rotation about the surface normal, which is the axis of rotation. In other words, the azimuth angles of the different channels can be at least partially different. In particular, all channels can, for example, be aligned with a point below the contact surface of the positioning aid system. In particular, at least one channel can then form a 0° acute angle about the center of the plate.

[0073] In an embodiment of the invention, the channels at the center of the plate are separated from each other by thinner walls compared to the channels located closer to the edge of the plate.

[0074] The inventors have recognized that using multiple channels allows for greater flexibility in the positioning of medical technology devices on a surface. In particular, the location can be chosen more flexibly. Specifically, the width of a single channel can be selected to be sufficiently small to ensure the stability of the plate without unduly restricting the placement of the medical technology device.

[0075] According to another aspect of the invention, the board includes a coupling device for coupling the board to a local coil, particularly a toroidal coil or a butterfly coil. Here, the local coil includes a mating member with the coupling device.

[0076] In particular, the board can be releasably coupled to the local coil. Here, the coupling device and its mating member can include plug-in and / or clamping devices or snap-fit ​​devices and / or screwing devices. Specifically, the coupling device can be plugged into and / or snap-fitted into or screwed onto the mating member. The board can be coupled to the local coil such that the board fills the opening of the local coil. Here, the local coil is particularly configured as a toroidal coil or a butterfly coil.

[0077] The inventors have recognized that directly coupling the plate to the local coil avoids the tedious positioning of the local coil relative to the plate. In particular, this can save time during the performance or preparation of minimally invasive surgery. The inventors have also recognized that this coupling ensures optimal positioning of the local coil relative to the plate, thereby optimally displaying the plate or at least one channel within the plate in medical images. This allows for simplified positioning of medical devices based on medical images using a positioning assistance system. Furthermore, the inventors have recognized that the plate can be removed after use, while the local coil can be reused multiple times. This may be necessary to meet medical hygiene standards.

[0078] According to another aspect of the invention, the width of the channel corresponds to the extension of the positioning assistance system parallel to the surface.

[0079] In other words, the channel or the cross-section of the channel includes the entire surface of the positioning assistance system or the contact surface of the positioning assistance system. In particular, the positioning assistance system thus includes exactly one channel.

[0080] The inventors have realized that the positioning of the medical device is most flexible if the width of the channel corresponds to the expansion of the positioning aid system. The inventors have realized that the position of the medical device is thus limited only by the area or expansion of the contact surface of the positioning aid system. The inventors have realized that the second angle of the medical device is thus limited only by the area or expansion of the contact surface of the positioning aid system and by the thickness of the positioning aid system.

[0081] According to another aspect of the invention, the channel is formed by a hollow column.

[0082] In particular, the walls of the hollow column form the walls of the channel. In other words, the channel has the shape of a hollow column. The hollow column can be configured as a "hollow" prism. The hollow column can include any cross-sectional area or any cross-section. For example, the hollow column can include a circular, square, elliptical, oval, or rectangular cross-section. In particular, the cross-section can form any polygon, especially a pentagon or quadrilateral. Alternatively, the cross-section can form a hexagon or octagon. The hollow column has two openings. The openings have the shape of a cross-section. In other words, the openings include cross-sections. One of the openings includes the contact surface between the positioning aid system and the surface.

[0083] The hollow column can be made of plastic, in particular, transparent plastic. Furthermore, the transparent plastic can be configured such that the medical device is visible through it as it enters the insertion channel. In particular, aqueous media can also be made transparent accordingly.

[0084] Alternatively, the hollow column can be made of metal. In particular, the metal can be non-magnetizable or slightly magnetizable.

[0085] Hollow columns can be constructed with a fixed shape. Alternatively, hollow columns can be constructed to be slightly deformable. In particular, hollow columns can then be constructed such that they are stable in a water-containing medium.

[0086] The inventors have recognized that hollow columns are suitable for filling with an aqueous medium. The inventors have also recognized that hollow columns can be constructed arbitrarily. In other words, the inventors have recognized that the cross-section of the hollow column can be constructed arbitrarily. The inventors have recognized that the positioning assistance system can thus have a shape with a corresponding cross-section, specifically suited to different minimally invasive surgeries. The inventors have recognized that it is helpful for positioning medical devices that the medical devices are visible within the channel. The inventors have recognized that, for this purpose, the hollow column can be constructed transparently. The inventors have recognized that this method can accelerate minimally invasive surgeries and simplify the positioning of medical devices.

[0087] According to another aspect of the invention, the two openings of the hollow column are sealed with a membrane. Here, the membrane can be punctured using medical technology equipment.

[0088] The film can be, in particular, a plastic film. The film can be connected to the hollow column. In particular, the film can be fused to the hollow column at least partially or sectionally.

[0089] The membrane can be configured to be so thin that it can be punctured by medical devices. The membrane can also be configured to create only a single hole at the insertion site when punctured by a medical device.

[0090] The membrane can be configured to seal tightly against the medical device when punctured, preventing the leakage of aqueous media at the insertion site. In particular, the membrane can be rubber-like and / or flexible.

[0091] One of the two films forms the contact surface between the positioning aid system and the surface.

[0092] The membrane is configured to prevent aqueous media from spilling or flowing out of the hollow column or channel. Alternatively or additionally, the membrane prevents contamination and / or fouling by aqueous media.

[0093] The inventors have recognized that a membrane can prevent contamination and / or soiling and / or leakage of an aqueous medium from a hollow column. The inventors have also recognized that sterility of the positioning aid system can be ensured in this manner.

[0094] According to another aspect of the invention, the channel is formed by a body made of an aqueous medium. Here, the body forms a positioning assistance system.

[0095] In particular, the aqueous medium is configured such that it can form a body with a fixed shape.

[0096] In particular, the body can be solid or non-deformable.

[0097] Alternatively, the body can be elastically deformable. In particular, the body can be deformed by applying pressure. In particular, the shape of the body can be adapted to its environment. In particular, when the pressure is removed, the body can always return to its initial shape.

[0098] Alternatively, the body can be elastically deformable. Here, the shape of the body can be customized. In particular, the operator can shape the body to be optimally configured for the corresponding minimally invasive surgery. Here, the shape of the body can be adapted to its environment.

[0099] In particular, the body can be constructed in a pillow shape. In other words, the body can be constructed as a pad. In particular, the positioning aid system can thus be constructed as a gel pillow or gel pad.

[0100] The inventors have realized that if a positioning aid system is placed on a surface, the shape of the system can be matched to that surface. The inventors have realized that this ensures the contact surface of the positioning aid system is in as complete contact as possible with the surface, or is placed planarly on the surface. In other words, the positioning aid system can be matched to curved surfaces. The inventors have realized that such a positioning aid system is particularly comfortable for patients because it does not create pressure points and can be matched to the shape of the body. The inventors have also realized that such a positioning aid system is unrestricted in terms of shape. In other words, the positioning aid system can be configured in any shape and is optimally configured for each minimally invasive procedure. The inventors have also realized that in such a positioning aid system, the positioning of the medical device within the channel is absolutely unrestricted. The medical device can be arbitrarily oriented or positioned at any angle across the entire contact surface.

[0101] According to another aspect of the invention, the body is surrounded by a thin film. Here, the film can be punctured using medical technology equipment.

[0102] The thin film can be constructed as described above. The thin film completely surrounds the body composed of an aqueous medium. In other words, the thin film forms the surface of the body.

[0103] The film can be made transparent, in particular. In other words, the film can be configured such that medical devices are visible through it as they are introduced into the channel. In particular, aqueous media can also be made transparent.

[0104] The aqueous medium can be configured as described above regarding the body. Alternatively, the aqueous medium can be configured in a liquid state.

[0105] The film can be made of polyester (PET), polycarbonate (PC), polyvinyl chloride (PVC), or polyethylene (PE).

[0106] The inventors have realized that, due to the surrounding membrane, an aqueous medium can have any desired consistency. The inventors have realized that the membrane is effectively sterilizable. The inventors have realized that the shape of a body can be predetermined using the membrane.

[0107] According to another aspect of the invention, the channel is divided into a plurality of chambers parallel to the surface. Here, an aqueous medium is doped with a contrast agent in at least one of the chambers. Here, the aqueous medium is differently doped in two chambers having at least one common boundary surface. Here, the contrast agent particularly includes gadolinium and / or iron oxide.

[0108] The statement "the chamber is doped" is equivalent to saying that the water-containing medium in the chamber is doped.

[0109] The chambers can be arranged in a checkerboard or honeycomb pattern.

[0110] Two chambers sharing a common boundary surface are, in particular, two chambers arranged side by side. In other words, two chambers sharing a common boundary surface are two adjacent chambers.

[0111] "Different doping" can specifically mean that chambers having at least one common boundary are doped with different contrast agents. Alternatively, "different doping" can mean that one chamber is doped with a contrast agent and another chamber connected to at least one common boundary is undoped. Alternatively, "different doping" can mean that the concentrations of contrast agents in the chambers having at least one common boundary are different or dissimilar. Here, the contrast agent in the chambers having at least one common boundary can be the same contrast agent.

[0112] If the chambers are arranged, for example, in a checkerboard pattern, an aqueous medium is doped with contrast agent in every other chamber. Chambers arranged in staggered rows or columns are each doped with contrast agent separately.

[0113] If a chamber has more than four boundary surfaces, the chamber can be doped with more than one contrast agent, such that an aqueous medium is doped with different contrast agents or different contrast agent concentrations in two chambers with a common boundary surface, or the aqueous medium is not doped in one chamber and is doped with a contrast agent in another chamber.

[0114] The chambers can be separated from each other by the thin films configured as described above. In other words, the boundary between two chambers can be formed by a thin film. The thin film can extend parallel to the surface normal. A chamber here includes the total thickness of the positioning aid system and a portion of the contact surface of the positioning aid system. This portion of the contact surface can be, in particular, 1 cm. 2 Or 2.25cm 2 Or 4cm2 The area.

[0115] The membrane can be puncturable by medical technology devices. In other words, the division of the channel can be configured such that the positioning, especially the location and / or angle, of the medical technology device is not limited by it.

[0116] The contrast agent is configured such that it is visible in medical images. In other words, the contrast agent is an MR contrast agent. In particular, the aqueous medium doped with the contrast agent produces a different signal than the undoped aqueous medium. Thus, the aqueous medium doped with the contrast agent appears differently in medical images than the undoped aqueous medium. The contrast agent may in particular include gadolinium and / or iron oxide and / or manganese compounds.

[0117] The inventors have recognized that chambers structure or divide the channel in medical images. They have also recognized that, in this way, suitable chambers can be selected based on medical images, within which the medical device should puncture the positioning aid system. Furthermore, they have recognized that, in this way, the positioning of the medical device can be simplified. In particular, the actual position of the medical device within the channel can be simplified, determined, realized, and adjusted based on medical images in this manner.

[0118] According to another aspect of the invention, the doped aqueous medium is visually stained with a first color and the undoped aqueous medium is stained with a second color. Here, the first and second colors are different from each other.

[0119] Below, stating "the chamber is stained" is equivalent to stating "the aqueous medium in the chamber is stained".

[0120] In particular, the first and second colors are easily distinguishable from each other. In particular, the first and second colors are visually distinguishable. In particular, one color can be darker than the other. For example, one color is blue and the other is yellow. Other color combinations are possible.

[0121] In embodiments of the present invention, the aqueous medium that is only doped or the aqueous medium that is only undoped can be dyed with the corresponding medium. In other words, the first color or the second color can be colorless.

[0122] If the chamber is doped with more than one contrast agent, such as as described above regarding a chamber with more than four adjacent chambers, the chamber can be stained with more than two different colors.

[0123] In particular, the chambers are stained such that two chambers with a common boundary surface are stained with visually different colors.

[0124] The inventors have recognized that chambers are thus directly visually distinguishable. In particular, the different representations of these chambers in medical images can be transformed into a reality visible to the naked eye through doping. The inventors have also recognized that this simplifies the positioning of medical devices. Specifically, the actual positions of the medical device relative to the channel in different colored chambers can be compared with the predetermined or optimal positions of the medical device relative to the channel in the medical images.

[0125] According to an optional aspect of the invention, the positioning assistance system includes a marker element. The marker element can be fixed to a medical technology device. Here, the marker element is visible in a medical image.

[0126] The marking element can be a blood vessel containing a contrast agent or a contrast agent solution. The contrast agent is particularly suitable for MRT imaging. In other words, the contrast agent is visible in the medical image. The contrast agent is particularly soluble. The contrast agent is particularly soluble in water. In other words, the contrast agent can be contained in a contrast agent solution. The marking element can be fixed to the medical device. The marking element is specifically fixed in such a way that it does not hinder the use of the medical device for minimally invasive surgery. The marking element can particularly be disposed in a vacancy within the medical device.

[0127] The inventors have recognized that medical technology devices are visible in medical images by means of marker elements. They have also recognized that this further simplifies the positioning of medical technology devices. In particular, if the channels are not filled with an aqueous medium, the medical technology device can also be shown in medical images in this way.

[0128] Preferably, the aqueous medium is doped with a contrast agent. Here, the contrast agent particularly includes gadolinium and / or iron oxide.

[0129] The contrast agent is configured such that it is visible in medical images. In other words, the contrast agent is an MR contrast agent or an MRT contrast agent. In particular, the contrast agent is dissolved in an aqueous medium. In particular, the contrast agent or contrast agent solution generates a signal that can be detected and displayed in medical images.

[0130] The inventors have realized that, in this way, at least one or more channels can be shown more clearly in medical images. The inventors have also realized that, when an aqueous medium is doped, if a medical device is introduced into the channel or the channel is punctured by a medical device, the compression or magnetic field of the aqueous medium in the channel caused by the medical device can be more clearly identified in the medical image. In other words, the medical device in the channel can be optimally and centrally displayed in the medical image by means of a contrast agent.

[0131] According to another aspect of the invention, the positioning assistance system includes an adhesive device. Here, the adhesive device is configured to fix the positioning assistance system to a surface.

[0132] In particular, the bonding device is disposed at the contact surface of the positioning aid system. The bonding device may include at least one bonding point. Alternatively, the bonding device may include the entire contact surface. In other words, the entire contact surface may be configured as an adhesive surface or an adhesive element, or may be configured as a bonding device.

[0133] The positioning aid system is here to be loosely fixed to the surface along with the bonding device.

[0134] The inventors have realized that this method prevents the positioning aid system from slipping off the surface. The inventors have realized that bonding can be achieved particularly simply and quickly. The inventors have also realized that patient comfort is not thereby reduced. The inventors have realized that the positioning aid system can be secured to any part of the patient's body by bonding. In particular, this also allows the positioning aid system to be placed on surfaces that are not geodesically horizontally oriented.

[0135] The present invention also relates to a method for locating medical technology devices using a positioning assistance system as described above, the method comprising the following steps:

[0136] - Place the positioning assistance system on the surface.

[0137] -The passage will be punctured using medical technology equipment.

[0138] - Medical images are detected using magnetic resonance imaging (MRI) equipment, in which medical technology devices are visible within an aqueous medium.

[0139] In particular, the method includes the steps of detecting a first medical image using a magnetic resonance imaging (MRI) scanner. The method specifically includes the steps of determining the location of at least one channel and a target location within a target area in the first medical image. The method specifically includes the steps of determining a path for a medical device from the location of the at least one channel to the target location. The method preferably includes the steps of determining a second angle relative to the surface normal, at which the medical device should pierce the at least one channel to follow the path. The method specifically includes the steps of piercing the channel with the medical device at the second angle. The method particularly includes the steps of detecting a second medical image using a magnetic resonance imaging (MRI) scanner. Here, the medical device is visible in the second medical image within an aqueous medium. The method specifically includes the steps of checking in the second medical image whether the positioning of the medical device is configured such that the medical device can follow the path.

[0140] The positioning assistance system is configured as described above. In particular, the positioning assistance system can be configured according to one of the aforementioned aspects.

[0141] In the method step of placing the positioning aid system on a surface, the positioning aid system is positioned relative to the surface. The surface is configured as described above. In particular, the surface constitutes the surface of the object, especially the patient. Placement may include simply placing and / or fixing. In particular, in the method step of placement, the positioning aid system is fixed or fastened to the object by means of a strap. Alternatively or additionally, in the method step of placement, the positioning aid system may be fixed or fastened to the surface by means of an adhesive device. Alternatively or additionally, the positioning aid system may be fixed or fastened to the surface by means of a suction system, especially by means of at least one suction cup, in the method step of placement. In particular, the positioning aid system may be placed together with a local coil. For this purpose, the positioning aid system may be coupled to the local coil by means of a coupling device. The local coil may be placed on the surface as known.

[0142] In the method step of detecting the first medical image, the first medical image is detected using an MRT device.

[0143] In particular, the first medical image, as described above, is an MRT image. In the first medical image, at least one channel is visible. Here, the channel is configured as described above. In particular, the channel is filled with an aqueous medium as described above. Specifically, the aqueous medium in at least one channel is visible or reflected in the medical image. The aqueous medium is configured as described above. The aqueous medium may be doped with a contrast agent as described above.

[0144] In the method steps of determining the location of at least one channel and the target location in the target area, the location of at least one channel and the target location are determined in a first medical image.

[0145] The location and target location of at least one channel can be determined using an MRT device. Alternatively, the location and target location of at least one channel can be determined using a computer system or computing unit, particularly an evaluation system. In particular, the location and target location of at least one channel can be determined from medical images using image processing. The location and target location of at least one channel can be displayed or provided by an operator using a display unit. The operator can be a doctor or medical assistant. The display unit can be, in particular, a screen or monitor.

[0146] The location of at least one channel is specifically indicated by where the at least one channel is mapped in the first medical image. The location of at least one channel can be predetermined by its centerline. In particular, the location of at least one channel can be defined as a position where the centerline of the channel intersects with the contact surface of the positioning aid system. Alternatively, the location of the channel can be described or specified by the total area of ​​the opening of the channel in the contact surface.

[0147] If the positioning assistance system includes multiple channels, the position in the first medical image is determined for each channel.

[0148] The target location is the location where the medical device should perform minimally invasive surgery. The target location is situated within the target area described above. The medical device and minimally invasive surgery are configured as described above.

[0149] In the method steps of determining the path of a medical technology device, the path of the medical technology device from the location of at least one channel to the target location is determined.

[0150] The path can be determined using MRT equipment. Alternatively, the path can be determined using a computer system or computing unit, especially an evaluation system. The path can be displayed or provided to the operator using a display unit.

[0151] The path description outlines how or by what route a medical device should traverse the surface or be guided to its target location after entering the site. Here, the path may consider one or more critical areas that the medical device should not traverse. In other words, the path can be configured to guide the device as directly as possible from its location to the target location, taking into account potential critical areas. To this end, it can be checked, using MRT equipment, a computer system, a computing unit, or an evaluation system, whether the path intersects with any critical areas. This check can be based on medical images. In other words, it can be checked in medical images whether the path intersects with at least one critical area. In particular, if the path intersects with a critical area, the path can be adjusted. Specifically, the path can then be adjusted so that it does not intersect with any critical area.

[0152] The path, in particular, indicates at which point the medical device should pierce the channel if the channel has a width greater than that of the medical device. In other words, the path can predetermine the position of the medical device. Specifically, if the position of at least one channel corresponds to the total area of ​​the channel's opening in the contact surface, then the channel can predetermine the position of the medical device. Furthermore, the position of the medical device then indicates where the medical device should pierce the channel.

[0153] In the method step of determining a second angle relative to the surface normal, the medical device shall pierce at least one channel at the second angle in order to follow the path.

[0154] The second angle can be determined using MRT equipment. Alternatively, the second angle can be determined using a computer system or computing unit, especially an evaluation system. The second angle can be displayed or provided to the operator using a display unit.

[0155] The second angle is constructed as described above. This second angle explains the angle at which medical equipment should puncture the channel to follow the path.

[0156] Optionally, an azimuth angle can also be determined for positioning the medical technology device. The azimuth angle is configured as described above. The azimuth angle is configured such that the medical technology device can follow a path. The azimuth angle specifies how the medical technology device should rotate relative to the surface normal in order to follow the path.

[0157] In the procedure of puncturing the channel, the channel is punctured or introduced at a second angle using medical technology equipment.

[0158] In particular, medical technology devices can be introduced into the channel taking azimuth into account. In other words, the orientation or positioning of the medical technology device can be preset or limited by a second angle and optionally by the azimuth when it is introduced or punctured into the channel.

[0159] When piercing the channel, the medical device is at least partially introduced into the channel. In particular, the medical device advantageously does not pierce the surface during the method steps described herein. The medical device is introduced into the channel at a location according to the path and at a second angle. The location and / or the second angle here define the positioning of the medical device.

[0160] In the method steps for detecting a second medical image, the second medical image is detected using an MRT device.

[0161] In particular, the second medical image is an MRT image, just like the first medical image. In the second medical image, the medical device is visible within an aqueous medium. Specifically, the medical device is at least indirectly visible in the aqueous medium. In other words, the aqueous medium in the channel is visible or mapped in the second medical image by the compression of the medical device. In particular, the medical device is also indirectly visible in the medical image by the magnetic field distortion generated by the medical device, which causes artifacts in the medical image. In particular, the second medical image can map the same image region as the first medical image.

[0162] In the method steps for checking the location of medical technology devices, the location of the medical technology devices is checked in the second image.

[0163] Specifically, it is examined whether the second medical device is positioned such that it can follow a predetermined path. Specifically, it is examined whether the position and second angle of the medical device, along with the optional azimuth angle, are configured to allow the medical device to be guided or moved along a path to the target location. In particular, the positioning of the medical device is determined or examined based on the second medical image during the examination.

[0164] In particular, the examination can be performed using image processing. For example, medical technology equipment, channels and target locations, and, if necessary, one or more key areas, can be segmented in a second medical image and examined based on said segments.

[0165] In particular, the system can be evaluated using MRT equipment or a computer system or computing unit. Furthermore, the operator can then be shown, via a display unit, whether the medical technology equipment is correctly positioned or whether repositioning is necessary.

[0166] In particular, when checking the location of medical devices, the devices should not be introduced into the object. In other words, at this point in time, the medical devices have not yet pierced the surface.

[0167] The inventors have recognized that path planning is possible based on a first medical image. They have also recognized that at least one channel is visible or mapped on the first medical image. In this way, a path from the channel to the target location can be planned. Furthermore, the inventors have recognized that the medical device is visible in a second medical image after being introduced or punctured through the channel. They have also recognized that, consequently, the location of the medical device can be checked before it is introduced into the object. In this way, repositioning of the medical device after its introduction into the object can be avoided. This can in particular result in time and cost savings and improved patient comfort.

[0168] According to another aspect of the invention, the method further includes the method step of setting a second angle by means of a holding device.

[0169] The holding device is configured as described above.

[0170] The second angle can be set before, after, or during the puncture of the channel. The second angle can also be set in relation to the path. In other words, the second angle can be set such that the medical device follows the path. In particular, the second angle can be set automatically by means of a holding device. In other words, the holding device can be set after the second angle is determined, such that the medical device is stabilized at the second angle by the holding device.

[0171] The inventors have recognized that the second angle can be stabilized using a holding device. In particular, the holding device prevents undesirable changes in the second angle. Furthermore, it is feasible to precisely set a previously determined second angle using the holding device. Additionally, the operator can free their hands by placing the medical technology device on the holding device.

[0172] According to another aspect of the invention, the aqueous medium hardens after the channel is punctured by a medical device. Here, the medical device is secured at a second angle by hardening.

[0173] Hardening is carried out as described above. In particular, hardening is carried out in the form of polymerization in an aqueous medium. In particular, the medical device can be at least partially coated with a polymerization catalyst. The polymerization catalyst can initiate polymerization upon contact with the aqueous medium. The aqueous medium and the polymerization catalyst can be configured as described above.

[0174] The speed of aggregation can determine how long a medical device can remain mobile or positioned within the channel after puncture.

[0175] The position and second angle of the medical device are fixed by hardening. Specifically, the positioning of the medical device within the channel is fixed. The medical device can then only move forward and backward. By moving forward, the medical device can, for example, be inserted into an object through a surface.

[0176] The inventors have recognized that hardening secures medical technology devices within a channel, specifically fixing the device's position. This prevents undesirable changes in positioning.

[0177] According to another aspect of the invention, in the method step of determining a path, paths from more than one of a plurality of channels to a target location are determined respectively. Here, in the method step of determining a second angle, a second angle is determined for each path. The method here also includes a method step of classifying the paths according to their orientation and / or their mechanical realizability.

[0178] If the positioning assistance system includes multiple channels, then more than one channel can be identified in the first medical image, and in particular the position of each channel.

[0179] In particular, paths from more than one channel to the target location can then be determined. Specifically, a path to the target location can be determined from each location, i.e., from each channel. Thus, multiple paths are determined. Each path can be constructed as described above.

[0180] For each defined path, a second angle can be determined, and the medical device should be introduced into the corresponding channel at the second angle or the medical device should pierce the corresponding channel at the second angle, thereby following the corresponding path.

[0181] In the method steps of categorizing paths, the previously determined paths are categorized.

[0182] Paths are classified into at least two levels. Paths are classified here in relation to their orientation and / or their mechanical feasibility. One level could be, for example, "good" or "suitable," and the other "poor" or "unsuitable." More refined grading is possible during classification.

[0183] When classifying based on direction, for example, a path that extends through or very close to a critical area can be classified as "poor." A path that surrounds a potential critical area or eliminates or reduces damage within a critical area can be classified as "good."

[0184] When classifying based on mechanical realizability, for example, the spatial extension of the path can be considered. A path with a significant bend, such that a medical device cannot follow the bend, can be classified as "poor." A path extending approximately in a straight line to the target location is classified as "good." Alternatively or additionally, the feasibility of a second angle previously determined for the path can be considered when classifying based on mechanical realizability. For example, the second angle may not be feasible because it is too large and impractical due to the limited width of the corresponding channel and / or the thickness of the positioning aid system. In other words, it may be infeasible if, when the second angle is too large, the medical device pierces the channel at the second angle. A path determined for such an impractical second angle can be classified as "poor." In particular, for classification, the width of the corresponding channel and / or the acute angle of the first angle and / or the thickness of the positioning aid system, the corresponding channel forming the first angle with the surface normal, can be known.

[0185] Two categories or classifications can be evaluated in combination and create combined classifications. For example, if a path is classified as "good" based on its extension and mechanical realizability, then the path can only be classified as "good".

[0186] Classification can be performed using MRT equipment. Alternatively, classification can be performed using a computer system or computing unit, particularly an evaluation system. The classification results can be provided or displayed to the operator on a display unit. In particular, paths can be displayed, shown, or provided to the operator overlaid on medical images. Here, for example, paths classified as "good" can be shown in green, while paths classified as "poor" can be shown in red. Alternative colors are feasible when displaying classifications. In particular, colors can be coordinated more finely for more refined classifications. Alternatively, only paths classified as "good" can be shown.

[0187] The operator can select a path based on classification, along which minimally invasive surgery should be performed. In other words, the operator can choose which path to take. Specifically, the medical device should then puncture the channel belonging to the selected path at the corresponding location and at a specific second angle. The device can be automatically configured to stabilize at the corresponding second angle during or after puncturing the channel. Alternatively, path selection can be automatic and based on classification.

[0188] The inventors have recognized that multiple channels are different initial points or starting points for performing minimally invasive surgery. The inventors have recognized that a channel is suited differently as an initial point in relation to its position and / or its width and / or the first angle of its corresponding acute angle. The inventors have recognized that this can be considered by means of path classification or categorization. The operator can then select the most suitable path based on the category.

[0189] According to one embodiment of the invention, the method includes the steps of placing a positioning assistance system on a surface, piercing a channel with a medical device, and detecting a medical image using a magnetic resonance imaging (MRI) scanner, wherein the medical device is visible in the medical image in an aqueous medium. The method further includes, in particular, the step of checking the positioning of the medical device in the medical image. The positioning assistance system is configured as described above. In particular, the positioning assistance system can be configured according to one of the described aspects.

[0190] In the method step of placing the positioning aid system on a surface, the positioning aid system is positioned relative to the surface. The surface is configured as described above. In particular, the surface constitutes the surface of the object, especially the patient. Placement may include simply placing and / or fixing. In particular, in the method step of placement, the positioning aid system is fixed or fastened to the object by means of a strap. Alternatively or additionally, in the method step of placement, the positioning aid system may be fixed or fastened to the surface by means of the adhesive device described above. Alternatively or additionally, the positioning aid system may be fixed or fastened to the surface in the method step of placement by means of a suction system, especially by means of at least one suction cup.

[0191] In the method of puncturing a channel using a medical device, the medical device is specifically introduced into the channel. Here, the channel is constructed as described above. Specifically, the channel is filled with an aqueous medium as described above. The medical device is constructed as described above. When puncturing the channel, the medical device is at least partially introduced into the channel. Specifically, the medical device advantageously does not puncture the surface. The medical device is introduced into the channel at a specific location and at a specific angle. The location and / or angle define the positioning of the medical device.

[0192] In the method steps for detecting medical images, the medical images are detected using an MRT device. Specifically, the medical image is an MRT image as described above. In the medical image, the medical device is visible in an aqueous medium. In particular, the medical device is at least indirectly visible in the aqueous medium. In other words, the aqueous medium in the channel is visible or mapped in the medical image by the compression of the medical device.

[0193] In the method steps for examining the positioning of medical technology devices, the positioning of the medical technology devices is examined or verified based on medical images. Specifically, it is examined whether the positioning of the medical technology devices is suitable for performing minimally invasive surgery. In other words, it is examined whether the medical technology devices can or should be further introduced into the object at their position and angle within their introduction channel to perform minimally invasive surgery. In particular, the positioning of the medical technology devices is determined or examined based on a second medical image during the examination.

[0194] In particular, the examination can be performed using image processing. For example, medical technology devices, channels, target locations, and optional one or more key areas can be segmented in a second medical image and the location can be examined based on said segments.

[0195] In particular, the examination can be performed using MRT equipment or a computer system or computing unit, especially to assess system performance. Specifically, the operator can then display, via a display unit, whether the positioning of the medical technology equipment is correct or whether repositioning is necessary. The display unit can be a screen or a monitor.

[0196] The inventors have recognized that the positioning, particularly the location and / or angle, of an object can be checked before the introduction of a medical technology device. They have also recognized that, with the aid of a positioning assistance system, the medical technology device is already visible in medical images before its introduction into the object. In this way, the need for repositioning the medical technology device after its introduction into the object can be avoided. This can particularly result in time and cost savings and improved patient comfort.

[0197] According to another aspect of the invention, the method further includes the method step of setting a second angle by means of a holding device.

[0198] The device and the second angle are configured as described above. The second angle, in particular, defines the positioning of the medical technology device in addition to its location.

[0199] In particular, a second angle can be set after or during puncture. This second angle can be set based on medical images. In other words, the second angle can be adjusted based on the positioning of the medical equipment within the medical image.

[0200] The inventors have recognized that the second angle can be stabilized by a holding device. In particular, the holding device can prevent undesirable changes in the second angle. Furthermore, the operator's hands are freed by placing the medical technology equipment on the holding device.

[0201] According to another aspect of the invention, the aqueous medium hardens after the channel is punctured by a medical device. Here, the medical device is secured at a second angle through hardening.

[0202] The second angle is configured as described above. Hardening is carried out as described above. In particular, hardening is carried out by polymerization in an aqueous medium. Specifically, the medical device can be at least partially coated with a polymerization catalyst. The polymerization catalyst can initiate polymerization upon contact with the aqueous medium. Here, the aqueous medium and the polymerization catalyst are configured as described above.

[0203] The speed of aggregation can determine how long a medical device can remain mobile or positioned within a channel after puncture.

[0204] By hardening, the second angle and position of the medical device are fixed. In particular, the positioning of the medical device in the channel is thus fixed. The medical device can then only move forward or backward.

[0205] The inventors have recognized the effectiveness of fixing medical technology devices within a channel through hardening. Specifically, this fixes the positioning of the medical technology devices. In this way, undesirable changes in positioning can be prevented.

[0206] The above-described features, characteristics, and advantages of the present invention become clearer and more readily understood in conjunction with the following drawings and description. Herein, the drawings, description, and embodiments of the present invention should not be limited in any way.

[0207] In different accompanying drawings, the same components are given corresponding reference numerals. The drawings are usually not to scale. Attached Figure Description

[0208] The above-described features, characteristics, and advantages of the present invention become clearer and more readily understood in conjunction with the following drawings and description. Herein, the drawings, description, and embodiments of the present invention should not be limited in any way.

[0209] In different accompanying drawings, the same components are given corresponding reference numerals. The drawings are usually not to scale.

[0210] The attached diagram shows:

[0211] Figure 1 A first embodiment of the positioning assistance system is shown;

[0212] Figure 2 A second embodiment of the positioning assistance system is shown;

[0213] Figure 3 This illustrates a third embodiment of the positioning assistance system;

[0214] Figure 4 A top view showing a third embodiment of the positioning assistance system;

[0215] Figure 5 An embodiment of a method for locating medical technology devices using a positioning assistance system is shown;

[0216] Figure 6 This illustrates a fourth embodiment of the positioning assistance system;

[0217] Figure 7 A fourth embodiment of a positioning assistance system with a path is shown;

[0218] Figure 8 A top view showing a fourth embodiment of the positioning assistance system;

[0219] Figure 9 A top view showing a fifth embodiment of the positioning assistance system;

[0220] Figure 10 A second embodiment of a method for locating medical technology devices using a positioning assistance system is shown. Detailed Implementation

[0221] Figure 1 A first embodiment of the positioning assistance system 1 is shown.

[0222] The positioning assistance system 1 is configured for placement on a surface 21. Surface 21 can, in particular, demarcate an object 2. In other words, surface 21 is the surface of object 2. Object 2 can be constructed of material 22 into which a medical device 3 should be introduced. The positioning assistance system 1 is configured to assist in positioning the medical device 3 relative to object 2. Object 2 can, in particular, be a patient, especially a human or animal. Therefore, material 22 can be human or animal tissue. Therefore, surface 21 can, in particular, be the patient's skin.

[0223] Medical device 3 is configured to perform minimally invasive surgery. The minimally invasive surgery is performed in target area 23 within object 2. In this embodiment of the invention, medical device 3 may be a biopsy needle. Alternatively, medical device 3 may be, for example, a catheter, a radiation source for brachytherapy, an endoscope, or an ablation system. Minimally invasive surgery may include, for example, tissue sampling, brachytherapy, stent implantation, ablation, or drainage. For minimally invasive surgery, medical device 3 should be introduced into surface 21 and guided through material 22 to target location 24 within target area 23. Here, medical device 3 moves along a path to target location 24. Along the path, medical device 3 should, as far as possible, avoid crossing and / or damaging critical areas. Critical areas of object 2 include, for example, areas and / or organs with increased bleeding risk. In order to follow the path, medical device 3 must be introduced into object 2 through surface 21 with appropriate positioning. Positioning here is defined by the position of medical device 3 relative to object 2 or surface 21 and / or by a second angle 21c. The second angle 21c describes the angle formed by the medical device 3 and the surface normal 21a of the surface 21. The second angle 21c can be an acute angle, i.e., an angle between 0° and 90°. Alternatively, the second angle can be 0°. Optionally, the positioning can be additionally defined by the rotation of the medical device 3 about the surface normal 21a of the surface 21, which serves as the axis of rotation. For this purpose, the positioning can be described in spherical coordinates. The second angle 21c here corresponds to the polar angle in spherical coordinates. The rotation of the medical device about the surface normal 21a of the surface 21, which serves as the axis of rotation, can be described by the azimuth angle in spherical coordinates.

[0224] The medical device 3 is either invisible, indistinct, or unmappible in a medical image examined using magnetic resonance imaging (MRT), or only very weakly visible, visible, or mappable. In other words, the medical device 3 cannot be directly mapped in the medical image, or only very weakly. If the medical device extrudes material visible in the medical image, then the medical device 3 is indirectly visible or mapped in the medical image. For example, the medical device 3 can be indirectly mapped in the medical image as it is introduced into the material 22 through surface 21. The medical image here is advantageously an MRT image or an MR image.

[0225] After the positioning assistance system 1 is placed on the surface 21, the positioning assistance system 1 is secured to the surface 21 by means of the contact surface 13. The contact surface 13 can be of any size, for example, 2 cm. 2 Or 4cm 2 Or 9cm 2 Or 25cm 2 The positioning assistance system 1 can be configured such that it is stably placed on the surface 21. In particular, the positioning assistance system 1 can be fitted or conformally shaped to the surface 21. In embodiments of the invention, the positioning assistance system 1 can at least approximately map the negative shape of the surface 21.

[0226] The positioning assistance system 1 can be fixed to surface 21 or object 2 during placement. In embodiments of the invention, the positioning assistance system 1 may include an adhesive device. The adhesive device is particularly located at the contact surface 13. The adhesive device is configured to releasably fix the positioning assistance system 1 to surface 21 at least point-by-point. In particular, the entire contact surface 13 can be adhesively configured. Alternatively or additionally, the positioning assistance system 1 can be fixed or secured to object 2 during placement by means of at least one strap. Alternatively or additionally, the positioning assistance system 1 can be fixed to surface 21 by means of a suction system. The suction system may include at least one suction cup by which the positioning assistance system 1 can be releasably fixed or secured to surface 21.

[0227] The positioning assistance system 1 includes a channel 11, which can be punctured by a medical device 3. In alternative embodiments, the positioning assistance system 1 may also include more than one channel 11.

[0228] In the illustrated embodiment, channel 11 is formed by a hollow column 15. The hollow column 15 here particularly forms the wall for channel 11. The hollow column 15 may particularly include a circular, square, elliptical, or rectangular cross-section. In particular, the cross-section of the hollow column 15 can be of any shape, especially any polygon. The hollow column 15 may be made of plastic. In particular, the hollow column 15 may be made of optically transparent plastic. Alternatively, the hollow column 15 may be made of a non-magnetizable or only weakly magnetizable metal.

[0229] In this embodiment, channel 11 is formed parallel to the surface normal 21a of surface 21. Alternatively, channel 11 may form an acute angle with the surface normal 21a of surface 21.

[0230] In the illustrated embodiment, the width of channel 11 corresponds to the extension of positioning aid system 1 parallel to surface 21. In other words, channel 11 almost encompasses the total contact surface 13. In particular, the opening of channel 11 constitutes the contact surface 13.

[0231] In alternative implementations, especially if the positioning assistance system 1 includes more than one channel 11, the width of the channel 11 may be less than the extension of the positioning assistance system 1 parallel to the surface 21.

[0232] Channel 11 is filled with an aqueous medium 12. The aqueous medium 12 can be configured in a liquid, jelly, or gel-like state. Specifically, the aqueous medium 12 can be configured such that it does not flow out of channel 11 or the hollow column 15. Furthermore, the aqueous medium 12 can be configured such that it stabilizes the medical device 3 when it is introduced into or punctured in channel 11. In other words, the positioning of the medical device 3 in this configured aqueous medium 12 can only be altered by applying a (slight) force or pressure. If no force is applied to the medical device 3, then in this embodiment, the medical device is stuck in its corresponding position within the aqueous medium 12.

[0233] In embodiments of the invention, the aqueous medium 12 may include at least one of the following materials: pectin, galanthine, agarose, polyacrylamide, or polyurethane polymer. In particular, the aqueous medium 12 may include two components. Here, one component may constitute a solid component and the other component may constitute a liquid component. The solid component may, in particular, be composed of one of the aforementioned materials. The solid component may, in particular, constitute a three-dimensional mesh structure or a three-dimensional network. The liquid component may be enclosed within the pores of the network. The liquid component may, for example, be water, especially distilled water.

[0234] The aqueous medium 12 is configured such that it is visible in medical images. In other words, the aqueous medium 12 generates a signal during magnetic resonance imaging (MRI), which can be detected and mapped in medical images. If the medical device 3 is introduced into the aqueous medium 12, i.e., the channel 11, the medical device extrudes the aqueous medium 12 at this location. In this way, the medical device 3 can indirectly become visible in medical images. In particular, the medical device 3 is thus visible in medical images before it is introduced into the object 2 through the surface 21.

[0235] In this way, the positioning of medical device 3 can be checked in medical images. Specifically, it can be checked whether the positioning of medical device 3 is suitable for its movement to target location 24. Here, it can be checked in particular whether medical device 3 crosses and / or damages critical areas on its path to target location 24. Thus, the positioning can be checked and, if necessary, corrected before introducing medical device 3 into object 2.

[0236] In embodiments of the invention, the aqueous medium 12 can harden after being punctured by the medical device 3. In particular, the aqueous medium 12 can polymerize. For this purpose, the medical device 3 can be at least partially coated with a polymerization catalyst. The polymerization catalyst can be a free radical initiator or a free radical-forming initiator. For example, the polymerization catalyst can be polyacrylamide or ammonium persulfate (APS) or a peroxide or azo compound. Alternatively, the polymerization catalyst can be an ionic initiator. In particular, the aqueous medium 12 in this case includes at least one polymerizable component. The polymerizable component here particularly includes polymer monomers, and the polymerizable component or the aqueous medium hardens into said polymer. Here, the monomer is characterized in particular by at least one double bond. The polymerizable component can particularly include dicarboxylic acids and polyols (e.g., glycerol) or diphenyl carbonate and aromatic glycols or vinyl chloride or ethylene. If the aqueous medium 12 comes into contact with the polymerization catalyst, the polymerization of the polymerizable component is activated, which causes the aqueous medium 12 to harden. Through hardening, the positioning of the medical device 3 is fixed after hardening. In particular, after hardening, the position and second angle 21c of the medical device 3 can no longer be changed. The medical device 3 can then move only forward and backward. By moving forward, the medical device 3 is introduced into the object 2.

[0237] In an alternative embodiment shown herein, the medical device 3 can be secured at a second angle 21c by means of a retaining device 14. The retaining device 14 may for this purpose include a bracket 14c by which the medical device 3 is supported relative to the surface 21. The bracket 14c can be extended between the two legs 14a, 14b of the retaining device 14 by an angle of 90° minus the second angle 21c. This angle can be changed by "moving the bracket 14c out and in". To "move the bracket 14c out and in", the length of the bracket 14c can be changed. For this purpose, the bracket 14c can be turned out by a larger or smaller distance using a screwing device. Alternatively, the bracket 14c can be configured as a spring, tensioned with a larger or smaller force. The medical device 3 can be placed on one of the legs 14a and stabilized at the second angle 21c.

[0238] In an embodiment of the invention, the opening of the hollow column 15 can be sealed with a membrane. The membrane can be punctured using a medical device 3. The membrane can be configured to prevent leakage and / or contamination of the channel containing an aqueous medium. The membrane can be at least partially fused to the hollow column at the respective opening. The membrane can be, in particular, a plastic film.

[0239] Figure 2 A second embodiment of the positioning assistance system 1 is shown.

[0240] The second embodiment largely corresponds to the one based on Figure 1The first embodiment is described above, and improvements can also be made using the implementation methods described in this context.

[0241] Unlike the first embodiment, channel 11 is not formed by a hollow column 15. According to the second embodiment, channel 11 is formed by a body made of an aqueous medium 12. Here, the body forms the positioning aid system 1. The aqueous medium 12 can therefore have a solid, jelly-like, or gel-like consistency. The aqueous medium 12 can particularly conform to the shape of the surface 21. In particular, the aqueous medium 12 can be deformed by force. In other words, the aqueous medium can be elastically constructed. After the force is removed, the aqueous medium 12 can regain its original shape. Alternatively, the aqueous medium 12 can have a kneadable or plastic consistency. In particular, the aqueous medium 12 can then be shaped into any shape.

[0242] In an embodiment of the invention, the body formed by the aqueous medium 12 can be surrounded by a thin film. The film can be punctured using a medical device 3. The film can, in particular, be pre-shaped to resemble the body. The positioning aid system 1 can then be configured as a gel pillow or gel pad.

[0243] Figure 3 A third embodiment of the positioning assistance system 1 is shown.

[0244] The third embodiment illustrates according to Figure 2 A variation of the second embodiment. Alternatively, in this embodiment, channel 11 can be as follows: Figure 1 It is formed from a hollow column 15 as described.

[0245] Channel 11 is parallel to surface 21 and divided into multiple chambers 11a, 11b according to a grid. In particular, the grid or division can be achieved using a membrane. Specifically, the membrane can be formed by a medical device 3. The membrane can be a plastic film. The membranes respectively form the boundary surfaces between two chambers.

[0246] In the example shown, the channel 11 is divided into multiple chambers 11a, 11b in a checkerboard pattern.

[0247] Here, the two chambers 11a and 11b with a common boundary surface, or two adjacent chambers 11a and 11b, are doped differently. In particular, at least one of the chambers 11a and 11b is doped with a contrast agent. Alternatively, the contrast agent concentrations in the two chambers 11a and 11b with a common boundary surface may be different.

[0248] In the illustrated embodiment, the aqueous medium 12a is doped with a contrast agent in every other chamber 11a. The aqueous medium 12b in the other chambers 11b is not doped. Alternatively, the aqueous medium 12b in the other chambers 11b may be doped with other contrast agents.

[0249] In alternative embodiments, chambers 11a and 11b may be configured or arranged in a honeycomb pattern, for example. In particular, if more than one contrast agent is used, doping of chambers 11a and 11b may be necessary to ensure that two adjacent chambers 11a and 11b are doped differently, or that one chamber 11a and 11b is undoped while the other chamber 11a and 11b is doped.

[0250] Contrast agents, especially those used in MRT imaging, generate signals that are detected and can be visualized in medical images. Consequently, an aqueous medium 12a doped with a contrast agent produces a different signal than an undoped aqueous medium 12b. Specifically, chambers 11a and 11b are mapped differently in medical images depending on whether they are filled with a doped aqueous medium 12a or an undoped aqueous medium 12b.

[0251] In an embodiment of the invention, the doped aqueous medium 12a is visually stained with a first color. The undoped aqueous medium 12b is visually stained with a second color. The first color and the second color are different here. In particular, the first and second colors are visually distinguishable. For example, the first color may be blue and the second color may be yellow or vice versa. Alternatively, the first or second color may be any color. In particular, the first or second color may be colorless. In particular, then correspondingly, the doped aqueous medium 12a or the undoped aqueous medium 12b is not stained. In particular, it is feasible in this way to visually distinguish the chamber 11a having the doped aqueous medium 12a and the chamber 11b having the undoped aqueous medium 12b.

[0252] In this way, the location of the medical device 3 can be given according to chambers 11a and 11b, similar to that on a chessboard. Here, chambers 11a and 11b can be distinguished in medical images based on contrast agents and, in the implementation scheme, visually by first and second colors.

[0253] If chambers 11a and 11b are doped with more than one contrast agent, then chambers 11a and 11b can be stained with more than two visually different colors. In particular, when one chamber 11a and 11b forms more than four boundary surfaces with four different chambers 11a and 11b, chambers 11a and 11b can be stained with more than two different colors. Specifically, chambers 11a and 11b are subsequently stained such that two chambers 11a and 11b with a common boundary surface are stained differently.

[0254] Figure 4 A top view showing a third embodiment of the positioning assistance system 1.

[0255] The chambers 11a and 11b are arranged in a checkerboard pattern. Here, the water-containing media 12a and 12b in the chambers 11a and 11b are mixed in a staggered manner in each row.

[0256] Alternatively, the chambers 11a and 11b may be constructed in a honeycomb pattern, for example. In particular, the cross-sections of the chambers 11a and 11b may be formed into arbitrary polygons. Here, the aqueous media 12a and 12b in the chambers 11a and 11b are alternately, staggeredly, or undoped, respectively.

[0257] Figure 5 An embodiment of a method for locating a medical technology device 3 using a positioning assistance system 1 is shown.

[0258] The positioning assistance system 1 for implementing the method is based on... Figures 1 to 4 It is constituted by one of the above embodiments.

[0259] In the method step of placing the positioning assistance system 1 onto the surface 21, the positioning assistance system 1 is placed on the surface 21. Here, placing S1, as described above, includes fixing or securing the positioning assistance system 1 to the surface 21 or to / at the object 2.

[0260] In the method step of piercing channel 11 (S2), a medical device 3 is introduced into channel 11. Specifically, the medical device 3 is introduced into channel 11 at a second angle 21c to the surface normal 21a of surface 21. In particular, the medical device 3 can be introduced into channel 11 at a location suitable for minimally invasive surgery. Here, the piercing S2 of channel 11 is described. Specifically, in this method step, the medical device 3 can pierce channel 11 without damaging surface 21.

[0261] In embodiments of the invention, the aqueous media 12, 12a, 12b filling the channel 11 can be hardened as described above after the medical device 3 punctures the S2 channel. Here, the medical device 3 is secured at a second angle 21c by hardening. In particular, the medical device 3 is secured at the location of its introduction channel 11. In other words, the positioning of the medical device 3 is secured by hardening.

[0262] In the optional method step of setting the second angle 21c of O1 using the holding device 14, the medical technology device 3 can be stabilized at the second angle 21c using the holding device 14. The holding device 14 can be configured as follows: Figure 1 The configuration described herein. The angle set by the retaining device 14 specifically corresponds to 90° minus the second angle 21c. Optional method steps can also be performed, in particular, before piercing the S2 channel 11.

[0263] In the method step of detecting the S3 medical image, the medical image is detected using an MRT device. Here, the medical technology device 3 is visible or reflected in the medical image within the aqueous mediums 12, 12a, and 12b. In particular, what is visible in the medical image is that the medical technology device 3 displaces the aqueous mediums 12, 12a, and 12b from the channels. In other words, the medical technology device 3 is at least indirectly visible or reflected in the medical image.

[0264] In the method steps for checking the positioning of medical device 3 in S4, the positioning of medical device 3 is checked based on medical images. Specifically, it can be checked whether the positioning of medical device 3 is suitable for performing minimally invasive surgery. In particular, it can be checked whether medical device 3 is positioned such that it can be introduced into object 2 to target position 24 along the planned path. Here, positioning describes the position of medical device 3 and / or the second angle 21c. Optionally, positioning may also describe the azimuth angle of medical device 3.

[0265] If the positioning of medical device 3 is unsuitable or suboptimal as visible on a medical image, medical device 3 can be repositioned if necessary. Therefore, the above-described method steps can be repeated at any frequency. In particular, repositioning is thus feasible without the medical device 3 having to repeatedly pass through surface 21 into object 2.

[0266] Where it is not yet clearly apparent, but is meaningful and within the scope of the invention, various embodiments, their various sub-aspects or features may be combined or interchanged with each other without departing from the scope of the invention. The advantages of the invention described with reference to one embodiment are also suitable for other embodiments where applicable, unless explicitly mentioned.

[0267] Figure 6 The fourth embodiment of the positioning assistance system 1 is shown.

[0268] The positioning assistance system 1 is configured to be placed on a surface 21. Surface 21 can, in particular, demarcate an object 2. In other words, surface 21 is the surface of object 2. Object 2 can be composed of material 22 into which a medical device 3 should be introduced. The positioning assistance system 1 is configured to assist in positioning the medical device 3 relative to object 2. Object 2 can, in particular, be a patient, especially a human or animal. Therefore, material 22 can be human or animal tissue. Therefore, surface 21 can, in particular, be the patient's skin.

[0269] Medical device 3 is configured to perform minimally invasive surgery. The minimally invasive surgery is performed in target area 23 of object 2. In this embodiment of the invention, medical device 3 may be a biopsy needle. Alternatively, medical device 3 may be, for example, a catheter, a radiation source for brachytherapy, an endoscope, or an ablation system. Minimally invasive surgery may include, for example, tissue sampling, brachytherapy, stent implantation, ablation, or drainage. For minimally invasive surgery, medical device 3 should be introduced into surface 21 and guided through material 22 to target location 24 in target area 23. Here, medical device 3 moves along paths 4.2, 4.3, and 4.3 to target location 24. Along paths 4.1, 4.2, and 4.3, medical device 3 should, as far as possible, avoid crossing and / or damaging critical areas 25. Critical areas 25 of object 2 are, for example, areas and / or organs with increased bleeding risk. In order to follow paths 4.1, 4.2, and 4.3, medical device 3 must be introduced into object 2 through surface 21 by means of appropriate positioning. Positioning here is defined by the location of the medical device 3 relative to the object 2 or surface 21 and / or by a second angle 21c. The second angle 21c describes the angle formed by the medical device 3 and the surface normal 21a of the surface 21. The second angle 21c can be, in particular, an acute angle, i.e., an angle between 0° and 90°. Alternatively, the second angle can be 0°. Optionally, positioning can be additionally defined by the rotation of the medical device 3 about the surface normal 21a of the surface 21, which serves as the axis of rotation. For this purpose, positioning can be described in spherical coordinates. The second angle 21c here corresponds to the polar angle in spherical coordinates. The rotation of the medical device about the surface normal 21a of the surface 21 can be described by the azimuth angle in spherical coordinates.

[0270] The medical device 3 is either invisible, indistinct, or unmappible in a medical image examined using magnetic resonance imaging (MRT), or only very weakly visible, visible, or mappable. In other words, the medical device 3 cannot be directly mapped in the medical image, or only very weakly. If the medical device extrudes material visible in the medical image, then the medical device 3 is indirectly visible or mapped in the medical image. For example, the medical device 3 can be indirectly mapped in the medical image as it is introduced into the material 22 through surface 21. The medical image here is advantageously an MRT image or an MR image.

[0271] After the positioning assistance system 1 is placed on the surface 21, the positioning assistance system 1 is secured to the surface 21 by means of the contact surface 13. The contact surface 13 can be of any size, for example, 2 cm. 2 Or 4cm 2 Or 9cm 2 Or 25cm 2The positioning assistance system 1 can be configured such that it is stably placed on the surface 21. In particular, the positioning assistance system 1 can be fitted or conformally shaped to the surface 21. In embodiments of the invention, the positioning assistance system 1 can at least approximately map the negative shape of the surface 21.

[0272] The positioning assistance system 1 can optionally be fixed to surface 21 or object 2 during placement. In embodiments of the invention, the positioning assistance system 1 may include an adhesive device for this purpose. The adhesive device is particularly disposed at the contact surface 13. The adhesive device is configured to releasably fix the positioning assistance system 1 to surface 21 at least point-by-point. In particular, the entire contact surface 13 can be adhesively configured. Alternatively or additionally, the positioning assistance system 1 can be fixed or secured to object 2 during placement by means of at least one strap. Alternatively or additionally, the positioning assistance system 1 can be fixed to surface 21 by means of a suction system. The suction system may include at least one suction cup by which the positioning assistance system 1 can be releasably fixed or secured to surface 21.

[0273] The positioning assistance system 1 includes at least one channel 11.1, 11.2, 11.3, 11.4, 11.5, which can be punctured by a medical device 3. In the illustrated embodiment, the positioning assistance system 1 includes at least three channels 11.1, 11.2, 11.3, 11.4, 11.5 in cross-section. In particular, the positioning assistance system 1 may include multiple channels 11.1, 11.2, 11.3, 11.4, 11.5. The multiple channels 11.1, 11.2, 11.3, 11.4, 11.5 may be arranged in a grid pattern in the plate 16.

[0274] The description and definition of “channel” or “at least one channel” can be applied to all channels 11.1, 11.2, 11.3, 11.4, and 11.5 of multiple channels 11.1, 11.2, 11.3, 11.4, and 11.5.

[0275] At least one channel 11.1, 11.2, 11.3, 11.4, 11.5 may be configured as a hole in plate 16. The hole may form two openings in plate 16. One of the two openings may be located in the contact surface 13. The hole may have an arbitrary cross-section. For example, the cross-section of the hole may include a polygon, a circle, or an ellipse.

[0276] In embodiments of the invention, the width of the openings in channels 11.1, 11.2, 11.3, 11.4, and 11.5 may be greater than the width of the medical device 3 that should pierce channels 11.1, 11.2, 11.3, 11.4, and 11.5. The width of channels 11.1, 11.2, 11.3, 11.4, and 11.5 is defined herein by a net width. Net width describes the shortest distance between two opposing walls. If the cross-section of channels 11.1, 11.2, 11.3, 11.4, and 11.5 comprises a circle, then the width is the diameter of the circle. If the cross-section of channels 11.1, 11.2, 11.3, 11.4, and 11.5 comprises a square, then the width is the side length of the square. The width of the medical device 3 is defined by the cross-section of the medical device 3. Width or net width herein describes the shortest distance between two opposing points on the surface of the medical device 3. The width of channels 11.1, 11.2, 11.3, 11.4, and 11.5 can be two, four, ten, or twenty times the width of medical technology device 3.

[0277] Channels 11.1, 11.2, 11.3, 11.4, and 11.5 are defined by centerlines 111.1 and 111.2. Centerlines 111.1 and 111.2 extend through the centers of channels 11.1, 11.2, 11.3, 11.4, and 11.5. In particular, the orientation of channels 11.1, 11.2, 11.3, 11.4, and 11.5 relative to surface 21 can be described by means of centerlines 111.1 and 111.2. Channels 11.1, 11.2, 11.3, 11.4, and 11.5 extend, in particular, with an acute angle 21b about the surface normal 21a of surface 21. In other words, the midlines 111.1 and 111.2 of channels 11.1, 11.3, 11.4, and 11.5 form an acute angle 21b with the surface normal 21a of surface 21. The acute angle 21b is 0° or between 0° and 90°. The acute angle 21b of different channels 11.1, 11.2, 11.3, 11.4, and 11.5 can be different. For example, all channels 11.1, 11.2, 11.3, 11.4, and 11.5 can be oriented such that their midlines 111.1 and 111.2 intersect at a point in object 2. In particular, the orientation of channels 11.1, 11.2, 11.3, 11.4, and 11.5, or the orientation of the centerlines 111.1 and 111.2 of channels 11.1, 11.2, 11.3, 11.4, and 11.5, can also be described by rotation or rotation angle about the surface normal 21a of the surface 21, which serves as the axis of rotation. For this purpose, the orientation of channels 11.1, 11.2, 11.3, 11.4, and 11.5, or the centerlines 111.1 and 111.2 of channels 11.1, 11.2, 11.3, 11.4, and 11.5, in spherical coordinates can be described. Here, the first acute angle 21b corresponds to the polar angle in spherical coordinates, and the rotation about the surface normal 21a of the surface 21, which serves as the axis of rotation, is described by the azimuth angle in spherical coordinates.

[0278] Channels 11.1, 11.2, 11.3, 11.4, and 11.5 are pierced by the medical device 3 at a second angle 21c, the value of which may be the same as or different from the value of the acute angle 21b. Specifically, the medical device 3 may be oriented or positioned parallel to, inclined to, or rotated relative to, the centerlines 111.1 and 111.2 of the channels when piercing them. In particular, the orientation of the medical device 3 relative to the centerlines 111.1 and 111.2 may be rotated about the surface normal 21a of the surface 21. Furthermore, the orientation or positioning of the medical device 3, or the orientation of the centerlines 111.1 and 111.2, may be given in spherical coordinates as described above. Here, the first angle 21b or the second angle 21c of the acute angle can respectively correspond to the polar angle. The orientation of the rotation about the surface normal 21a of the surface 21, which is the axis of rotation, can then be described by the corresponding azimuth angle. If the two polar angles and two azimuth angles of the orientation of the medical device 3 are equal to the medians 111.1 and 111.2, then the medical device 3 is oriented parallel to the medians 111.1 and 111.2. Alternatively, the orientation of the medical device 3 relative to the medians 111.1 and 111.2 can be rotated.

[0279] In the illustrated embodiment, plate 16 is releasably coupled to local coil 17 via a coupling device. Local coil 17 may in particular be a toroidal coil or a butterfly coil. Plate 16 is particularly disposed within an opening of local coil 17. Plate 16 includes the coupling device. Local coil 17 includes a mating member for the coupling device. The coupling device may in particular include insertion devices and / or clamping devices or snap-fit ​​devices and / or screwing devices. In particular, the coupling device may be inserted into and / or snap-fitted into or screwed onto the mating member.

[0280] At least one channel 11.1, 11.2, 11.3, 11.4, 11.5 is filled with an aqueous medium 12. The aqueous medium 12 may be configured in a liquid, jelly-like, or gel-like state. In particular, the aqueous medium 12 may be configured such that it does not flow out of the channels 11.1, 11.2, 11.3, 11.4, 11.5. In particular, the aqueous medium 12 may be configured such that it stabilizes the medical device 3 when it is introduced into or punctured in the channels 11.1, 11.2, 11.3, 11.4, 11.5. In other words, the positioning of the medical device 3 in the thus configured aqueous medium 12 can only be changed by applying a (slight) force or pressure. If no force is applied to the medical device 3, then in this embodiment, the medical device is stuck or stabilized in its respective position within the aqueous medium 12.

[0281] In embodiments of the invention, the aqueous medium 12 may include at least one of the following materials: pectin, galanthine, agarose, polyacrylamide, or polyurethane polymer. In particular, the aqueous medium 12 may include two components. Here, one component may constitute a solid component and the other component may constitute a liquid component. The solid component may, in particular, be composed of one of the aforementioned materials. The solid component may, in particular, constitute a three-dimensional mesh structure or a three-dimensional network. The liquid component may be enclosed within the pores of the network. The liquid component may, for example, be water, especially distilled water.

[0282] The aqueous medium 12 is configured such that it is visible in medical images. In other words, the aqueous medium 12 generates a signal during magnetic resonance imaging (MRI), which is detected and can be mapped in medical images. If the medical device 3 is introduced into the aqueous medium 12, i.e., the channel 11, the medical device extrudes the aqueous medium 12 at this location. In this way, the medical device 3 can indirectly become visible in medical images. In particular, the medical device 3 is visible in medical images before it is introduced into the object 2 through the surface 21.

[0283] In this way, the positioning of medical device 3 can be checked in medical images. Specifically, it can be checked whether the positioning of medical device 3 is suitable for its movement to the target location 24. Here, it can be checked in particular whether medical device 3 crosses and / or damages critical areas 25 along paths 4.1, 4.2, and 4.3 to the target location 24. Thus, the positioning can be checked and, if necessary, corrected before introducing medical device 3 into object 2.

[0284] In embodiments of the invention, the aqueous medium 12 can harden after being punctured by the medical device 3. In particular, the aqueous medium 12 can polymerize. For this purpose, the medical device 3 can be at least partially coated with a polymerization catalyst. The polymerization catalyst can be a free radical initiator or a free radical-forming initiator. For example, the polymerization catalyst can be polyacrylamide or ammonium persulfate (APS) or a peroxide or azo compound. Alternatively, the polymerization catalyst can be an ionic initiator. In particular, the aqueous medium 12 in this case includes at least one polymerizable component. The polymerizable component here particularly includes polymer monomers, and the polymerizable component or the aqueous medium hardens into said polymer. Here, the monomer is characterized in particular by at least one double bond. The polymerizable component can particularly include dicarboxylic acids and polyols (e.g., glycerol) or diphenyl carbonate and aromatic glycols or vinyl chloride or ethylene. If the aqueous medium 12 comes into contact with the polymerization catalyst, the polymerization of the polymerizable component is activated, which causes the aqueous medium 12 to harden. Through hardening, the positioning of the medical device 3 is fixed after hardening. In particular, after hardening, the position and second angle 21c of the medical device 3 can no longer be changed. The medical device 3 can then move only forward and backward. By moving forward, the medical device 3 is introduced into the object 2.

[0285] In an alternative embodiment shown herein, the medical device 3 can be secured at a second angle 21c by means of a retaining device 14. The retaining device 14 may for this purpose include a bracket 14c by which the medical device 3 is supported relative to the surface 21. The bracket 14c can be extended between the two legs 14a, 14b of the retaining device 14 by an angle of 90° minus the second angle 21c. This angle can be changed by "moving the bracket 14c out and in". To "move the bracket 14c out and in", the length of the bracket 14c can be changed. For this purpose, the bracket 14c can be turned out by a larger or smaller distance using a screwing device. Alternatively, the bracket 14c can be configured as a spring, tensioned with a larger or smaller force. The medical device 3 can be placed on one of the legs 14a and thus stabilized at the second angle 21c.

[0286] In one embodiment of the invention, the openings of channels 11.1, 11.2, 11.3, 11.4, and 11.5, or the holes constituting channels 11.1, 11.2, 11.3, 11.4, and 11.5, can be sealed with a membrane. The membrane is configured such that it can be punctured by a medical device 3. The membrane is particularly a plastic film. The membrane prevents the aqueous medium 12 from flowing out of channels 11.1, 11.2, 11.3, 11.4, and 11.5 and / or from contamination or soiling by the aqueous medium 12.

[0287] In one embodiment of the invention, the aqueous medium 12 may be doped with a contrast agent. The contrast agent is configured such that it is visible in medical images. In particular, the aqueous medium 12 doped with the contrast agent is visible in medical images. The contrast agent is thus an MRT contrast agent. The contrast agent here particularly includes gadolinium and / or iron oxide.

[0288] Figure 7 A fourth embodiment of a positioning assistance system 1 with paths 4.1, 4.2, and 4.3 is shown.

[0289] The drawing exemplarily illustrates paths 4.1, 4.2, and 4.3 from each of the three shown channels 11.1, 11.2, and 11.3 to the target location 24 in the target area 23. The medical device 3 can move along one of these paths 4.1, 4.2, and 4.3 to the target location 24. For this purpose, the corresponding channels 11.1, 11.2, and 11.3 should be pierced by the medical device 3 in the appropriate positioning as described above. The appropriate positioning can be checked in the medical image as described above before the medical device 3 pierces the surface 21.

[0290] Paths 4.1, 4.2, and 4.3 can be configured such that they surround the critical region 25. In other words, paths 4.1, 4.2, and 4.3 are configured such that the medical device 3 does not cross or damage the critical region 25 when guided along one of paths 4.1, 4.2, and 4.3. Paths 4.1, 4.2, and 4.3 can be determined, in particular, by means of an MRT device or by means of a computer system or computing unit, especially an evaluation system. In particular, paths 4.1, 4.2, and 4.3 can be determined based on image processing of medical images.

[0291] Paths 4.1, 4.2, and 4.3 can be categorized. In particular, paths 4.1, 4.2, and 4.3 can be categorized based on their orientation and / or their mechanical feasibility. Specifically, paths 4.1, 4.2, and 4.3 can be categorized into at least two levels or categories. For example, levels can be categorized as "good" or "suitable" and "poor" or "unsuitable".

[0292] If paths 4.1, 4.2, and 4.3 are classified according to their direction, then paths 4.1, 4.2, and 4.3 that extend through or very close to critical region 25 can be classified as "poor" or "unsuitable".

[0293] If paths 4.1, 4.2, and 4.3 are classified according to their mechanical feasibility, then it can be considered whether the medical device 3 can follow the paths 4.1, 4.2, and 4.3 to be classified and / or whether a suitable positioning of the medical device 3 can be achieved with the aid of the positioning assistance system 1. In the illustrated embodiment, the left-hand path 4.1 is significantly curved to surround the critical region 25. It is possible that the medical device 3 cannot follow path 4.1 due to the significant curvature. In other words, the medical device 3 may be too rigid for following path 4.1. For this reason, path 4.1 is mechanically unfeasible and is classified as “poor” or “unsuitable”. In the illustrated embodiment, the right-hand path 4.3 extends directly to the target position 24 at a gentle angle relative to the surface. In other words, the second angle of the right-hand path 4.3 is relatively large. However, due to the width of channel 11.3 and the thickness of plate 16 or positioning assistance system 1, a suitable positioning of the medical device 3 for following path 4.3 is not feasible or feasible. Medical device 3 must be introduced into channel 11.3 at an excessively large second angle 21c along the extension of path 4.3. For this reason, path 4.3 can also be classified as "poor" or "unsuitable".

[0294] The intermediate path 4.2 appears to be mechanically feasible and does not damage the critical area 25. Path 4.2 can therefore be associated with the grades “good” or “suitable”.

[0295] To create a general category for paths 4.1, 4.2, and 4.3 from the two described categories, all paths 4.1, 4.2, and 4.3 that are already classified as "Good" or "Suitable" in either of these two categories can also be classified as "Good" or "Suitable" in the general category. Paths 4.1, 4.2, and 4.3 that are already classified as "Poor" or "Unsuitable" in at least one of the above categories can also be classified as "Poor" or "Unsuitable" in the general category.

[0296] The grades, classifications, or categories of paths 4.1, 4.2, and 4.3 can be provided to the operator. The operator here can be, in particular, the person performing and / or preparing minimally invasive surgery. The operator can be, in particular, a physician or medical assistant. Paths 4.1, 4.2, and 4.3 can be shown to the operator using a display unit that overlaps with the medical image. The display unit here can be, in particular, a screen or monitor. Here, different grades of paths 4.1, 4.2, and 4.3 are shown in different colors. For example, paths 4.1 and 4.3 with a grade of "poor" or "unsuitable" can be shown in red, while paths 4.2 with a grade of "good" or "suitable" can be shown in green. Alternative colors or structures for different grades when showing paths 4.1, 4.2, and 4.3 can be considered. Alternatively, only paths 4.2 classified as "good" or "suitable" can be shown to the operator.

[0297] Figure 8 A top view showing a fourth embodiment of the positioning assistance system 1.

[0298] The positioning assistance system 1, in the illustrated embodiment, includes five channels 11.1, 11.2, 11.3, 11.4, and 11.5. Alternatively, the positioning assistance system 1 may also include more than or less five channels 11.1, 11.2, 11.3, 11.4, and 11.5. In other words, the positioning assistance system 1 includes multiple channels 11.1, 11.2, 11.3, 11.4, and 11.5.

[0299] Channels 11.1, 11.2, 11.3, 11.4, and 11.5 can be configured as holes in plate 16 as described above. Channels 11.1, 11.2, 11.3, 11.4, and 11.5 are arranged in a grid pattern in plate 16. In the illustrated embodiment, channels 11.1, 11.2, 11.3, 11.4, and 11.5 have a circular cross-section or a circular cross-sectional area. In alternative embodiments, the cross-section of at least one channel 11.1, 11.2, 11.3, 11.4, and 11.5 may include an alternative shape, such as any polygon or ellipse.

[0300] Figure 9 A top view showing a fifth embodiment of the positioning assistance system 1.

[0301] Positioning assistance system 1 shows that for in Figures 6 to 8 This describes an alternative implementation of the positioning assistance system 1. The positioning assistance system 1 shown here differs from the first embodiment in the cross-section of the channel 11 and the number of channels 11. The rest... Figures 1 to 3 The description can be similarly applied to the positioning assistance system 1 shown here.

[0302] The positioning assistance system 1 includes multiple channels 11, all of which are filled with the aforementioned water-containing medium 12. For overview purposes, only one channel 11 is shown as a reference numeral in the drawing. The channels 11 are honeycomb-shaped and arranged in a grid pattern.

[0303] The walls between the channels 11 can be constructed to be sufficiently thick to ensure the stability of the plate 16. The walls between the channels 11 can also be constructed to be thin, allowing for maximum flexibility in selecting the location where the medical device should puncture the channels 11. The walls can be, for example, 0.1 mm, 0.5 mm, 1 mm, 0.5 cm, or 1 cm thick. The wall thickness can be variable, especially when the channels 11 form a first acute angle 21b with the surface normal 21a of surface 21 that is not equal to 0°. In other words, the thickness of the wall between the two channels can vary with respect to the thickness of the positioning aid system 1 when the first acute angle and / or azimuth angle of the channels are different. In other words, the wall thickness can be variably constructed along the direction of the surface normal 21a of surface 21.

[0304] Figure 10 A second embodiment of a method for locating a medical technology device 3 using a positioning assistance system 1 is shown.

[0305] The positioning assistance system 1 for implementing the method is based on... Figures 6 to 8 The above embodiments constitute the configuration.

[0306] In the method step of placing the positioning assistance system 1 (S11), the positioning assistance system 1 is placed on the surface 21. Here, the placement (S10) can include fixing or securing the positioning assistance system 1 to the surface 21 or to the object 2 as described above. In particular, before placement, the plate 16 of the positioning assistance system 1 can be coupled to the local coil 17 using a coupling device as described above.

[0307] In the method steps of detecting the first medical image, the first medical image is detected using an MRT device. In other words, the first medical image is therefore an MRT image. The positioning assistance system 1 on surface 21 is specifically mapped in the first medical image. Specifically, the target area 23 and target location 24 are also mapped in the first medical image. In particular, one or more key regions 25 may also be mapped in the first medical image.

[0308] In the method steps of determining the positions of at least one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5 and the target position 24 in the target area 23 in S13, the positions of at least one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5 and the target position 24 are determined in the first medical image. The method steps can be implemented, particularly by means of an MRT device and / or a computer system or computing unit, especially for evaluating system implementation. The positions of at least one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5 can be defined by the intersection of the centerlines 111.1, 111.2 of at least one channel 11, 11.3, 11.4, 11.5 and the contact surface 13. Alternatively, the position of at least one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5 may include the entire opening of channel 11, 11.1, 11.2, 11.3, 11.4, 11.5 in the contact surface. If the positioning assistance system 1 includes multiple channels 11, 11.1, 11.2, 11.3, 11.4, 11.5, then the positions of more than one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5, and especially all channels 11, 11.1, 11.2, 11.3, 11.4, 11.5, can be determined.

[0309] In the method steps of determining paths 4.1, 4.2, and 4.3, paths 4.1, 4.2, and 4.3 for medical technology device 3 are determined from the positions of channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 to the target position 24. These method steps can be particularly aided by MRT equipment and / or by computer systems or computing units, especially for evaluating system implementation. In particular, paths 4.1, 4.2, and 4.3 for medical technology device 3 are determined for more than one channel 11, 11.1, 11.2, 11.3, 11.4, and 11.5, and especially for all channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5. Paths 4.1, 4.2, and 4.3 can be configured to form the shortest possible distance from the corresponding locations of channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 to the target location 24 without crossing the critical area 24. In determining S4 paths 4.1, 4.2, and 4.3, the location of the medical device 3 can be determined in particular, at which the medical device 3 should pierce channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5.

[0310] In the method step of determining the second angle 21c in S15, the angle relative to the surface normal 21a of the surface 21 is determined, and the medical device 3 should pierce at least one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5 at said angle to follow the corresponding paths 4.1, 4.2, 4.3. This method step can be implemented, in particular, by means of an MRT device and / or by means of a computer system or computing unit, especially an evaluation unit. In particular, the second angle 21c can be determined for more than one channel 11, 11.1, 11.2, 11.3, 11.4, 11.5, and for each channel 11, 11.1, 11.2, 11.3, 11.4, 11.5, paths 4.1, 4.2, 4.3 have also been determined for said channel.

[0311] Optionally, an azimuth angle for the orientation or positioning of the medical device 3 can also be determined. The azimuth angle here represents the rotation of the medical device 3 about the surface normal 21a of the surface 21, which serves as the axis of rotation. The azimuth angle is determined such that the medical device 3 can follow paths 4.1, 4.2, and 4.3. In particular, the orientation or positioning of the medical device 3 when piercing channels 11, 11.1, 11.2, 11.3, 11.4, 11.5, and 11.5 can be given in spherical coordinates.

[0312] In an optional method step of classification O2, paths 4.1, 4.2, and 4.3, determined in the method step of determining paths 4.1, 4.2, and 4.3 in S14, will be classified. This method step can be particularly aided by MRT equipment and / or computer systems or computing units, especially for evaluating system implementation. In particular, if more than one path 4.1, 4.2, and 4.3 has been determined, all paths 4.1, 4.2, and 4.3 will be classified in the method step of classification O2. The classification of paths 4.1, 4.2, and 4.3 determined in the method step of classification O2 can be particularly as per the description of... Figure 2 As described.

[0313] In particular, classification O2 can be based on image processing of the first medical image. Alternatively or additionally, classification O2 can be performed by applying a training function to paths 4.1, 4.2, 4.3 and / or the first medical image. The training function can be based, in particular, on machine learning or deep learning.

[0314] For training the training function, it can be applied to multiple pre-classified paths and a first medical image. Here, the training function trains on paths among multiple paths. The classification determined by the training function for each path is compared with the pre-determined classification of the corresponding path. The training function is then adjusted such that when the training function is repeatedly applied to paths, the classification determined by the training function better corresponds to the pre-determined classification. Training is repeated iteratively for a certain period until a break criterion is met. The break criterion may in particular include the minimum similarity between the classification determined by the training function and the pre-determined classification. Alternatively or additionally, the break criterion may be a maximum number of iterations or adjustments to the training function.

[0315] In the optional method step of setting the second angle 21c of O1, the second angle 21c is set by means of the holding device 14. If more than one path 4.1, 4.2, 4.3, and thus more than one second angle 21c, has been determined, the second angle 21c of the selected path 4.1, 4.2, 4.3 is set by means of the holding device 14. In particular, paths 4.1, 4.2, 4.3 can be selected based on classification. Alternatively, additionally, or supplementarily, paths 4.1, 4.2, 4.3 can be selected based on the operator's personal preference. The selection can be automated or performed manually by the operator.

[0316] The device 14 can be referenced here. Figure 6 As described above, the angle set by the holding device 14 corresponds in particular to 90° minus the second angle 21c. In particular, the holding device 14 can be automatically set such that the holding device 14 stabilizes the medical technology device 3 at the previously determined second angle 21c.

[0317] In the method steps of piercing S16 channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5, the medical device 3 is introduced into channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5. Specifically, the medical device 3 is introduced into channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 at a second angle 12c to the surface normal 21a of surface 21. Specifically, the medical device 3 can be introduced into channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 at a location suitable for minimally invasive surgery and / or at a suitable second angle 21c and / or at a suitable azimuth angle as described above. Here, piercing S2 channel 11 is described in channel 11. Specifically, the medical device 3 can pierce channel 11 in this method step without damaging surface 21. In particular, when multiple paths 4.1, 4.2, and 4.3 have been determined, the medical device 3 is introduced into channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 corresponding to the selected paths 4.1, 4.2, and 4.3. The method of piercing channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 of S6 can also be performed, in particular, when the second angle 21c of O1 is optionally set.

[0318] In embodiments of the present invention, the aqueous medium 12 used to fill channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 can be hardened as described above after the medical device 3 punctures the S2 channel. Here, the medical device 3 is fixed at a second angle 21c by hardening. In particular, the medical device 3 is fixed at its position in the inlet channel 11. In other words, the positioning of the medical device 3 is fixed by hardening.

[0319] In the method step of detecting the second medical image S17, the second medical image is detected using an MRT device. Here, in the second medical image, the medical device 3 in the aqueous medium 12 is mapped or visible. Specifically, what is visible in the medical image is that the medical device 3 extrudes the aqueous medium 12, 12a, 12b in the channels. In particular, the medical device 3 can also be indirectly mapped in the medical image by artifacts. These artifacts are generated or caused by magnetic field distortion induced by the medical device 3. This magnetic field distortion is generated when the medical device 3 is at least partially composed of metal, especially a magnetizable metal. In other words, the medical device 3 is at least indirectly visible or mapped in the medical image by extrusion and / or magnetic field distortion. In particular, the target location 24 and / or one or more key regions 25 can also be mapped in the second medical image. In particular, the image portion mapped in the second medical image can correspond to the image portion mapped in the first medical image. In other words, the same portion or region of the object 2 and / or the positioning assistance system 1 can be mapped in both the first and second medical images.

[0320] In the method step of checking S18, it is checked in the second medical image whether the positioning of the medical device 3 is configured such that it can follow the corresponding paths 4.1, 4.2, and 4.3. In particular, it can be checked whether the positioning of the medical device 3 is suitable for performing minimally invasive surgery. In particular, it can be checked whether the medical device 3 is positioned such that it can be guided along the specific and selected paths 4.1, 4.2, and 4.3 to the target position 24 in the object 2. Here, positioning describes the position of the medical device 3 and / or the second angle 21c. Optionally, positioning may also describe the azimuth angle of the medical device 3.

[0321] Inspection S18 can be performed manually, for example by an operator. Alternatively, inspection S8 can be performed, particularly with the aid of an MRT device and / or a computer system or computing unit, especially an evaluation system. In particular, inspection S8 can be based on image processing of a second medical image, particularly by segmentation. For inspection S8, medical technology device 3, channels 11, 11.1, 11.2, 11.3, 11.4, 11.5 and / or the second target location 24 can be segmented in the second medical image. Additionally, one or more key regions 25 can also be segmented in the second medical image.

[0322] If the positioning of medical device 3 is not suitable or optimal for the selected steps 4.1, 4.2, and 4.3, as identifiable on the medical image, medical device 3 can be repositioned if necessary. For this purpose, the above method steps can be repeated at least partially and arbitrarily. In particular, the method steps of piercing channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 (S6), detecting the second medical image (S7), and checking the positioning of medical device 3 in channels 11, 11.1, 11.2, 11.3, 11.4, and 11.5 (S8) are iteratively performed in relation to the second medical image until the positioning of medical device 3 is suitable for performing minimally invasive surgery. In particular, this repositioning is feasible without the medical device 3 needing to repeatedly pierce surface 21 to be introduced into object 2.

[0323] Where it is not explicitly stated but is meaningful and within the scope of the invention, various embodiments, their various sub-aspects or features may be combined or interchanged with each other without departing from the scope of the invention. The advantages of the invention described with reference to one embodiment also apply to other embodiments where applicable, unless explicitly stated otherwise.

Claims

1. A positioning assistance system (1) for positioning a medical technology device (3) based on at least one medical image, The positioning assistance system (1) is configured for placement on the surface (21). The positioning assistance system (1) includes at least one channel (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) for the medical technology device (3). The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) and the surface normal (21a) of the surface (21) form an acute angle (21b). The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) can be punctured using the medical technology device (3). The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are filled with an aqueous medium (12). The medical technology device (3) in the aqueous medium (12) can be shown in the medical image. The medical technology device (3) is coated with a polymer catalyst. The aqueous medium (12) comprises at least one polymerizable component. The aqueous medium (12) hardens after being punctured by the medical technology device (3).

2. The positioning assistance system (1) according to claim 1. The at least one of the medical images is a magnetic resonance tomography (MRI) image.

3. The positioning assistance system (1) according to claim 1 or 2. The medical device (3) mentioned above is a biopsy needle.

4. The positioning assistance system (1) according to claim 1 or 2. The aqueous medium (12) includes at least one of the following materials: pectin, galantine, agarose, polyacrylamide, or polyurethane polymer.

5. The positioning assistance system (1) according to claim 1 or 2. The positioning assistance system (1) includes a holding device (14) for the medical technology device (3). The holding device (14) is configured to stabilize the medical technology device (3) at a second angle (21c) relative to the surface normal (21a) of the surface (21).

6. The positioning assistance system (1) according to claim 1 or 2. The positioning assistance system (1) includes a board (16). The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are configured as holes in the plate (16).

7. The positioning assistance system (1) according to claim 6. The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) have a wider width than the medical technology device (3). The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) can be pierced by the medical technology device (3) at a second angle (21c) relative to the surface normal (21a) of the surface (21).

8. The positioning assistance system (1) according to claim 6. The positioning assistance system (1) includes multiple channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5). The plurality of channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are arranged in a grid pattern in the plate (16).

9. The positioning assistance system (1) according to claim 6. The plate (16) includes a coupling device for coupling the plate to a local coil (17). The local coil (17) therein includes the mating part of the coupling device.

10. The positioning assistance system (1) according to claim 9. The local coil (17) is a toroidal coil or a butterfly coil.

11. The positioning assistance system (1) according to claim 1 or 2. The width of the channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) corresponds to the extension of the positioning assistance system (1) parallel to the surface (21).

12. The positioning assistance system (1) according to claim 11. The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are formed by hollow columns (15).

13. The positioning assistance system (1) according to claim 11. The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are formed by a body composed of an aqueous medium (12, 12a, 12b). The body portion therein forms the positioning assistance system (1).

14. The positioning assistance system (1) according to claim 13. The body portion is surrounded by a thin film. The thin film can be punctured by the medical technology device (3).

15. The positioning assistance system (1) according to claim 11. The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are parallel to the surface (21) and divided into multiple chambers (11a, 11b) according to a grid. The aqueous medium (12, 12a, 12b) in at least one of the chambers (11a, 11b) is doped with a contrast agent. The water-containing medium (12, 12a, 12b) in the two chambers (11a, 11b) having at least one common boundary surface is doped differently.

16. The positioning assistance system (1) according to claim 15. The contrast agent mentioned above includes gadolinium and / or iron oxide.

17. The positioning assistance system (1) according to claim 15. The doped aqueous medium (12a) is visually stained with the first color. The unadulterated aqueous medium (12b) is visually stained with a second color. The first color and the second color are different from each other.

18. The positioning assistance system (1) according to claim 1 or 2. The aqueous medium (12) therein is doped with a contrast agent.

19. The positioning assistance system (1) according to claim 18. The contrast agent mentioned above includes gadolinium and / or iron oxide.

20. The positioning assistance system (1) according to claim 12. The two openings of the hollow column (15) are sealed with a membrane and / or the channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are sealed with a membrane at the two openings, wherein the membrane can be punctured by the medical device (3).

21. The positioning assistance system (1) according to claim 1 or 2. The positioning assistance system (1) includes an adhesive device. The bonding device is configured to releasably fix the positioning aid system (1) to the surface (21).

22. A method for positioning a medical technology device (3) using a positioning assistance system (1) according to any one of claims 1 to 21, the method comprising the following steps: - Place the positioning assistance system (1) (S1, S11) on the surface (21), - The channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are punctured (S2, S16) using the medical technology device (3). - Medical images (S3, S17) were examined using magnetic resonance imaging (MRI) equipment. The medical technology device (3) is visible in the medical image within the aqueous medium (12, 12a, 12b).

23. The method according to claim 22, further comprising: - Check the positioning of the medical technology device (3) in the medical image (S4, S18).

24. The method according to claim 22 or 23, further comprising the following method steps: - A second angle (21c) is set relative to the surface normal (21a) of the surface (21) by means of the holding device (14) of the positioning assistance system (1) for the medical technology device (3).

25. The method according to claim 22 or 23, The aqueous medium (12, 12a, 12b) hardens after the channel (11) is punctured (S2, S16) by the medical device (3), and the aqueous medium (12) comprises at least one of the following materials: pectin, galantine, agarose, polyacrylamide, or polyurethane polymer. The medical technology device (3) is fixed by hardening at a second angle (21c) relative to the surface normal (21a) of the surface (21).

26. The method according to claim 22 or 23, comprising the following method steps: - The first medical image was detected using a magnetic resonance imaging (MRI) scanner (S12). - In the first medical image, determine (S13) the position of the at least one channel (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) and the target position (24) in the target area (23). - Determine (S14) the path (4.1, 4.2, 4.3) of the medical technology device (3) from the position of the at least one channel (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) to the target position (24). - Determine (S15) a second angle (21c) relative to the surface normal (21a) of the surface (21), at which the medical device (3) shall pierce the at least one channel (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) to follow the path (4.1, 4.2, 4.3). - The puncture (S16) step includes puncturing the channel (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) at the second angle (21c) using the medical technology device (3). - The step of detecting (S3) the medical image includes / forming a second medical image by means of the magnetic resonance tomography device (S17), wherein the medical technology device (3) is visible in the second medical image within the aqueous medium (12). - In the second medical image, detect (S18) whether the positioning of the medical technology device (3) in the channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) is configured such that the medical technology device (3) can follow the path (4.1, 4.2, 4.3).

27. The method according to claim 26, The aqueous medium (12) hardens after the channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are punctured using the medical device (3), and the aqueous medium (12) comprises at least one of the following materials: pectin, galantine, agarose, polyacrylamide, or polyurethane polymer. The second angle (21c) of the medical technology device (3) is fixed by hardening.

28. The method according to claim 26, In the method step of determining the path (4.1, 4.2, 4.3) in (S14), the path (4.1, 4.2, 4.3) from the position of more than one channel (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) to the target position (24) is determined respectively, wherein the multiple channels (11, 11.1, 11.2, 11.3, 11.4, 11.5, 11.5) are arranged in a grid in the plate (16) of the positioning assistance system (1). In the method step of determining (S15) the second angle (21c), an angle is determined for each path (4.1, 4.2, 4.3). The method further includes the following method steps: - Classify the paths (4.1, 4.2, 4.3) according to their orientation and / or their mechanical realizability (O2).

Images