Surgical tool with positioning guidance

Abstract

A powered surgical tool for a user to manipulate intended tissue in a surgical site in a patient may include a body having a tissue manipulation portion that is energizable and has a manipulation member for manipulating the intended tissue, and a projection device having an exit port. The projection device can be supplied with power in order to emit an optical positioning marker from the exit port in a positioning direction onto the surgical site in a manner operatively associated with the operating direction and visible to the user, the operating member and the operating direction are configured to provide information relating to at least one of a position and an orientation of the operating member and the operating direction within the surgical site. An imaging device may be provided to acquire an image of the surgical site using an optical receiver attached to the body. The device may also measure and / or indicate a distance from the surgical site.

Description

Technical Field

[0001] The present disclosure relates generally to surgical tools for manipulating tissue in a surgical site of a patient and, more particularly, to such surgical tools that provide positioning guidance to a user. Background Art

[0002] Electric surgical tools have been developed to manipulate (i.e., change, cut, remove or destroy) tissue in a desired area within a surgical site during medical or dental surgery. Such tools can use contact structures (e.g., abrasives) or non-contact structures (e.g., lasers) to achieve such manipulations. Therefore, surgical tools use means such as ultrasonic vibrations, oscillating motions, rotational motions, laser energy, electrical energy, electromagnetic energy, magnetic energy, radiofrequency energy, radioactive energy, chemical energy or reactants, mechanical energy, and thermal energy to manipulate tissues to achieve the desired surgical results. Whether as part of a surgical tool or as part of a separate insertion tool, an additional catheter can be used to provide fluid to flush and / or cool the surgical site, and / or take away blood or removed / destroyed tissue from the surgical site.

[0003] When performing such a surgical procedure, the surgeon needs information about the position and alignment of the surgical tools, as well as the tool characteristics and operating elements, and about the orientation of the tools relative to the tissue in the surgical site. Such information needs exist regardless of whether the tools are operated directly by the surgeon or by a robot.

[0004] If a given surgical procedure is such that the wound cavity at the surgical site is open, the surgeon can obtain such information by direct visual observation of the surgical tools and the surgical site. If the surgical procedure is such that the surgeon cannot directly see the target tissue, other indirect visualization methods may be used, such as inserting a camera on a tool separate from the surgical tools into the surgical site, performing X-ray imaging or magnetic resonance imaging of the surgical site on the patient, etc. The indirect visualization method selected depends on factors such as the surgical location, the size and characteristics of the wound cavity, the tools and techniques used, and the surgeon's preference.

[0005] Indirect visualization is typically achieved using an additional optical tool (e.g., an endoscope) that emits a broad beam of illumination to the surgical site and uses a camera to view the tool and the surgical site. Conventional endoscopes provide a two-dimensional, non-stereoscopic view in which the alignment of the tool with the tissue and / or the point of contact with the tissue is inferred. Therefore, the precision of the surgery depends primarily on the surgeon's ability to determine the position of the tool within the surgical site based on experience and training. In addition, the use of a conventional endoscope allows the surgeon to observe the surgical procedure only from the perspective of the endoscope (i.e., from the viewpoint of the position of the camera lens on the endoscope), and not from a relative "third person" perspective (i.e., from a viewpoint different from the viewpoint provided by the camera lens on the endoscope, or from a movable viewpoint).

[0006] While existing surgical tools and methods have been successful and adequate for their intended purposes, improvements in surgical tools and methods that provide positioning and visualization information to the surgeon would be welcome. Summary of the invention

[0007] According to certain aspects of the present disclosure, an electric surgical tool for a user to operate an intended tissue in a surgical site in a patient's body is disclosed. For example, the electric surgical tool may include a main body and a projection device, and the main body includes a main part and a tissue operation part. The tissue operation part can be powered and has an operating member for operating the intended tissue. The main body and the tissue operation part are configured together to define an operating direction of the operating member relative to the surgical site, and the tissue operation member is powered and aligned along the operating direction to operate the intended tissue arranged along the operating direction. The projection device has an emission port and can be powered to emit an optical positioning mark from the emission port along the positioning direction to the surgical site. The emission port is located on the main body so that the positioning direction is operationally associated with the operating direction, and the optical positioning mark is visible to the user to provide information related to at least one of the position and orientation of the operating member in the surgical site, and to provide information related to at least one of the position and orientation of the operating direction in the surgical site. Various options and modifications are possible.

[0008] For example, the operating direction may be parallel to the positioning direction. The body may include a central portion and a distal end extending from the central portion in a distal direction, and the operating direction and the positioning direction extend in the distal direction. The body may also include a central portion and a distal end extending from the central portion in a distal direction, and the operating direction and the positioning direction extend in a lateral direction that is angled with the distal direction, and the lateral direction may also be perpendicular to the distal direction. The operating portion may include, be located at, or be adjacent to the distal end of the body of such a structure.

[0009] The projection device may include an electric light source, and the emission port may include a lens for directing light from the electric light source in the form of a beam to the positioning direction to form an optical positioning mark. An optical unit remote from the tool may be provided, the electric light source is located in the optical unit, and the optical unit may also include a camera for receiving an acquired image of the surgical site.

[0010] The exit port may emit a light beam having a plurality of parallel rays such that the size of the optical positioning mark is substantially constant regardless of the distance between the exit port and the optical positioning mark within the surgical site. The optical positioning mark may have various shapes, such as at least one dot, at least one line, a plurality of characters, a plurality of symbols, marks, etc. The optical positioning mark may be sized relative to the operating member to indicate an area within the surgical site that will be contacted if the operating member is moved in the operating direction to contact the intended tissue. The exit port may emit a light beam having a plurality of non-parallel rays centered on the positioning direction such that the size of the optical positioning mark varies depending on the distance between the exit port and the optical positioning mark within the surgical site.

[0011] The emission port can emit a light beam, and the tool can include a detector for electro-optical ranging to determine the distance between the emission port and the optical positioning marker in the surgical site. The tool can include multiple emission ports and multiple optical receivers attached to the body, the multiple optical receivers are used to obtain images of the surgical site, and at least one optical receiver of the multiple optical receivers is combined with at least one imaging device to perform electro-optical ranging.

[0012] The projection device can be configured to emit at least two light beams from at least one exit port, and the optical positioning mark includes a plurality of different parts created by the at least two light beams. Two different parts of the plurality of different parts can have different wavelengths in the visible spectrum. The plurality of different parts are spaced relative to the operating member so as to indicate the area within the surgical site to be operated if the operating member is moved in the operating direction to contact the intended tissue. At least one exit port can be a single exit port, and the single exit port is configured to split the light into at least two light beams. At least one exit port can also include a plurality of exit ports, each of which is configured to emit one of the at least two light beams.

[0013] At least one imaging device for acquiring an image of the surgical site may also be provided. The at least one imaging device may acquire an image of the surgical site using an optical receiver attached to the body. The imaging device may include a camera for receiving the image from the optical receiver. The camera may be located in an optical unit remote from the tool.

[0014] The projection device may include an electric light source, the emission port may include a lens for directing light from the electric light source in the form of a beam to the positioning direction to form an optical positioning mark, and the electric light source is located in the optical unit. A plurality of emission ports and a plurality of optical receivers may be distributed around the tool.

[0015] The at least one imaging device may use a plurality of optical receivers, a plurality of images acquired by the plurality of optical receiver devices may be complementary to each other, and the plurality of optical receivers may be spaced apart from each other on the main body.

[0016] One of the plurality of imaging devices can acquire an image including an optical positioning mark along the operating direction, and another of the plurality of imaging devices can acquire an image guided along a direction different from the operating direction. At least one imaging device can include an optical receiver, which can also serve as an emission port of the projection device.

[0017] A plurality of positioning marks may be distributed on the main body, so that the orientation of the main body can be identified by detecting the positions of the plurality of positioning marks.

[0018] A display device may be provided for displaying an image that provides information about at least one of the position and orientation of the operating member within the surgical site, and provides information about at least one of the position and orientation of the operating direction within the surgical site. The image may be a visual image of the surgical site. The image may include optical positioning markers. The image may also include a representation of the position and orientation of the operating member relative to the intended tissue. The image may be an augmented reality image.

[0019] The operating member may be one of a laser element, an ultrasonic element, an oscillating element, a rotating element, a thermal element, a radio frequency element, an electric element, an electromagnetic element, a magnetic element, a radiation element, and a chemical element.

[0020] The main body may include a handle and a protective cover, the protective cover is located near the operating member of the tissue operating part and is configured to at least partially surround the first part of the operating member so that the first part does not contact the surgical site, and the shield is configured to expose the second part of the operating member for operating the intended tissue in the surgical site. The emission port may be located on the protective cover, at least the distal end portion of the protective cover may be located at the distal end of the main body relative to the operating member, and the emission port is located on the distal end portion of the protective cover. The projection device may be configured to have two emission ports, one of the two emission ports is located on the protective cover, and the other of the two emission ports is located on the main body and spaced from the protective cover. The device may also include an imaging device, the imaging device having at least two optical receivers attached to the main body, the at least two optical receivers are used to acquire images of the surgical site, at least one of the at least two optical receivers is located on the protective cover, and at least another of the at least two optical receivers is located on the main body and spaced from the protective cover. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] Figure 1 is an isometric view of a surgical tool according to certain aspects of the present disclosure.

[0022] Figure 2A yes Figure 1 A close-up side view of the distal portion of the tool is shown, the distal portion having a distally directed projection.

[0023] Figure 2B yes Figure 1 A close-up top view of the distal portion of the tool is shown.

[0024] Figure 3 is an isometric diagram showing a surgeon using Figure 1 The tool is shown with direct visual observation of the optical positioning markers projected on the surgical site.

[0025] Figure 4A is a schematic view of one possible system for projecting optical positioning markers from a tool and optionally for acquiring an image of a surgical site using an optical unit of the tool.

[0026] Figure 4B yes Figure 4A Schematic representation of the individual components of the optical unit shown.

[0027] Figure 5 is a schematic view showing optical positioning markers and other optional markers projected on the surgical site by the projection device and imaging device on the tool as visually viewed by the surgeon on a display from a first-person perspective.

[0028] Fig. 6A and Figure 6B 2 are schematic side views, respectively showing multiple possible orientations and parallel projections of projected positioning markers of the tool when the tool moves from a first distance to a second distance (ie, contact) relative to the surgical site.

[0029] Fig. 7A and Figure 7B 2 are schematic side views, respectively illustrating multiple possible orientations and non-parallel projected positioning marks of the tool when the tool is moved from a first distance to a second distance (ie, contact) relative to the surgical site.

[0030] Fig. 8A and Figure 8B are schematic isometric views respectively illustrating multiple possible orientations of the tool and non-linear (conical) projected positioning markers as the tool moves from a first distance to a second distance (ie, contact) relative to the surgical site.

[0031] Fig. 9 is a close-up side view of an alternative distal portion of the tool having four distally-oriented projection devices for projecting four spaced-apart optical positioning markers.

[0032] Fig.10 is a schematic isometric view showing a tool having four optical positioning marks provided by a Fig. 9 The distal portion of the tool is shown projecting four optical positioning markers distributed around and equidistantly spaced from the intended contact point.

[0033] Fig.11A and Fig. 11B are simplified isometric views showing multiple possible orientations of the tool and four distally directed and parallel projected positioning markers as the tool moves from a first distance to a second distance (ie, contact) relative to the surgical site.

[0034] Fig. 11C is a schematic side view of a plurality of projected locator marks including letters or other symbolic indicators to indicate intended contact points.

[0035] Fig.11D is a schematic side view of a plurality of projected positioning marks including a plurality of lines (crosshairs) to indicate intended contact points.

[0036] Fig. 12A and Fig. 12B 2 are schematic side views, respectively showing multiple possible orientations of the tool and distally and non-parallel projected upper and lower positioning markers as the tool moves from a first distance to a second distance (i.e., contact) relative to the surgical site.

[0037] Fig.13A and Fig. 13B are schematic side views respectively illustrating multiple possible orientations of a tool having two exit ports emitting separate light beams in orthogonal directions as the tool moves from a first distance to a second distance (ie, contact) relative to a surgical site.

[0038] Fig.14A is a close-up side view of an alternative distal portion of a tool having a distal protective shield and four laterally oriented and parallel projecting projection devices (for projecting four spaced apart optical positioning markers) and having an imaging device thereon.

[0039] Fig. 14B yes Fig.14A A close-up front view of the distal portion of the tool is shown.

[0040] Fig.15 is an isometric diagram showing a surgeon using a Fig.14A The distal portion of the tool is shown with direct visual observation of multiple optical positioning markers projected onto the surgical site.

[0041] Fig.16 is a schematic view showing a plurality of optical positioning markers projected on a surgical site as visually viewed by a surgeon on a display generated by an imaging device.

[0042] Fig.17 It can be used Figure 1-16 Schematic views of various systems of tools and various related components are shown. DETAILED DESCRIPTION

[0043] Reference will now be made in detail to the accompanying drawings, in which examples of implementing the present disclosure are shown. The detailed description uses numbers and letter labels to refer to features in the drawings. Like or similar reference numerals in the drawings and description are used to refer to like or similar parts of the present disclosure.

[0044] The accompanying drawings and detailed description provide a complete and enabling description of the present disclosure and the manner and process of making and using the same. Each embodiment is provided to illustrate the subject matter and not to limit it. In fact, it will be apparent to those skilled in the art that various modifications and variations may be made to the disclosed subject matter without departing from the scope or spirit of the present disclosure. For example, features shown or described as part of one embodiment may be used with another embodiment to produce yet another embodiment.

[0045] The present disclosure generally relates to embodiments and aspects of powered surgical tools that can be used to perform surgical procedures on a human or animal body.The examples discussed below are exemplary only and should not be considered limiting.

[0046] The examples discussed below integrate optical properties into surgical tools, including one or more projection devices and / or one or more imaging devices. The disclosed projection devices are not only lighting devices, but are also configured to assist in at least one of the following operations: positioning surgical tools, visualization, determining and / or indicating the distance between the tool and the expected (target) tissue in order to operate the surgical site and / or wound cavity. The disclosed imaging device is configured to assist in visualization. Certain aspects of the following examples provide first-person perspective visualization from the viewpoint of the tissue operating member of the surgical tool. Other aspects provide the projection of one or more positioning marks to guide the surgeon and assist in tool alignment, as well as determine and / or indicate the distance between the operating member of the tool and the tissue. A further aspect is to provide predetermined alignment marks on the surgical tool to assist in determining the position and orientation of the surgical tool. These tools can be used for medical or dental surgery, or surgery performed on any part of the human body by a medical / dental professional, or surgery performed on an animal body by a veterinary professional. The use of "surgeon" mentioned herein is for convenience only, and it should be understood that such a user may be any type of medical professional, such as a doctor, dentist, oral surgeon, specialist, assistant, veterinarian, etc., and the electric surgical tool is configured to be performed by such a person in a direct, cooperative or robotic manner for a specific purpose. Therefore, the electric surgical tools described and claimed herein include, but are not limited to, any type of electric tool used by any person when performing any such surgical procedure on the human or animal body. Other aspects of the present disclosure are set forth in detail below and / or listed in the following claims.

[0047] According to certain aspects of the present disclosure, Figure 1-6B A first embodiment of a powered surgical tool is shown that is capable of generating optical positioning marks for assisting a user in positioning the tool to manipulate target tissue. It should be understood that the specific disclosed aspects of the tool are merely exemplary and that many types of surgical tools may be used with one or more of the disclosed optical positioning features or functions based on the present disclosure. In addition, Figure 1-6B The embodiments include several optional features, all of which are not required in any one particular tool according to the present disclosure in order to enjoy certain beneficial aspects of the present disclosure.

[0048] like Figure 1As shown, the tool 20 includes a body 22, the body 22 has a central portion 24, and one or more cables 26a, 26b, 26c are attached to the central portion 24 to provide power, control signals and / or optical communication functions to the tool, or to provide power, control signals and / or optical communication functions from the tool. One or more optional additional conduits 28a, 28b can be provided to achieve other functions, such as providing flushing fluid to the surgical site and aspirating fluid and material from the surgical site. As described below, multiple cables and multiple conduits can be connected to one or more other components of the surgical system. More or fewer cables or conduits can be used. For example, if necessary, all or some cables, all or some conduits, or all cables and conduits can be located in a sheath or the like, so as to simplify or more compactly connect the tool to the rest of the system. In addition, if necessary, wireless communication devices can be used instead of cables carrying electronic components, signal transmission, etc.

[0049] The tissue manipulation portion 30 is attached to the body 22. If desired, the manipulation portion 30 can be removably attached to the central portion 24 of the body by a connecting portion 32. In this case, the body 20 can be used in a modular manner with different types of manipulation members, whether provided together as a kit or separately. In addition, the manipulation portion 30 can be removable for cleaning and reuse, or in a disposable embodiment, the manipulation portion 30 can be removable and can be discarded.

[0050] like Figure 1 As shown, the tissue manipulation portion 30 is attached to the central portion 24 of the body 22 at the distal end, and the manipulation member 34 of the manipulation portion 30 further extends distally to form the end of the tool 20. Figure 1 In the example shown, the operating portion 30 and its operating member 34 extend linearly along the central axis 36, but it should be understood that other linear, curvilinear or angled shapes, whether regular or irregular, are feasible. In addition, the operating member 34 is not necessarily located at the distal end of the operating portion 30 and / or the tool 20, and more than one operating portion or an operating portion with more than one exposed portion can be used.

[0051] As shown, the operating member 34 is a conventional mechanical rotating abrasive that destroys tissue by direct contact when rotating. It should be understood that in addition to mechanical and / or rotating members, other types of operating members can also be used in the tool 20. Therefore, as used herein, "operation" can be any type of change, cutting, removal or destruction of tissue in the expected area of ​​the surgical site. Such tools can use contact structures (such as abrasives, drills, ultrasonic horns) or non-contact structures (such as lasers) to achieve such operations. Therefore, in addition to tools using rotary motion, tools using oscillating motion, ultrasonic vibration, laser energy, electrical energy, electromagnetic energy, magnetic energy, radio frequency energy, radioactive energy, chemical energy or reactants, mechanical energy and thermal energy can be used, and the operating parts, operating members, tools and components in the entire surgical system are modified or replaced accordingly. Electricity can be provided by conventional electrical means and / or pneumatic means. Therefore, the description and description of the electric, mechanical, and rotating operating parts in the following examples are not intended to limit the scope of the present invention.

[0052] Regardless of the type of tool and operating portion selected, the body 22 and tissue operating portion 30 are configured together to define an operating direction of the operating member 34 relative to the surgical site S. For an operating member located at a distal end (e.g., member 34), the operating direction can be a direction toward the distal end (a direction along or parallel to the central axis 36) and / or can be a direction other than the distal direction (a direction at an angle to the central axis 36, a direction extending laterally from the central axis 36 (e.g., radially), etc.), depending on the tool, the surgical procedure or its portion or step, the surgeon's preference, etc. Figure 3-6B As shown, the operative direction is the distal direction along axis 36. Thus, when tissue manipulation member 34 is powered and aligned along the operative direction, tissue manipulation member 34 can move along the operative direction to manipulate (ie, contact and mechanically remove) desired tissue disposed along the operative direction.

[0053] The tool 20 and / or its overall control system may include at least one projection device with an emission port attached to the body 22 to assist in properly positioning the tool 20 so as to contact the intended tissue (and only the intended tissue) within the surgical site. The one or more projection devices and their multiple emission ports that can be used with the tools disclosed herein can have a variety of designs to provide different functions and benefits to the surgeon. In the most basic arrangement, the projection device of the tool used herein can project a beam of light from an emission port to form an optical positioning marker, which is essentially a "dot" or "spot" that lights up at the point where the beam of light falls on the surgical site.

[0054] Figure 1-32 shows an arrangement in which the tool 20 includes a projection device having an emission port 38 configured on the operating portion 30 so as to project an optical positioning mark 40 onto the surgical site S along the positioning direction, the optical positioning mark 40 being formed by a light beam 42 from the main body 22. In essence, the point where the light beam 42 emitted from the emission port 38 irradiates the surgical site S is the optical positioning mark 40 (at Figure 3 40) so that the tool alignment relative to the expected contact point 46 can be determined and adjusted. Figure 3 As shown, the exit port 38 may (only) include an exit optical device (lens, aperture, slit, pinhole, mask, filter, etc.) of a projection device for projecting a light beam. However, in some embodiments, the exit port 38 may also include an entrance lens / optical receiver of an imaging system (e.g., an imaging device (e.g., a camera with a CCD)) to project the light beam on a screen (e.g., Figure 5 As an alternative, the exit port 38 may include an exit port for projecting an optical positioning marker, and a second lens (not shown) may be provided as an entrance lens / optical receiver for acquiring the image. However, in situations where onboard imaging is desired, certain advantages are provided that the dual-purpose ports, lenses, or equivalents are overlapping or adjacent structures capable of emitting optical positioning markers and collecting light for the imaging device.

[0055] Figure 1-2B Also shown are optional multiple alignment marks 54 that can be placed on the tool 20 to provide the surgeon with a visual indication of the tool's orientation. The multiple marks 54 can have various shapes, such as one or more dots, lines, rings, etc., and the multiple marks 54 can be distributed along any and all sides of the operating portion 30 of the tool 20. The multiple marks 54 can be visually observable (directly or through an onboard or separate camera), and / or the multiple marks 54 can be observable through alternative imaging devices (e.g., X-ray imaging, MRI, radio frequency-generated acoustic imaging, photoacoustic imaging, ultrasound imaging, etc.). Such marks can be used with any of the embodiments disclosed herein.

[0056] Figure 4A A schematic view of an example of an optical system that can be used with tool 20, the optical system generating at least a light beam for projecting at least one optical positioning mark, Figure 4B Certain components of the optical unit within the optical system are shown.

[0057] like Figure 4AAs shown, the tool 20 includes an emission port 38, which is functionally arranged to project light onto the surgical site S and / or detect an image of the surgical site S in a direction associated with the orientation of the operating member 34. In an optical unit 60 in communication with the emission port 38, light can be generated and / or received. Figure 4A As shown, the optical unit 60 is spaced apart from the tool 20 and connected by a communication cable 26c, which may include a waveguide (e.g., one or more optical fibers) and / or one or more power or data cables. Such multiple optical fibers and multiple cables may be combined into a single conduit. However, part or all of the optical unit 60 may be located on or within the tool 20.

[0058] The cable 26c may also include multiple separate parts (e.g., one part from the outlet port 38 to the optical connector in the tool 20, and another part extending from the optical connector in the tool 20 to the optical unit 60). Such multiple detachable parts may be useful, for example, the operating part 30 with the outlet port 38 mounted thereon may be detachable from the rest of the tool 20.

[0059] like Figure 4B As shown, the optical unit 60 is attached to and in communication with the optical cable 26c and the output cable 51 to transmit the imaging signal to the display device 50. It should be understood that at least the transmission between the optical unit 60 and the display 50 may also be wireless.

[0060] At least one projection device 62 is arranged in the optical unit 60, and at least one projection device 62 may include multiple laser diodes or multiple LEDs with multiple beam shaping lenses, and multiple laser diodes or multiple LEDs are most suitable for high-intensity beam projection, preferably emitting multiple parallel beams. In combination with diffractive lenses, masks, filters, slits and apertures, multiple laser diodes and multiple LEDs are further suitable for patterned beam projection and multiple matrix displays / AMOLEDs. A reflecting device (as described below, which may be a beam splitter 64) may be provided to redirect the light from the projection device 62 toward the exit port 38 into a waveguide (e.g., an optical fiber) (e.g., in the cable 26c) for emission onto the surgical site. Other focusing and guiding devices may be used, including devices that are not reflected by a beam splitter. In combination with lenses and apertures, multiple projection devices are capable of projecting multiple radially shaped beams with a focus in a fixed direction to further assist in optical distance determination, and project indicators or multiple lines.

[0061] like Figure 4A and Figure 4BAs shown, one or more projection devices 62 can use multiple optical fibers and multiple waveguides so that the optical unit 60 with the projection device 62 is spaced apart from the tool 20. However, as mentioned above, some laser diodes and LEDs and the required lenses are small enough, so if necessary, these laser diodes and LEDs can be mounted on the operating part 30 and / or the main body 22. Therefore, at least the light source / projection device 62 in the optical system can be located on the tool, on a main power supply near the tool, or even separate from the tool. The projection device 62 can be a laser, a diode, an incandescent bulb, a neon lamp, a matrix display or any other light source or device. In order to shape the beam as required, the shaping of the emitted light can be achieved by using the apertures and lenses located at the element 38, or the apertures and lenses including the element 38, which is located at the distal end exit of the waveguide. Therefore, the positions of the multiple emission ports 38 of the multiple projection devices 62 shown in the figure only represent the emission points of the light source, and the light to be emitted in the one or more configurations described above is from such a device 38 "upstream".

[0062] When optical fibers are used, the optical system can include not only a projection device, but also an imaging device. In this case, an imaging device 66 (e.g., a camera) having, for example, an imaging CCD 68 can be included in the optical system, for example, in the optical unit 60. The use of such an imaging device 66 allows the display of an observed image on the screen 50, for example, the observed image is obtained by an optical receiver or lens on the tool 20, which can be an emission port 38 co-located at the end of the projection device, or can be another lens on the tool 20 (not shown).

[0063] like Figure 4BAs shown, the device 66 is arranged so that light entering the optical unit 60 through the optical cable 26c passes through the beam splitter 64, then through the optional safety filter 70 and possibly other optical waveguides or devices before being irradiated to the CCD 68. The light beam 42 that forms the optical positioning mark emitted from the emission port 38 originates from the projection device 62 and is emitted as a beam 42a within the optical unit 60. The light beam 42a is then coupled into the optical fiber of the cable 26c by a conventional beam coupler (not shown) to project the light beam 42 from the emission port 38 at the far end of the optical fiber cable 26c. Light entering the optical receiver (e.g., the emission port 38 or another port or lens on the tool 20) is coupled into the cable 26c and transmitted as a beam 72 within the optical unit 60 to the CCD 68 of the optical device 66. By using optical fiber and bidirectional transmission, common components can be used in the optical system to simultaneously perform projection and imaging / observation, although separate paths for projection and imaging / observation are also feasible. The optics, CCD and associated control equipment can be configured and programmed to simultaneously provide real-time imaging and capture video or still photographs for storage in computer memory within the system or in removable storage media located remotely.

[0064] Figure 5 A first person view from the tool's perspective on a screen 50 is shown. From this perspective, the projected one or more optical positioning markers 40 provide support to the surgeon in determining the distance and alignment of the tool. In addition, the use of a screen 50 allows for the display of multiple "augmented reality" virtual markers (52a, 52b, 52c) on the screen, which in addition to displaying the projected positioning markers (42) also assist the surgeon in determining distance and alignment. If active distance measurement is provided, each virtual marker will indicate a different distance from the surgical site at the expected contact point 46, so that as the displayed end of the operating member 34 reaches each virtual marker in turn as the tool approaches, the surgeon obtains a real-time indication of the distance from the contact portion 46. For example, by electro-optical distance measurement, virtual marker distance information can be obtained, in which case accurate dynamic information values ​​can be determined and displayed, and if desired, the numerical values ​​can be displayed next to multiple markers. Alternatively, in a passive system, multiple markers are displayed at a fixed distance from the tool head and provide a more approximate distance indication (similar to some displays on conventional automotive rearview cameras). Whether on an active or passive basis, the distance information used to draw the multiple virtual markers on the screen 50 can be pre-derived from the field of view of the imaging device, thereby providing indicators to guide the surgeon's eyes to help determine relative distances.

[0065] As shown, the projection device's exit port 38 is located on the body so that the light originally generated by the projection device 62 is emitted along a positioning direction that is operationally associated with the operating direction. For example, the projection device can project a light beam 42, and when the light beam 42 is incident on the surgical site S, an optical positioning mark 40 is generated (marked with a circle in the figure for clarity, but it can be one or more points, lines, characters, geometric shapes, or any desired visible mark). Since the position of the exit port 38 on the tool is fixed, the position of the optical positioning mark 40 has a certain predetermined relationship with the orientation and / or position of the operating member 34 of the tool 20. By understanding the predetermined relationship, the surgeon thereby obtains information related to the position and orientation of the operating member relative to the surgical site S.

[0066] For example, if desired, the light beam 42 can extend distally and parallel to the central axis 36 and maintain a predetermined known distance 44 (e.g., 1 cm) from the central axis 36. Thus, if the tool 20 is moved in an operating direction 48 parallel to the central axis (see Figure 6B ) is moved to contact the surgical site at point 46, the optical positioning mark 40 will be located at a distance 44 from the position 46, and the central axis 36 will contact the surgical site S at the position 46 (the center of which is marked with an X in the figure for clarity). In other words, the light beam 42 produces a visually discernible optical positioning mark 40 at a known distance 44 from the point on the surgical site S that contacts the center of the operating member 34, and if the operating member 34 is moved axially, the operating member 34 will act on the surgical site. When the surgeon moves the tool in a direction closer to the surgical site in the patient's body, the optical positioning mark 40 remains visible and provides information to the surgeon so that the tool can be properly and reliably operated to reach and contact the intended target tissue at point 46.

[0067] The distance 44 (e.g., 1 cm, but other values ​​are also suitable) is predetermined and communicated to the surgeon during training. Thus, a skilled surgeon will understand that the tool 20 with the optical positioning marker 40 located at a distance 44 (1 cm) above the expected contact position 46 is first positioned on the surgical site S (see FIG. Fig. 6A ), and then, while maintaining the position of the optical positioning mark, by moving the optical positioning mark in the operating direction 48 toward the desired contact position (distal and axial, see Figure 6B) Move the tool 20 so that the center of the operating member 34 will contact the desired contact location 46 (in this example, along the central axis 36). The distance 44 can be selected by the arrangement and configuration of the operating member 34, the ejection port 38, the operating portion 30, etc. By using a sufficient offset, a light beam 42 is generated that is parallel to the central axis 36 but sufficiently spaced from other parts of the tool 20 to prevent the light beam from being obscured or blocked, and the optical positioning marker 40 can be made visible at the distance 44 near the target site 46.

[0068] Therefore, by direct visual observation, the optical positioning mark 40 can be noticed. However, the mark and the surrounding parts can also be captured by an imaging device such as a camera, an endoscope, etc. (independent of the tool 20 or carried with the tool 20) and displayed on a display device (such as an electronic screen). Therefore, the optical positioning mark 40 provides information related to at least one of the position and orientation of the operating member 34 in the surgical site and / or information related to at least one of the position and orientation of the operating direction in the surgical site.

[0069] In the non-limiting example above, the tool 20 uses a distal operating direction 48 (along the central axis 36) and a parallel light beam 42 (see Fig. 6A and Figure 6B ). However, the operating direction 48 of the contact need not necessarily be distal or parallel to the central axis 36. If so, the exit port 38 of the projection device can be constructed and aimed accordingly so as to project the light beam 42 in a complementary direction to produce the optical positioning mark 40 at the desired location. For example, if the operating direction 48 is perpendicular to the central axis 36 (extending radially outward from the central axis 36), the light beam 42 can extend radially outward from the central axis and be aligned with the central axis, or can extend in a direction parallel to the line (which extends radially outward from the central axis and is aligned with the central axis) (see Figure 13A-Figure 16 ). Other angles and orientations besides distal or radial / perpendicular are possible, depending on factors such as the tool, the type of operative portion involved, the surgical procedure, surgeon preference, etc.

[0070] Furthermore, the light beam 42 does not necessarily have to be projected parallel to the operating direction 48 or the central axis 36 . Fig. 7A and Figure 7B An alternative aiming of the projection device's exit port 38 and light beam 42 is shown. Here, the light beam 42 is angled downward (as shown) and passes below the central axis 36. In this orientation, the position of the optical positioning marker 40 on the surgical site S changes as the tool 20 moves along the operating direction 48. Thus, Fig. 7A The distance 44 is greater than Figure 7B The distance 44 at the time of contact with the expected position 46 is shown in the figure. Figure 7BThe optical positioning mark 40 in the embodiment is slightly above the position 46 when in contact, and the construction of the tool 20 and the projection device's emission port 38 can make the mark above, below, beside, or coincident with the target position 46 (if shading is avoided). Figure 7B The operating direction 48 in FIG. 4 is shown as being parallel to the central axis 36 , however, this is not required and may instead be parallel to the beam 42 or aligned with neither, depending on factors such as tool type and configuration, surgical procedure, surgical preference, etc.

[0071] Furthermore, the emitted light beam does not have to be a single light beam, does not have to be projected as only one point, and does not have to use only parallel light beams to project an optical positioning mark having a static size. Fig. 8A and Figure 8B An alternative one or more optical positioning marks are shown, which include an outer (circular) portion 40a formed by a beam 42a and a central (point) portion 40b formed by a beam 42b. The beam 42a is conical, and the beam 42b is linear as the above beam 42. Beam shaping can be achieved by using multiple masks, multiple apertures, multiple filters, or multiple lenses at one or more exit ports 38. Since the beam 42a is conical, for example, when the operating member 34 is moved to contact the operating member 34 with the expected position 46 ( Figure 8B ), the outer portion 40a has a first size ( Fig. 8A ), and has a (smaller) second size at a smaller second distance. The center portion 40b is optional, and as shown, the center portion 40b can be spaced apart from the contact position 46 at a distance 44. Fig. 6A and 6B The use of a non-parallel, non-axial beam allows the size of the optical positioning marker 40a to change as the tool moves toward or away from the surgical site, and the observed size provides the surgeon with information about the distance to the surgical site. As described above, it is also feasible to arrange the optical positioning marker 40a to be non-parallel to the central axis 36 and / or the operating direction 48, depending on the above factors.

[0072] It should be understood that in embodiments where multiple beams are projected (whether from a single exit port or from multiple exit ports), the different beams may be composed of light of different wavelengths, which can also provide information to the surgeon. Such beams can be generated in different ways, for example, by coupling two colors of light or a broad spectrum of light into an optical fiber or waveguide and then separating the individual colors using wavelength sensitive filters or beam splitters, or by using light polarization and polarization filtering. Such color differentiation can be applied to all embodiments disclosed herein that use multiple beams.

[0073] Figure 9-11B An alternative design is shown in which multiple beams are emitted from multiple exit ports dispersed circumferentially around the tool. Fig. 9 and Fig.10 As shown, four exit ports 38a, 38b, 38c, 38d emit multiple light beams 42a, 42b, 42c, 42d to form multiple optical positioning marks 40a, 40b, 40c, 40d. The light from all exit ports can be generated by a single light source, such as in the optical unit described above, which is located on the tool or remotely operated. Alternatively, multiple light sources can be provided, each of which provides light to one or more exit ports. If so, multiple conventional light guides can be used as needed to split the generated light into different optical fibers leading to each exit port.

[0074] Although the multiple beams may be directed in other relative orientations as described above, Fig. 9 The device shown generates a plurality of light beams extending parallel to the central axis 36 and the operating direction 48 (eg, Fig. 11B Each beam is projected to a plurality of equal distances 44a, 44b, 44c, 44d away from the intended contact point 46 (see Fig.10 ), however these distances are not necessarily equal. Fig.11A and Fig. 11B The plurality of parallel light beams 42 a - 42 d are shown forming a plurality of markings 40 a - 40 d that remain equally spaced from the contact point 46 as the tool moves in an operating direction 48 parallel to the central axis 36 .

[0075] Despite Figure 9-11B Four such beams are shown spaced 90 degrees apart, but it will be appreciated that two or more beams may be used arranged around point 46, equidistant or unequally spaced and / or circumferentially, as desired.

[0076] Fig. 11C Shows the Figure 9-11B A slight variation of the device shown in FIG. 4 is made in which one or more of the four optical positioning marks 40a-40d can be in a shape other than a dot or a line. As shown in the figure, Fig. 11CThe multiple markings in include indicators to provide the surgeon with information about the orientation of the tool 20 relative to the target 46 (X). Mark 40d is the letter R (for right), mark 40b is the letter L (for left), and marks 40a and 40c are arrows (for up and down, respectively). When the tool is oriented (by the surgeon or the robot) so that mark 40a (upward arrow) points upward, the use of such indicators on one or more marks can provide additional feedback that can help directly operate the tool or robotically operate the tool through a user interface (for example, using similar indicators on one or more input devices thereof). Any symbols, indicators, designs, etc. can be created to allow one or more optical positioning marks to provide additional information to the surgeon. This information may be more important in cases where the operating portion is asymmetrical relative to the tool, or where the orientation of the tool within the surgical site or during a particular surgical step is critical.

[0077] Fig.11D Another variation is shown in which four optical positioning markers 40a-40d together form two lines of intersection at the target site 46. Each of the plurality of emission ports 38a-38d is configured to emit light beams 42a-42d in a widened line, all of which can intersect and overlap at the target site 46 along the axis 36. It is feasible to form such an intersection using only two such emission ports separated by 90 degrees, but the emission ports must be arranged so that the operating member 34 does not cause occlusion. As the tool 20 moves closer to the target site 46, the intersection formed by the plurality of optical positioning markers 40a-40d becomes smaller, thereby providing alignment and distance feedback to the surgeon.

[0078] Fig. 12A and Fig. 12B Another variation is shown in which multiple exit ports emit multiple non-parallel beams that cross across the target area. As shown, two exit ports 38a, 38b are disposed on opposite sides of the central axis 36. Two beams 42a, 42b are emitted and cross just in front of the operating member 34. When the tool is in Fig.11A When the tool is in the position shown, the two optical positioning markers 40a, 40b are spaced a distance 44 from the contact point 46. As the tool moves in the operating direction 48, the two optical positioning markers 40a, 40b converge on the point 46, thereby assisting the surgeon in alignment and providing information about the distance to the target as the distance 44 decreases. It should be understood that more than two such emission ports may be used, and the emission ports may be arranged uniformly or non-uniformly, at different angles or spacings on one or more paths around the central axis 36 as desired.

[0079] Fig.13A and Fig. 13BAn alternative design is shown, wherein one or more exit ports include multiple optical devices, lenses, etc., and the exit port can emit a light beam that is split into at least two parts so that at least two parts extend from the exit port in different directions. At least in some applications, the splitting of the light beam can be more efficient spatially and commercially than providing an exit port for each light beam. As shown, two exit ports 38a, 38b emit four light beams 42a1, 42a2, 42b1, 42b2 to produce four optical positioning markers 40a1, 40a2, 40b1, 40b2. Two light beams 42a1 and 42b1 extend forward parallel to the central axis 36, and two light beams 42a2 and 42b2 extend perpendicular to the central axis 36 (aligned with each other). When operating the tool during surgery, the four light beams and four markers can assist the surgeon in identifying some parts of the surgical cavity other than the target area. There can be one or more beam splitters, each of which can split the light into two or more beams. The multiple beams can also be aimed in different directions, such as parallel, non-parallel, perpendicular, skewed, etc. The light from each exit port can be generated by a single light source, such as in the optical unit described above, which is located on the tool or remotely operated. Alternatively, multiple light sources can be provided, each providing light to one or more exit ports. If so, multiple conventional light guides can be used as needed to split the generated light into different optical fibers leading to each exit port. Therefore, the use of beam splitting provides further options for the generation and direction of multiple optical positioning marks.

[0080] Fig.14A and Fig. 14B An alternative design of the operating portion 130 of the tool 120 is shown. The operating portion 130 includes a shield 131 to prevent contact with some parts of the surgical site, but also allows contact with other parts of the surgical site when the tool is moved and used. Depending on the surgical procedure, this shield can have different arrangements and orientations. As shown, the shield 131 covers the bottom side 134a and distal end 134b of the operating member 134 of the operating portion 130.

[0081] The presence of the shield 131 allows at least one ejection port to be placed in the shield 131 to project optical positioning marks from the ejection port. As shown, two ejection ports 138a, 138b are located at or adjacent to the distal end 131a of the shield, and two ejection ports 138c, 138d are located in the proximal region 131b. The four ejection ports are located around the operating member 134 in the transverse direction and emit four light beams 142a, 142b, 142c, 142d to produce four optical positioning marks 140a, 140b, 140c, 140d. The multiple light beams extend parallel to the operating direction 148 (towards the contact point 146 of the central target area), where the multiple light beams and the operating direction are perpendicular to the central axis 136.

[0082] The surgical site and multiple optical localization markers can be directly visualized ( Fig.15 ) or visualized on a separately provided display screen 150 ( Fig.16 , by using multiple optical receivers on the tool 120, the multiple optical receivers are within or separated from the multiple emission ports). Therefore, if necessary, one or more optical receivers 158a, 158b can be set on the tool 120 to image the surgical site and multiple optical positioning markers 140a-140d. As shown, the optical receiver 158a is located at the distal end 131a of the protective cover, and another optical receiver 158b is adjacent to the proximal end 131c adjacent to the protective cover portion 130. Each optical receiver can provide its own perspective, or computer processing can be used to combine multiple perspectives provided by multiple optical receivers to generate a single perspective in two dimensions or three dimensions. As shown, two receivers 158a, 158b are provided that are axially located at the top of the tool 120 and point in the direction of operation, but if necessary, the two or more receivers can be distributed in different ways and can point outward in more directions to provide up to 360 degrees of viewing angle of the entire wound cavity.

[0083] For example, multiple optical receivers can be connected to an optical unit (such as unit 60 mentioned above) having one or more CCDs via multiple optical fibers and multiple waveguides. If so, by triangulating the location of a given point in the surgical site using two optical receivers with known positions on the tool (e.g., by identifying the CCD pixels affected by objects observed from the two locations), the distance to the given point can be determined. Thus, using two optical receivers 158a, 158b, the distance to the expected contact point 146 or one of the multiple optical positioning markers 140a-140d can be determined. The distance information can be provided to the surgeon in different ways, such as through a screen readout, through augmented reality on a screen (such as screen 150), etc.

[0084] Fig.17A schematic diagram showing the components of the tools described herein and their interconnection with other components within a surgical system. As mentioned above, the tools described herein can be of various types, and thus the system for controlling the tools can be varied accordingly in a conventional manner understood by those skilled in the art.

[0085] As shown in the figure and as mentioned above, tool 20 can be connected with multiple cables 26a-26c and multiple conduits 28a, 28b.For example, multiple cables can be connected with these elements (it can include or contain multiple characteristics of optical unit 60, as mentioned above) of such as power module 27a, control module 27b and optical communication module 27c in system 200.Multiple conduits can be connected with surgical fluid source 29a and suction device 29b, and suction device 29b is used to remove any material from the fluid in the patient's body and removed from the patient during the operation.Each in multiple modules and fluid source / remover is controlled by one or more controllers 202 (one is shown) in system 200 for function and / or provides power. As schematically shown for simplicity, the controller 202 may include or be connected to a central processing unit 204, a memory 206, programming data and other stored data 208, and at least one input-output device 210, which is used to activate and control the features and functions of the tool 20, and is also used to activate and control multiple modules 27a-27c, fluid source 29a, remover 29b and display 50.

[0086] It should be understood that several separate controllers are actually provided to control different parts of the tool and the entire surgical system. One or more controllers do not have to be located at the same location as the tool, and one or more controllers may be at least partially remote (on-site) or remote (off-site), connected via conventional wired or wireless connections. The input-output device 210 may include a plurality of operable input devices, such as buttons, triggers, switches, keyboards, keypads, touch screens, microphones, etc., which are located on the tool itself and on other devices within the system for controlling various elements of the system. For output, a plurality of items such as screens, lights, indicators, speakers, etc. can be provided to provide feedback to the user regarding the status of the tool and its various components or the surgical procedure. One or more conventional power sources (not shown) may be provided to Fig.17 Power the tool, controller and all other components shown.

[0087] In use, surgical tools having positioning and / or guiding properties, such as those described above, may be beneficial in surgeries described as "delicate" because the tissue to be operated on is in close proximity to tissue such as nerves, blood vessels, etc. that must not be disturbed or damaged. In addition, such devices may be beneficial in surgeries where the tissue to be operated on is difficult to reach and / or cannot be directly viewed, such as spinal surgery, which requires access from the back but the surgical procedure is performed ventrally.

[0088] During surgery, use e.g. Fig.14A When using a tool such as that shown in / 14B, the surgeon first starts and performs a functional / diagnostic check of the tool and the connection system to ensure that everything is in working order and connected correctly. The operating components and the multiple projection devices are then turned off. The tool is first inserted into the wound cavity protective cover to prevent the working end from getting stuck or undesired tissue damage, for example in the case of a tool with a grinder head. During the approach phase, the operating components of the tool as well as the multiple projection devices can be turned off, and only one or more cameras will be turned on from the beginning. After the tool is inserted into the wound, one or more projection devices can be turned on to produce one or more optical positioning marks to ensure that multiple light beams do not accidentally shine into the eyes of someone in the surgical team. Then, by feel and observation of the screen (such as in Fig.14A / 14B- Fig.15 , or if being used, by direct visual observation), guide the tool to the approximate intended contact area within the surgical site.

[0089] Approaching the surgical site and tissue to be avoided is guided primarily by one or more cameras of the tool and by using multiple positioning markers and any distance information provided on the screen, so that it is known how far or close the tool and the operating members of the tool are to the target surgical site and various areas to be avoided.

[0090] When the surgical site is reached and viewed from the tool's perspective, the tool, in particular the operating member facing the surgical site, is precisely aligned. Precise alignment can be checked by utilizing any distance information provided on the screen using electro-optical distance measurement and information about multiple distances within the wound cavity that can be obtained. When multiple positioning markers are used, the multiple positioning markers outline the contour / edge of the area of ​​the working surface, and this contour is consistent with the area of ​​the planned surgery while avoiding any sensitive areas, at which time the working surface (operating member) of the tool will be opened.

[0091] The tool with the opening operating member is then carefully moved toward the surgical site to ensure that the correct alignment is not lost during the approach process, and the main part of the surgical procedure, such as tissue removal, is started. During this movement, alignment information feedback is provided to the surgeon through multiple optical positioning marks, multiple marks on the tool, so that the desired alignment is maintained through contact. After a brief contact, the tool can be moved back to observe the progress of the surgical procedure, and if necessary, the tool can be realigned to further contact the target area or adjacent target areas and then moved into contact. As needed, this alignment and contact can be repeated multiple times until the end of the surgical procedure, for example when the purpose of the tissue operation is achieved and the purpose of the tissue operation is confirmed by observation and / or electro-optical distance measurement, and certain landmarks in the wound and / or multiple optical positioning marks and / or decisions made based on the information / images provided can be referenced.

[0092] In the final stage of the surgical procedure, the tool is withdrawn from the surgical site and the operating member is closed, which is essentially the reverse of the steps of the first approach / insertion stage. During the extraction process, as during the insertion process, it is of utmost importance for the surgeon to avoid contact with sensitive tissue and unnecessary damage to the tissue.

[0093] The surgical procedure can be used with image-guided surgical methods, for example, using positioning information and alignment information provided by third-person information (e.g., X-ray, ultrasound, CT, MRI, positron emission tomography) of the image-guided system, which can supplement information from positioning and imaging, especially information from the first-person perspective. This information can be displayed on a split screen or multiple screens in addition to images from the tool, images from an endoscope viewing the tool, or combined with a virtual display, virtual reality imagery, and / or augmented reality imagery. In addition, as an option, the surgeon can select and switch between different views to be displayed, depending on the preferred viewpoint at each stage of the surgical procedure.

[0094] Surgical procedures using the tools disclosed above can also be performed by a robot managed / controlled by a surgeon who can select images / viewpoints before and during surgery based on preference. Other support devices that help improve the precision and quality of the surgical procedure, such as an N-type positioner, can also be employed.

[0095] Thus, the disclosed subject matter provides an easy-to-use and user-friendly device and system for assisting a surgical procedure by providing at least one optical positioning marker projected from a surgical tool. The present disclosure is applicable to many different surgical tools and surgical procedures, and the multiple optical positioning markers can have a variety of forms. Thus, the disclosed concepts are not intended to be limited to application to any particular tool or surgical procedure, or to any number or orientation of one or more optical positioning markers.

[0096] Although the preferred embodiments of the present invention have been fully described above, it should be understood that any and all equivalent implementations of the present invention are included within the scope and spirit of the present invention. Therefore, the described embodiments are presented only by way of example and are not intended to limit the present invention. Therefore, although specific embodiments of the present invention have been described and shown, it will be understood by those of ordinary skill in the art that since many modifications may be made, the present invention is not limited thereto. Therefore, it is contemplated that any and all such embodiments are included in the present invention, as these embodiments may fall within the literal or equivalent scope of the appended claims.

Claims

1. An electric surgical tool for a user to manipulate desired tissue in a surgical site in a patient's body, the electric surgical tool comprising: a body comprising a main portion and a tissue manipulation portion, the tissue manipulation portion being powered and having a manipulation member for manipulating the intended tissue, the body and the tissue manipulation portion being configured together so as to define an manipulation direction of the manipulation member relative to the surgical site, wherein the tissue manipulation member is powered and aligned along the manipulation direction to manipulate the intended tissue arranged along the manipulation direction; and A projection device having an emission port, the projection device being capable of being supplied with electric power to emit an optical positioning mark from the emission port along a positioning direction onto the surgical site, the emission port being located on the main body so that the positioning direction is operationally associated with the operating direction, wherein the optical positioning mark is visible to the user so as to provide information related to at least one of the position and orientation of the operating member within the surgical site, and to provide information related to at least one of the position and orientation of the operating direction within the surgical site.

2. The electric surgical tool according to claim 1, wherein: The operating direction is parallel to the positioning direction.

3. The electric surgical tool according to claim 1 or 2, wherein: The body includes a central portion and a distal end extending from the central portion in a distal direction, and the operating direction and the positioning direction extend in the distal direction.

4. The electric surgical tool according to claim 1 or 2, wherein: The body includes a central portion and a distal end extending from the central portion in a distal direction, and the operating direction and the positioning direction extend in a lateral direction at an angle to the distal direction.

5. The electric surgical tool according to claim 4, wherein: The lateral direction is perpendicular to the distal direction.

6. The electric surgical tool according to any one of claims 1 to 5, wherein: The projection device comprises an electric light source, and the emission port comprises a lens, wherein the lens is used to guide the light from the electric light source to the positioning direction in the form of a light beam to form the optical positioning mark.

7. The electric surgical tool according to claim 6, further comprising an optical unit remote from the tool, wherein the electric light source is located in the optical unit.

8. The electric surgical tool according to claim 7, wherein: The optical unit further includes a camera for receiving an acquired image of the surgical site.

9. The electric surgical tool according to any one of claims 1 to 7, wherein: The exit port emits a light beam having a plurality of parallel rays such that a size of the optical positioning marker remains substantially constant regardless of a distance between the exit port and the optical positioning marker within the surgical site.

10. The electric surgical tool according to claim 9, wherein: The optical positioning mark includes at least one dot.

11. The electric surgical tool according to claim 9 or 10, wherein: The optical positioning mark includes at least one line.

12. The electric surgical tool according to any one of claims 9 to 11, wherein: The optical positioning marker is sized relative to the operating member to indicate an area within the surgical site that will be contacted if the operating member is moved in the operating direction to contact the intended tissue.

13. The electric surgical tool according to any one of claims 1 to 12, wherein: The emission port emits a light beam having a plurality of non-parallel light rays centered on the positioning direction, so that the size of the optical positioning mark varies according to the distance between the emission port and the optical positioning mark in the surgical site.

14. The electric surgical tool according to any one of claims 1 to 13, wherein: The exit port emits a light beam, and the tool includes a detector for electro-optical ranging to determine the distance between the exit port and the optical positioning marker in the surgical site.

15. The electric surgical tool according to claim 14, wherein: The detector includes a camera located within or connected to the optical receiver.

16. The electric surgical tool according to any one of claims 1 to 15, wherein: The projection device is configured to emit at least two light beams from at least one emission port, and the optical positioning mark includes a plurality of different parts created by the at least two light beams.

17. The electric surgical tool according to claim 16, wherein: Two different portions of the plurality of different portions have different wavelengths in the visible spectrum.

18. The electric surgical tool according to claim 16 or 17, wherein: The plurality of different portions are spaced apart relative to the operating member so as to indicate areas within the surgical site that will be operated on if the operating member is moved in the operating direction to contact the intended tissue.

19. The electric surgical tool according to any one of claims 16 to 18, wherein: The at least one exit port is a single exit port configured to split the light into the at least two light beams.

20. The electric surgical tool according to any one of claims 16 to 19, wherein: The at least one exit port comprises a plurality of exit ports, each exit port being configured to emit one of the at least two light beams.

21. The powered surgical tool of any one of claims 1 to 20, further comprising at least one imaging device for acquiring images of the surgical site.

22. The electric surgical tool according to claim 21, wherein: The at least one imaging device acquires the image of the surgical site using an optical receiver attached to the body.

23. The electric surgical tool according to claim 22, wherein: The imaging device includes a camera for receiving the image from the optical receiver.

24. The electric surgical tool according to claim 23, wherein: The camera is located in an optical unit remote from the tool.

25. The electric surgical tool according to claim 24, wherein: The projection device comprises an electric light source, the emission port comprises a lens, the lens is used to guide the light from the electric light source to the positioning direction in the form of a light beam to form the optical positioning mark, and the electric light source is located in the optical unit.

26. The powered surgical tool of claim 22, comprising a plurality of said emission ports and a plurality of said optical receivers distributed around said tool.

27. The electric surgical tool according to claim 22, wherein: The at least one imaging device uses a plurality of the optical receivers, and a plurality of images acquired by the plurality of the optical receiver devices are complementary to each other.

28. The electric surgical tool according to claim 27, wherein: A plurality of the optical receivers are spaced apart from each other on the body.

29. The electric surgical tool according to any one of claims 21 to 28, wherein: One of the plurality of imaging devices acquires an image including the optical positioning mark along the operating direction, and another of the plurality of imaging devices acquires an image directed along a direction different from the operating direction.

30. The electric surgical tool according to any one of claims 21 to 29, wherein: The at least one imaging device comprises an optical receiver which also serves as the emission port of the projection device.

31. The electric surgical tool according to any one of claims 1 to 30, further comprising a plurality of positioning marks distributed on the main body, so that the orientation of the main body can be identified by detecting the positions of the plurality of positioning marks.

32. The electric surgical tool according to any one of claims 1 to 31, further comprising a display device for displaying an image, wherein the image provides the information related to at least one of the position and the orientation of the operating member within the surgical site, and provides the information related to at least one of the position and the orientation of the operating direction within the surgical site.

33. The electric surgical tool according to claim 32, wherein: The image is a visual image of the surgical site.

34. The electric surgical tool according to claim 32 or 33, wherein: The image includes the optical positioning mark.

35. The electric surgical tool according to any one of claims 32 to 34, wherein: The image includes a representation of the position and the orientation of the operative member relative to the intended tissue.

36. The electric surgical tool according to any one of claims 32 to 35, wherein: The image is an augmented reality image.

37. The electric surgical tool according to any one of claims 1 to 36, wherein: The operating member is one of a laser element, an ultrasonic element, an oscillating element, a rotating element, a thermal element, a radio frequency element, an electric element, an electromagnetic element, a magnetic element, a radiation element, and a chemical element.

38. The electric surgical tool according to any one of claims 1 to 37, wherein: The body includes a handle and a protective cover, wherein the protective cover is located near the operating member of the tissue operating part and is configured to at least partially surround a first portion of the operating member so that the first portion does not contact the surgical site, and the protective cover is configured to expose a second portion of the operating member for use in operating the intended tissue within the surgical site.

39. The electric surgical tool according to claim 38, wherein: The injection port is located on the protective cover.

40. The electric surgical tool according to claim 38 or 39, wherein: At least a distal end portion of the protective cover is located at a distal end on the main body relative to the operating member and the handle, and the ejection port is located on the distal end portion of the protective cover.

41. The electric surgical tool according to any one of claims 38 to 40, wherein: The projection device is configured to have two emission ports, one of the two emission ports is located on the protective cover, and the other of the two emission ports is located on the main body and spaced apart from the protective cover.

42. The electric surgical tool according to any one of claims 38 to 41, further comprising an imaging device, wherein the imaging device has at least two optical receivers attached to the main body, the at least two optical receivers being used to acquire images of the surgical site, at least one of the at least two optical receivers being located on the protective cover, and at least another of the at least two optical receivers being located on the main body and spaced apart from the protective cover.

Images