Surgical navigation system and navigation method with improved instrument tracking

Abstract

A navigation system having a presentation device, a medical instrument to be tracked, a data providing unit, the unit being adapted to provide digital 3D shot data, a medical imaging device having a shot head, which is adapted to create a visual shot of a surgical area of a patient and to detect and track the medical instrument to be tracked relative to the shot head, a tracking system, which is adapted to detect and track the shot head of the imaging device and to detect at least one partial section of the patient for registration with the 3D shot data, and a control unit, which is adapted to process the data of the imaging device, the data of the tracking system and the provided 3D shot data and to determine a position and / or orientation of the instrument to be tracked by correlating the tracking from the tracking system to the shot head and the tracking from the shot head to the instrument and to create a correlated presentation of the 3D shot data registered with the patient and the position and / or orientation of the instrument and to visually output the correlated presentation by the presentation device.

Description

Technical Field

[0001] This disclosure relates to a surgical navigation system for navigating during surgical procedures on a patient to track / trace at least one medical instrument used in the procedure. Furthermore, this disclosure relates to navigation towers, navigation methods, and computer-readable storage media. Background Technology

[0002] Typically, surgical navigation can only be performed using specialized instruments with marking systems, such as infrared reference points or electromagnetic tracking systems. These instruments are called pointers or indicators and are particularly well-suited for marking positions in three-dimensional space with their tips, which are then detected by the navigation system.

[0003] Currently, to obtain the necessary navigation information during surgery, the user, such as the surgeon, must interrupt their workflow, take a specially adapted (pointer) instrument into their hand, and guide it to the desired position, where the sole function of the (pointer) instrument is to provide navigation information. This continuous change between instruments adversely prolongs the operation for the patient and also leads to surgeon fatigue. Furthermore, multiple medical instruments with different functions are always provided.

[0004] Furthermore, a current problem is that navigation systems typically use external camera systems, such as stereo cameras spaced apart from the surgical area. Therefore, in surgical navigation systems, such as infrared-based systems, the visible area is severely limited in the unclear environment of the surgical area, especially when the navigation system and surgical microscope are used simultaneously. Instrument tracking is temporarily interrupted, and tracking accuracy deteriorates. Moreover, limitations must be observed regarding the openable visible area used for camera systems, further complicating surgery on the patient. Summary of the Invention

[0005] Therefore, the task and objective of this disclosure is to provide a surgical navigation system, a navigation tower, a navigation method, and a computer-readable storage medium that avoids or at least reduces the disadvantages of the prior art. In particular, a surgical navigation system and method should be provided that offers higher accuracy in tracking / tracing medical instruments and allows for continuous and uninterrupted tracking and even better detection of the surgical area. Users, especially surgeons, should have access to better and safer navigation modes. Furthermore, a sub-task is to better support and expedite surgical workflows. Another sub-task can be considered as using existing surgical instruments as pointers or requiring only slight modifications, particularly only supplementing existing surgical instruments. Additionally, another sub-task is to increase the available navigation time during surgery.

[0006] The objectives of this disclosure are achieved in respect of surgical navigation systems of this type by the features of the invention, in respect of navigation towers of this type by the features of the invention, in respect of navigation methods by the features of the invention, and in respect of computer-readable storage media by the features of the invention.

[0007] Therefore, the basic concept of this disclosure lies in the fact that, in surgical navigation systems and methods, medical instruments are not detected directly and absolutely, for example, through a camera system, but indirectly, on the one hand, through tracking by the camera head of an imaging medical device positioned closer to the surgical area than the camera system, and on the other hand, through tracking of the medical instruments by the camera head itself, so that the position and / or orientation of the instruments can be calculated or determined by the cascaded connection of the two tracking methods. If the patient is registered relative to the navigation system, 3D imaging data, especially preoperative 3D imaging data, such as MRT and / or CT scans, are also registered relative to the patient, and the specific position and / or orientation of the instruments can be determined for navigation in the 3D imaging data and then presented to the user.

[0008] To a certain extent, this approach decouples the direct tracking of instruments with at least two parts of sequential tracking: one part is the tracking by the imaging head, and the other part is the independent tracking of the instrument via the imaging head. The two tracking methods provide two separate (coordinate) transformations, which are correlated to obtain a transformation of the instrument being tracked. Due to this independence, different tracking systems and / or methods can be used, allowing for the use of a tracking system aligned with the imaging head and suitable for larger distances to track the imaging head, while simultaneously enabling different and specifically adapted tracking methods to track the instrument for smaller distances within the surgical area. In this way, even common, standardized medical instruments, especially surgical instruments, can be detected, which is impossible in the prior art.

[0009] Through this serial tracking of at least two coupled or two-stage components, exceptionally high tracking accuracy / precision can be achieved due to the small distance between the imaging medical device (especially a stereo microscope) and the instrument being used. This also avoids the line-of-sight problems, as is often the case with an external navigation camera, since the navigation camera does not need to observe the instrument being tracked itself, but only the imaging medical device's head, especially the microscope head of an optical system with a surgical microscope. Furthermore, the surgical workflow is not interrupted by the use of the navigation system, because standard instruments can also be tracked by detecting and tracking the instruments through the imaging device's head, without the need for replacement with navigation instruments such as pointers.

[0010] Furthermore, surgery utilizing navigation methods becomes safer because the net navigation time available to surgeons is further increased. Standard surgical instruments are guided throughout their use.

[0011] In other words, a surgical navigation system is provided for navigating and tracking at least one object, particularly a medical device, during surgical procedures on a patient, comprising: a presentation device, particularly a monitor, for presenting visual content; at least one object to be tracked, particularly a medical device; a medical imaging device having a camera head adapted to create optical or visual imaging of a surgical area in the patient, and to detect the object to be tracked, particularly the medical device, in the surgical area of ​​the patient and to track / trace the object to be tracked relative to the camera head; and an (external) tracking system adapted to at least detect the camera head of the imaging device and track relative to the tracking system, and to detect and, particularly, track the patient having a surgical area for registration. The system comprises at least one segment; a data providing unit, particularly a storage unit, adapted to provide digital 3D imaging data of the patient, particularly preoperative 3D imaging data; and a control unit adapted to process data from the imaging device, data from the tracking system, and the provided 3D imaging data, and to determine the position and / or orientation of the object to be tracked, particularly the instrument, particularly the instrument tip, by associating (transformation or transformation matrix) the tracking from the tracking system to the imaging head and the tracking from the imaging head to the object, particularly the instrument, and transmitting this to the 3D imaging data of the patient registered with the tracking system and visually outputting the 3D imaging data via a presentation device. The control unit can create an associated presentation with the patient-registered 3D imaging data and the determined / calculated position and / or orientation of the instrument and visually output this associated presentation via a presentation device. In this way, the surgeon can display the precise position of the (virtual) instrument, particularly the instrument tip, in the 3D imaging data on, for example, a surgical monitor.

[0012] Therefore, based on the patient being examined, the imaging head being examined, and the instruments being examined through the imaging head, the position and / or orientation of the instruments, especially the instrument tips, can be determined using 3D imaging data. In this way, the position and / or orientation of surgical instruments can be determined relative to the patient's 3D imaging data (3D images).

[0013] Therefore, a navigation system is provided for tracking surgical instruments and displaying their position, especially their orientation, relative to 3D image data (3D image set) of the patient during surgery, wherein the instrument is tracked by an optical system, the optical system is tracked by a tracking system of the navigation system, and the patient is also tracked by the navigation system (for registration with the 3D image data).

[0014] The term "position" refers to a geometric location in three-dimensional space, specifically described using coordinates in a Cartesian coordinate system. In particular, this position can be described by three coordinates: X, Y, and Z.

[0015] The term "orientation" further describes a direction in space (approximately at that location). Orientation can also be described by referring to a direction or rotation in three-dimensional space. In particular, this orientation can be described using three angles.

[0016] The term "orientation" encompasses both position and orientation. In particular, orientation can be described using six coordinates: three positional coordinates (X, Y, and Z) and three angular coordinates for orientation.

[0017] Here, the term 3D is defined as the presentation of photographic data in space, i.e., in three dimensions. The patient's body or at least a portion of the body having a spatial extent can exist digitally as photographic data in a three-dimensional space having, for example, a Cartesian coordinate system (X, Y, Z).

[0018] The medical instruments to be tracked can be, for example, pipettes or forceps, whose distal tips allow for particularly precise definition of points in space. Smaller medical devices can also be tracked via surgical navigation systems.

[0019] Advantageous implementation methods are described below.

[0020] According to a preferred embodiment, the medical imaging device is a surgical microscope and / or a medical endoscope / surgical endoscope, adapted to perform spatial detection for tracking, and particularly equipped with a 3D camera system for detecting depth information. For example, in craniotomy, the surgical microscope supports the surgeon during the procedure. A tracking system of a surgical navigation system is used to track the position of the microscope head. In particular, a stereomicroscope is used during surgery to identify surgical instruments and calculate their relative positions to the microscope's image sensors. Therefore, the imaging device (vision system) can be a surgical microscope or a surgical endoscope. In particular, the surgical navigation system can thus be used in conjunction with a surgical microscope, especially a stereomicroscope, where the control unit is particularly adapted to provide the corresponding navigation data. Using a (typical) surgical microscope, it is possible to aim at the portion of interest in the surgical area at a distance of several centimeters and to locate and track instruments with particularly high precision.

[0021] According to another preferred embodiment, the imaging head of the medical imaging device may have a stereo camera for stereo imaging, and the control unit is particularly adapted to detect the three-dimensional position and / or orientation of the instrument, especially the tip of the instrument, relative to the imaging head in space by means of machine vision from the stereo imaging. In other words, the imaging device may include a stereo camera system and / or a 3D camera system with depth information. Therefore, only the control unit must be adapted accordingly for evaluation, and standardized equipment, such as a stereo microscope or endoscope with an end-side stereo camera, can be used.

[0022] According to another embodiment of this disclosure, the navigation system may include an image analysis device adapted for three-dimensional spatial detection of the actuator from at least two shooting perspectives, particularly stereoscopic shooting, using machine vision. In other words, the navigation system may include a camera system with at least one camera and perform three-dimensional detection and tracking of the actuator based on machine vision.

[0023] Preferably, the control unit can be adapted to determine the three-dimensional position and / or orientation of the instrument using image processing (analysis) techniques and / or using triangulation of stereoscopic images and / or reconstruction of parallax overlap from stereoscopic images. In particular, the control unit can also be adapted to perform navigation using the principles of 3D reconstruction and position determination based on stereoscopic images. Here, specifically for each pixel in the left image of a stereoscopic image, the corresponding pixel is located in the right image. The positions of these two pixels are used to calculate the apparent depth of that pixel. Alternatively or additionally, image processing techniques can be used to calculate the orientation (3D position) of the surgical instrument relative to the imaging head. In particular, the orientation (3D position) of the instrument can be determined by identifying the instrument in the left and right images based on the principles of triangulation. Alternatively or additionally, the position and / or orientation can be determined by reconstruction of parallax overlap from stereoscopic images. The instrument is identified in this depth map / parallax map, and its orientation (3D position) is calculated directly from the corresponding depth value. Instrument identification can be performed using methods such as: image processing methods for each color image captured by the left or right camera; image processing methods using a pair of left and right cameras simultaneously; image processing methods using a single disparity map / depth map; or image processing methods using a combination of the above methods. In particular, machine vision methods also include deep learning methods using neural networks or image transformations (vision transformers); manually designed features, such as line recognition or color recognition; or adaptation of 3D models to images. Preferably, at least one instrument is tracked via machine vision, via a surgical (stereoscopic) microscope, and the surgical microscope itself is tracked via a navigation system.

[0024] In particular, the predetermined / defined optical pattern detected by the imaging head can be set, especially integrated, on the optically visible outer side of the medical device to be tracked, particularly on the distal end or end segment of the device. The control unit itself is adapted to identify and decrypt the optical pattern or compare the optical pattern with a reference stored in a storage unit and determine the position of the device tip relative to the optical pattern or the geometry of the device based on the detected optical pattern. Thus, the control unit can obtain information about the position of the device tip or the geometry of the device through the optical pattern. Therefore, the at least one device has a predefined optical pattern / optical mark, especially integrated in the distal end or end segment, and is detected by the imaging head. Information transmitted via the optical pattern can be useful because it is difficult to identify the accurate position of the device tip due to occlusion of the device tip or in the case of low contrast of the device. However, it is significantly simpler to identify a specific optical pattern on the body segment of the device, and the control unit can use this information to infer the position of the device tip. One advantage is that it provides better ergonomics for navigation. In particular, the surgical instruments used in the navigation system are not modified or are only slightly modified, especially by markings preferably at or in the area of ​​the tip. Compared to traditional navigation instruments with large, rigid bodies, performing such seemingly simple and minor modifications allows for more precise instrument tracking. For example, direct optical marking can be achieved by simply engraving specific patterns on the instrument, such as QR codes, data matrix codes, barcodes, lines, dots, or textures. The optical mark can be a QR code, at least two loops with a predefined distance between them, or other clearly defined patterns that the control unit can decrypt and, in particular, associate with stored information. These optical marks can be used, in particular, to encode the position of the instrument tip and / or indicate the geometry of the instrument. Specifically, the predetermined optical pattern can be a QR code, and the distance from the QR code to the instrument tip can be encoded and stored within the QR code, thereby enabling the determination of the instrument tip's position.

[0025] According to another embodiment, the optical pattern may be a QR code, wherein the distance from the QR code to the instrument tip is encoded and stored in the QR code, thereby enabling the determination of the position of the instrument tip.

[0026] In particular, image processing technology can be used to learn the visual appearance of existing surgical instruments to provide optimal recognition accuracy.

[0027] According to the implementation, the geometry of at least one medical device, and in particular multiple medical devices, is stored in a storage unit, especially through initial three-dimensional detection via the imaging head and / or the tracking system. The control unit determines the position, and in particular the orientation, of the distal tip based on a portion of the device to be tracked detected by the imaging head and the stored geometry. Device identification can be simplified, in particular, by unifying the visual or geometric appearance of the at least one device. Therefore, the device does not need to be altered, and the known stored geometric information is used to identify the 3D shape of the device and ultimately determine its orientation.

[0028] Preferably, the tracking system may have an infrared-based camera system and / or an electromagnetic-based system and / or an IMU (Inertial Measurement Unit)-based tracking system. In the case of an IMU, the IMU may be particularly arranged in the camera head to track the camera head.

[0029] The objective of this disclosure is achieved in the area of ​​mobile medical navigation towers by comprising: a navigation system according to this disclosure; and a drivable base / mobile vehicle with wheels for the mobile placement of the navigation tower. Through its design as a compact mobile unit, the navigation tower can be flexibly placed in different locations within the operating room. Therefore, a mobile and trolleyable medical vehicle with a navigation system according to this disclosure is proposed, particularly featuring a computer and monitor for implementing the control unit.

[0030] In terms of navigation methods for navigating during a patient's surgical procedure to track / trace at least one medical device, particularly in the surgical navigation system of this disclosure, this task is addressed through the following steps:

[0031] Register the patient's 3D imaging data with respect to the patient's specific areas, particularly those of the patient.

[0032] The medical imaging device detects and tracks the instrument to be tracked using its camera lens;

[0033] The imaging head of the medical imaging device is detected and tracked by a tracking system;

[0034] By associating the tracking of the camera head with the tracking of the medical device, the position and / or orientation of the medical device are determined / calculated;

[0035] In particular, the detected position and / or orientation of the medical device is transmitted to the 3D imaging data (3DA); and

[0036] The presentation is achieved by outputting 3D imaging data from the presentation device in combination with at least the stated position and / or orientation of the medical device.

[0037] According to an embodiment, the navigation method may further include the steps of: creating a stereoscopic image using an imaging medical device; creating a depth map with depth information based on the stereoscopic image using image processing techniques and / or using triangulation and / or using parallax overlap reconstruction; and determining the position and / or orientation of the device based on the stereoscopic image and the depth map.

[0038] In particular, when the predetermined optical pattern is a QR code and the distance between the QR code and the instrument tip is encoded in the QR code, the navigation method further includes the steps of: decoding the QR code; reading the distance to the instrument tip; determining the position of the instrument tip relative to the camera head; and determining the position relative to the 3D imaging data via the tracking camera head.

[0039] In the case of a computer-readable storage medium, the task is satisfied in such a way that the computer-readable storage medium includes instructions that, when executed by a computer, cause the computer to perform the method steps of the navigation method according to this embodiment.

[0040] Any disclosure relating to the navigation system of this disclosure is equally applicable to the navigation method of this disclosure, and vice versa. Attached Figure Description

[0041] The invention will now be explained in more detail with reference to the accompanying drawings and preferred embodiments. It is shown that:

[0042] Figure 1 A schematic view showing a surgical navigation system with a preferred embodiment of a stereoscopic surgical microscope;

[0043] Figure 2 Show Figure 1 A detailed schematic view of the navigation system in the image, showing the instrument being tracked by the camera head of a surgical microscope;

[0044] Figure 3 Show Figure 1 and Figure 2 A schematic view of a stereoscopic image taken with a microscope lens, showing the inspection of surgical instruments;

[0045] Figure 4 Shown by according to Figures 1 to 3 A schematic view of 3D reconstruction based on triangulation from stereoscopic photography;

[0046] Figure 5 A schematic view showing the depth map obtained from a stereoscopic image used for three-dimensional inspection of an instrument to be tracked;

[0047] Figure 6A second preferred embodiment of the surgical navigation system is shown, wherein a QR code is visibly mounted on the distal end section of the instrument;

[0048] Figure 7 A third preferred embodiment of the surgical navigation system is shown, wherein spaced-apart rings are disposed on and are visible on the distal end section of the instrument;

[0049] Figure 8 A mobile navigation tower with a surgical navigation system is shown as another preferred fourth embodiment; and

[0050] Figure 9 A flowchart illustrating a preferred embodiment of the navigation method is shown.

[0051] Wherein: 1-Surgical navigation system; 2-Presentation device; 4-Medical instrument; 6-Imaging device / stereo microscope; 8-Picture head; 10-Tracking system; 12-Storage unit; 14-Control unit; 16-Instrument tip; 18-Depth map; 20-Optical marker; 22-Distal end region of the instrument; 24-QR code; 26-Side surface; 28-Longitudinal axis of the instrument; 30-Ring; 32-Ring assembly; 100-Navigation tower; 102-Wheel; P-Patient; E-Surgical area; A-(Stereo) S1 - Step to detect 3D imaging data before surgery; S2 - Step to register the patient with respect to the 3D imaging data; S3 - Step to orient the imaging head to the surgical site; S4 - Step to track the imaging head using a tracking system; S5 - Step to track the instrument using the imaging head; S6 - Step to detect the patient's orientation using a tracking system; S7 - Step to determine the position and / or orientation of the instrument relative to the 3D imaging data; S8 - Step to create associated presentation and output using a presentation device.

[0052] The accompanying drawings are schematic in nature and are for illustrative purposes only. The same elements are given the same reference numerals. Features of the various embodiments may be substituted for each other. Detailed Implementation

[0053] In order to explain this disclosure and its principles Figure 1 A surgical navigation system 1 for navigating during surgery at patient P is shown in a schematic side view. The navigation system 1 has a presentation device 2 in the form of a surgical monitor for visually outputting navigation information to the surgeon.

[0054] In the patient's surgical area, here on the patient's head, the surgeon responds using medical instruments 4, such as forceps, pipettes, or sealing instruments. The surgeon wants to use navigation system 1 to track the medical instruments and perform the surgery accordingly.

[0055] The stereoscopic surgical microscope (hereinafter simply referred to as microscope) 6, serving as a medical imaging device, has a (stereo) microscope head as an imaging head 8, which has an optical system (not shown) with sensors connected downstream, such as CMOS sensors or CCD sensors, to create a visual stereoscopic image A (two video shots spaced apart from each other from different locations) of a portion or segment of the surgical area E in the patient P. In addition to the surgical area itself, the microscope 6 also detects and tracks a medical instrument 4 used by the surgeon in the surgical area E. As will be explained in more detail later, the navigation system 1 can detect and track or trace the instrument spatially in terms of its position and orientation (i.e., its orientation relative to the imaging head 8) based on the stereoscopic image A.

[0056] The external tracking system 10 of the navigation system 1, especially the infrared-based tracking system 10, is arranged in the form of an external (stereo) camera in the area of ​​the patient's legs. This tracking system also detects the camera head 8 of the microscope 6 and can detect and track the microscope in three dimensions, especially when an infrared marker is attached to the microscope.

[0057] A data providing unit, in the form of storage unit 12, such as an SSD memory, provides preoperative digital 3D imaging data 3DA of the patient P in the form of MRT and / or CT images for navigation. The patient P is detected by tracking system 10, for example, by placing infrared markers on the patient's head and registering them relative to the 3D imaging data 3DA. In this way, "real" current data, especially stereoscopic image A, is associated with "virtual" 3D imaging data 3DA. Tracking system 10 also detects possible movement of the patient's body during surgery and re-registers the patient to the 3D imaging data 3DA as the patient moves.

[0058] Here, the control unit 14 of the navigation system 1 is particularly adapted to process the data from the imaging device 6, the data from the tracking system 10, and the provided 3D imaging data 3DA, and to determine the orientation of the tracked instrument 4 and the position of the instrument tip 16 of the instrument 4 by associating the tracking from the tracking system 10 to the imaging head 8 and the tracking from the imaging head 8 to the instrument 4. Specifically, the tracking system 10 provides a first transformation matrix for tracking the imaging head 8 (microscope head) to infer the current local coordinate system of the imaging head 8 from the local coordinate system of the tracking system 10 (here, the local coordinate system of the external (stereo) camera). The tracking of the instrument 4 by the imaging head 8 provides a second transformation matrix from the local coordinate system of the imaging head 8 to the local coordinate system of the instrument 4. The control unit 14 processes these first and second transformation matrices from the local coordinate system of the external (stereo) camera toward the instrument 4 itself into a total transformation matrix.

[0059] Furthermore, patient P is also registered with tracking system 10, which means that the relationship between patient P's local coordinate system and the local coordinate system of the external (stereo) camera is also detected. This relationship is provided to control unit 14 as a transformation matrix on the patient side. In addition, patient P is registered with 3D imaging data 3DA, so that (ideally) the real patient P is consistent with the 3D imaging data 3DA.

[0060] Therefore, on the one hand, through the total transformation matrix from instrument 4 (via imaging head 8) to the external camera and further from the external camera to the patient P or to 3D imaging data 3DA, the orientation (position and orientation) of the instrument 4 to be tracked can be transferred to the 3D imaging data 3DA and displayed accordingly for navigation. The control unit creates an associated presentation that, on the one hand, has the 3D imaging data 3DA registered with the patient P and on the other hand, displays the position and / or orientation of instrument 4 together in the 3DA imaging data 3DA (position or orientation correct, especially orientation correct), especially a virtual geometric model of instrument 4. This associated presentation is then output by the surgical monitor, and the surgeon can see the position of instrument 4 and its instrument tip 16 in the patient P at any time, even if the instrument tip 16 is not visible.

[0061] The combination of two tracking devices provides surgeons with exceptionally flexible and safe navigation. The visible area of ​​microscope 6 is typically perpendicular to the surgical area E containing tissue, minimizing obstruction from other objects. Standardized tracking instruments 4 can also be used for navigation during surgery, as special pointer instruments are unnecessary due to the excellent visual inspection and accompanying tracking capabilities provided by microscope 6.

[0062] To explain the tracking of the camera head 8 to the device 4, Figure 2 and Figure 3 On the one hand, it is shown in detailed partial views. Figure 1 The microscope 6 is shown, along with an exemplary (two-dimensional) stereoscopic image A. The imaging head 8 of the microscope 6 has an optical system and two spaced-apart image sensors connected downstream, such as... Figure 3 As schematically illustrated, the image sensor sequentially provides two (slightly) different shots (left and right) from correspondingly different viewpoints. Depth can then be determined by analyzing the images taken from the left and right shots, as shown in the following reference. Figure 4 and Figure 5 The explanation given.

[0063] exist Figure 4The principle of 3D reconstruction from two two-dimensional images (stereoscopic image A with left and right views) is illustrated in the diagram. Here, depth information for 3D reconstruction is obtained using the principle of triangulation. Therefore, 3D spatial detection, especially 3D detection of the instrument 4 to be tracked, can be performed using stereoscopic imaging. Tracking of the instrument 4 is implemented here by the control unit 14. Therefore, in this embodiment, if the surgical microscope 6 only provides stereoscopic image A to the control unit 14, it is sufficient for the control unit 14 to determine the orientation of the instrument 4 relative to the imaging head 8 (more precisely, relative to the sensor) based on the aforementioned image analysis.

[0064] Therefore, by using image analysis to track the device 4 through the camera head 8 and the tracking of the camera head 8 through the tracking system 10, and the association of the 3D imaging data 3DA with respect to the patient P registration, it is possible to present the orientation of the device 4, especially the position of the device tip 16, in the 3D imaging data in a particularly simple and reliable manner.

[0065] exist Figure 5 The diagram further illustrates 3D reconstruction based on stereoscopic image A. Here, for each pixel in the left image, a corresponding pixel is found in the right image (or vice versa), where the depth of the pixel is calculated by control unit 14 based on these two pixels. If this is performed for each pixel of stereoscopic image A, a depth map 18 is finally generated (in...). Figure 5 (Illustrated in the right image), the spatial three-dimensional structure is determined by using the depth map together with the left and right images of stereoscopic imaging A, and thus the orientation of instrument 4 and the position of instrument tip 16 can also be detected.

[0066] Figure 6 A surgical navigation system 1 with exemplary imaging is schematically illustrated according to another preferred second embodiment. Navigation system 1 and... Figures 1 to 5 The only difference in the navigation system is that the current navigation system has a specially adapted instrument 4 with optical markers 20 to be tracked, and the control unit 14 is adapted to assign information to the optical markers and to determine the position of the instrument tip 16.

[0067] Specifically, a QR code 24 is engraved on the lateral surface / side surface 26 of the instrument 4 in the distal end region 22. Thus, a standardized instrument 4 can be subsequently modified and adapted, requiring only a particularly simple and rapid engraving, for example, using a laser. Information that the control unit can decrypt and interpret is encoded in the QR code 24. On one hand, distances in cm can be directly encoded in the QR code 24, allowing the position of the instrument tip 16 to be inferred directly from the position of the QR code 24 along the longitudinal axis 28 of the instrument 4, independent of the evaluation procedure. Alternatively, the QR code can have an ID as a reference, allowing the position of the instrument tip 16 to be inferred using data stored in the storage unit 12, which also contains the distance from the QR code 24 to the instrument tip 16. In this way, the instrument tip 16 can also fade into the 3D imaging data 3DA without direct visual contact, assisting the surgeon during navigation.

[0068] Figure 7 Another preferred embodiment of the surgical navigation system is shown. Unlike the second embodiment with QR code 24, the instrument 4 to be tracked has a circumferential ring 30, which is combined into ring groups 32. The ring groups 32 are arranged along the longitudinal axis 28 of the instrument 4 with the circumferential rings 30 and encode the distance from the respective ring group 32 to the instrument tip 16. A first ring group 32 with a single circumferential ring is arranged at a distance of 10 cm, a second ring group 32 with two rings is arranged at a distance of 20 cm, and a third ring group 32 with three rings 30 is arranged at a distance of 30 cm. On the other hand, the control unit 14 is adapted to determine the distance to the instrument tip 16 by means of the ring groups 32.

[0069] By means of optical markings 20 on particularly well-visible sections of instrument 4, the position, especially orientation, of the instrument tip 16 relative to the optical markings and, if necessary, also relative to characteristic design features can be encoded, or even the geometric information of instrument 4 can be encoded directly or indirectly through a database.

[0070] Figure 8 A mobile navigation tower 100 with a surgical navigation system 1 is shown as another preferred fourth embodiment. Equipped with wheels 102, the navigation tower 100 can be flexibly used at different locations within the operating room. The surgeon can view on a monitor a side-by-side presentation of microscope images and a correlated presentation with 3D imaging data (3DA), as well as the orientation of the instruments 4 fading in.

[0071] Figure 9 A flowchart illustrates a navigation method according to a preferred embodiment, which can be performed in a surgical navigation system, particularly in the navigation system 1 described above.

[0072] In the first step S1, the preoperative 3D imaging data of patient P is examined.

[0073] In the second step S2, the patient P is registered with the 3D imaging data using 3DA.

[0074] Preferably, in step S3, the imaging device 6 (visualization system) or the camera head 8 is directed onto the surgical area E on the patient P.

[0075] In step S4, the imaging head of the imaging device is positioned and tracked by the tracking system.

[0076] In step S5, the (three-dimensional) orientation (position and orientation) of the instrument relative to the imaging head 8 is determined by the imaging device, especially by stereo imaging.

[0077] Preferably, in one step, the surgical instrument 4 can be guided by the surgeon in the surgical area E.

[0078] Preferably, in step S6, the patient is detected and located in three dimensions by the tracking system 10.

[0079] In the subsequent step S7, the position and / or orientation of the computing device 4 relative to the patient P is calculated, and thereby the position and / or orientation of the computing device relative to the previously registered 3D imaging data 3DA is calculated.

[0080] Finally, in step S8, an associated presentation is generated and the position and / or orientation of the device 4 are faded into the 3D capture data 3DA and output through the monitor.

Claims

1. A surgical navigation system (1) for navigating and tracking at least one medical device during surgical procedures on a patient (P), comprising: Presentation device (2), used to present visual content; At least one medical device to be tracked (4); A data providing unit, the data providing unit being adapted to provide digital 3D imaging data (3DA) of the patient (P). Medical imaging device (6), having a camera head (8); A tracking system (10) adapted to detect and track the camera head (8) of the medical imaging device (6) and to detect and track at least one portion of the patient (P) for registration with the 3D imaging data (3DA); Its features The imaging head of the medical imaging device (6) is adapted to create an image of a segment of the surgical area (E) of the patient (P), and to detect and track a medical device (4) to be tracked relative to the imaging head (8). A control unit (14) is adapted to process data from the medical imaging device (6), data from the tracking system (10), and provided 3D imaging data (3DA), and to determine the position and / or orientation of the medical device (4) to be tracked by associating tracking from the tracking system (10) to the imaging head (8) and tracking from the imaging head (8) to the medical device (4), and to create an association presentation with the 3D imaging data (3DA) registered with the patient (P) and the position and / or orientation of the medical device (4) and output the association presentation through the presentation device (2).

2. The surgical navigation system (1) according to claim 1, characterized in that, The medical imaging device (6) is a surgical microscope or medical endoscope adapted to perform three-dimensional detection for tracking.

3. The surgical navigation system (1) according to claim 1 or 2, characterized in that, The imaging head (8) of the medical imaging device (6) has a stereo camera for stereo imaging (A), and the control unit (14) is adapted to detect the position and / or orientation of the medical device (4) relative to the imaging head (8) by means of machine vision from stereo imaging (A).

4. The surgical navigation system (1) according to claim 3, characterized in that, The control unit (14) is adapted to determine the position and / or orientation of the medical device (4) by means of triangulation of the stereoscopic image (A) and / or reconstruction of parallax overlap of the stereoscopic image (A).

5. The surgical navigation system (1) according to claim 1, characterized in that, A predetermined optical pattern (20) is arranged on the outside of the medical device (4) to be tracked, and the control unit (14) is adapted to decrypt the optical pattern (20) or compare it with a reference stored in a storage unit, and determine the position of the device tip (16) relative to the optical pattern (20) or the geometry of the medical device (4) based on the detected optical pattern (20).

6. The surgical navigation system (1) according to claim 1, characterized in that, The geometry of the at least one medical device (4) is stored in the storage unit (12), and the control unit (14) determines the position of the device tip (16) based on a portion of the medical device (4) detected by the camera head (8) and the stored geometry.

7. The surgical navigation system (1) according to claim 1, characterized in that, The tracking system (10) has an infrared-based camera system and / or an electromagnetic-based system and / or an IMU-based tracking system.

8. The surgical navigation system (1) according to claim 1, characterized in that, The navigation system (1) has an image analysis device adapted to perform three-dimensional spatial detection of the orientation of the medical device (4) from at least two shooting angles.

9. A mobile medical navigation tower (100), comprising: The surgical navigation system (1) according to claim 1; and A drivable vehicle with wheels (102) is used for the mobile placement of the navigation tower (100).

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