Device for documenting the use of inserted implants, and method to this end

Abstract

The invention relates to a device (1) for documenting a use of one or more implants (8) which are inserted in an operation and comprise an identifier (10) at an implant surface (9), wherein the implant or implants can be provided for an operation and used therein, the device comprising a housing (2) with a housing interior (3), positioned in which there is at least one light source (4) and at least one camera (5) for recording images of a multiplicity of implants (8) of an operation set (6) before and after an operation, and an image evaluation apparatus for evaluating the images recorded by the at least one camera (5) before and after the operation for the purpose of determining the implant or implants (8) inserted during the operation. According to the invention, provision is made for the at least one light source (4) and the at least one camera (5) to be configured such that reflections at the implant surfaces (9) are reduced to allow sufficient recognition of the identifiers. Moreover, the invention relates to a method with such a device (1) and a use of surface-coated implants (8).

Description

[0001] Device for documenting the use of implanted implants and methods for this purpose

[0002] The invention relates to a device for documenting the use of one or more implants used in an operation, which implants have an identifier on an implant surface and wherein the implant(s) can be provided for an operation and used in this operation, comprising a housing with a housing interior in which at least one light source and at least one camera for recording images of a plurality of implants of a surgical set before and after an operation are positioned, as well as an image evaluation device for evaluating the images recorded by the at least one camera before and after the operation in order to determine the implant(s) used during the operation.

[0003] Furthermore, the invention relates to a method for documenting the use of one or more implants used in an operation, which implants have an identifier on an implant surface and wherein the implant(s) can be provided for and used in an operation.

[0004] Medical technology has developed a wide range of implants for various surgeries, making it possible to treat various bone fractures or even completely or partially replace joints affected by wear, such as knee or hip joints. The individual implants can vary in complexity and range, for example, from simple screws to complex, multi-part implants with relative mobility and fixability of individual components.

[0005] In medical operations, efforts are already being made to optically track surgical instruments during an operation, as disclosed in US 2013 / 0113929 A1. This document discloses a system with multiple stationary cameras covering various areas of an operating room and connected to a data processing device via which, based on the images from the cameras, individual positions of the pieces of the surgical instrument can be localized. This is subsequently used to instruct the operating room staff accordingly if necessary. This is intended to make an operation more efficient. US 2015 / 0250551 A1 discloses a method and a device for detecting the loss of individual pieces of surgical instruments. For this purpose, a tray with a plurality of areas for the surgical instruments to be deposited is provided.The tray contains identifiers, such as a barcode, for each piece of surgical equipment to be stored. The tray can be scanned using a device with at least one camera, allowing image analysis to determine whether one or more pieces of the surgical equipment are missing.

[0006] For other reasons, there is also an effort to be able to identify implants during surgery, including, as addressed in DE 69921 864 T2, for regulatory reasons.

[0007] It is desirable to be able to determine exactly which implant(s) have been inserted into a human body, even long after an operation. This may be necessary, for example, to be able to replace certain defective batches in a timely manner if necessary. Another aspect is that implants inserted in or on the human or animal body can be exposed to corrosion, even if they are only temporarily fixed in the body. This can release substances into the human body and possibly remain there even after the implant has been removed. However, there are still few studies on the effects of corrosive degradation of implants containing corresponding elements on the human or animal body. Careful documentation would provide a suitable basis, particularly for long-term studies.

[0008] Another aspect of desirable, accurate documentation is the legal issues that arise, for example, in the event of implant failure. Being able to assign an implant to a specific batch from a manufacturer can be crucial for liability issues.

[0009] A method and device for suitable documentation of implants have already been disclosed in WO 2021 / 217189 A1 by the applicant. A surgical set containing implants is provided, which is scanned with a camera and a light source so that identifiers on the individual implants can be recorded and subsequently identified using suitable image analysis. This process is performed before and after a surgery. Documenting the corresponding difference reveals which implant(s) were inserted into or onto the person undergoing surgery. The device and method are fundamentally reliable. The mobility of the camera, together with a light source, generally ensures suitable conditions for the camera to capture high-quality images, enabling precise assignment during image processing.However, with round surfaces such as screw heads, problems can arise in the recognition of the identifiers, which usually contain many numbers and / or letters.

[0010] Based on the prior art, it is the object of the invention to further develop a device of the type mentioned at the outset in such a way that it allows reliable detection of identifiers of a large number of implants with a simple structure.

[0011] A further aim of the invention is to provide a method of the type mentioned at the outset which can be carried out using simpler means without any loss of reliability in the documentation of the implant(s) inserted.

[0012] The object of the invention is achieved if, in a device of the type mentioned at the outset, the at least one light source and the at least one camera are configured such that reflections on the implant surfaces are reduced for sufficient recognition of the identifiers.

[0013] The device according to the invention enables reliable recognition of identifiers.

[0014] The intended reduction of reflections makes it possible to very reliably detect identifiers of individual implants. The at least one light source and the at least one camera, preferably a plurality of light sources and a plurality of cameras, are coordinated with one another in such a way that reflections are reduced compared to direct illumination of the implants by the at least one light source. The at least one camera, preferably a plurality of cameras, can be movable or, if appropriate, stationary. A combination of movable cameras together with stationary cameras is also possible. The at least one light source, preferably a plurality of light sources, can be arranged in such a way that the implant surfaces to be recorded by the camera(s) are not directly illuminated. This makes it possible to reduce, in particular minimize, reflections.The reduction of reflections refers to a situation in which an implant is illuminated from above with an equivalent light source, as is known from the prior art, for example according to the cited.

[0015] WO 2021 / 217189 A1, according to which a camera is moved together with a light source. Thus, according to the invention, the at least one light source and the at least one camera are configured such that reflections on the implant surfaces are reduced. This desired reduction comes at the expense of illumination of the implant surfaces, which in turn is detrimental to the recognition of the identifiers. According to the invention, the reduction of reflections and the associated lower illumination of the implant surface create a suitable balance in that the reflections are sufficiently reduced for a given recognizability of the identifiers. In other words, one can also speak of a favorable balance between sufficient illumination and minimized reflections.

[0016] Image analysis is performed using state-of-the-art methods. At least one camera is suitably connected to a data processing system, for example, via a wired or wireless connection. The captured images are analyzed in the data processing system to determine the identifier of each implant and, preferably, assign it to a specific position on the surgical set.

[0017] The image analysis can take place directly in or on the device if the device is equipped with the appropriate resources. It is also possible for the image analysis to take place via a remotely located server. The device can be connected to the server via radio or landline for this purpose. It is preferred that the device is equipped with a data processing device that processes the rapid recognition of the identifiers on site, for example a laptop or tablet PC. The data processing device can be integrated into the external housing of the device to enable simple operation. The device is usually designed to be transportable by hand. Typical dimensions depend on the surgical sets to be inspected and can, for example, be 50 cm x 35 cm x 35 cm in terms of length, width, and height.

[0018] Although a single light source is sufficient, several light sources can advantageously be provided. The light sources can, for example, be arranged at least partially at approximately equal distances from one another inside the housing.

[0019] If multiple light sources are provided, these can preferably be LED light sources. If the light sources are LED light sources, they can be arranged as strips. The LED strips are usually arranged in a rectangle corresponding to the interior of the housing. The LED strips can be arranged adjacent to an inner side of the housing interior defined by housing parts. This allows illumination from an inner wall of the housing into the actual interior of the housing. The LED strips or, if applicable, other light sources are preferably arranged in a plane that lies below the plane into which the surgical set is inserted. This automatically achieves indirect illumination of the implant surfaces because the implant surfaces are facing away from the radiation direction of the light sources.

[0020] The at least one light source can be a point-shaped light source. Alternatively, the at least one light source can also be elongated. If multiple light sources are provided, they are advantageously either point-shaped, linear, or strip-shaped, so that the most homogeneous lighting conditions possible are achieved inside the housing. The specific type of light source is not important; indirect illumination of the implant surfaces should be ensured.

[0021] In principle, one camera can be sufficient. However, if an entire cross-section of the housing interior or an entire surgical set is to be covered, it is advantageous to provide several cameras whose fields of view preferably overlap. With several cameras arranged or aligned with overlapping fields of view, a high quality of the output images to be processed or analyzed can be achieved for subsequent image processing. Because the cameras in the overlapping areas record implants from different perspectives, it can be taken into account that the implants may have different heights, the identifiers may be attached in different positions and / or individual implant surfaces may be inclined relative to an optical camera axis. The more individual fields of view of individual cameras overlap, the better the result of the image analysis and thus the reliability of the process can be.Ideally, each individual area of ​​an image recording is covered by at least two cameras, preferably three or more, for documentation purposes. An upper limit is determined by the usefulness for subsequent image processing. If three or four cameras cover a single area across the assigned field of view, very good and reliable results can be achieved.

[0022] For conventionally sized surgical sets, two or three cameras are preferably provided, which are arranged at the head end inside the housing. The cameras can be arranged so that they can be moved. If this is the case, a servo motor is provided to move the cameras, which is connected to the cameras in order to move them. The servo motor is set up so that the cameras can be moved together along a longitudinal axis of the device. The cameras are preferably moved so that they each take images at predetermined positions along the longitudinal axis. For example, with a set of three cameras, the entire area of ​​a housing interior can be captured along the length and width by four images along the longitudinal axis, at the aforementioned predetermined positions. The individual images recorded by the cameras along the longitudinal axis overlap.This makes it possible to obtain a complete, unambiguous image of the area in both the longitudinal and transverse directions for image analysis. The cameras are moved from one predetermined position to the next. However, it is also possible for the cameras to move continuously at a specific speed, generating images, which are then analyzed.

[0023] The at least one camera can be aligned so that its optical axis is perpendicular to the surgical set, which is generally at least largely flat. The cameras are arranged in a suitable number and at a suitable distance from one another so that those areas of the surgical set in which implants are located are completely covered, preferably with the aforementioned overlap of the fields of view. An inclination of the optical axes of the cameras deviating from a normal position relative to the surgical set is also possible.

[0024] For the simplest possible setup, it is preferred that the optical axis of at least one camera or the optical axes of multiple cameras are each perpendicular to the plane into which the surgical set is inserted. The viewing direction of a camera is thus perpendicular to the surgical set. As mentioned above, the light sources are preferably arranged below the surgical set and the associated insertion surface.

[0025] The at least one light source is preferably arranged stationary. This means that the light source(s) cannot be moved or otherwise positionally changed within the housing. It may be provided that the light source(s) are pivotable in order to change or optimize the lighting settings and the fields of view. However, it is preferred that the light source(s) be set up once and then neither moveable nor pivotable. The at least one camera or possibly several cameras are generally not pivotable during operation, but can be designed to be pivotable in order to be suitably adjusted for ongoing operation.

[0026] In a particularly preferred variant, the at least one light source is positioned for indirect illumination of the implants. The at least one light source can be arranged below the insertion surface for the surgical set and thus illuminates the implant surfaces that are captured by the camera(s) from below. Through this indirect illumination, the at least one light source and the at least one camera are configured such that reflections on the implant surfaces are reduced for sufficient recognition of the identifiers. By appropriately positioning the at least one light source inside the housing, reflections on the implant surfaces can be avoided or at least reduced. Such reflections are particularly disruptive and can lead to an identifier no longer being able to be determined. This is significantly reduced by the indirect illumination.It is advantageously provided that the at least one light source is positioned with an emission direction opposite a field of view of the at least one camera. Furthermore, components for generating scattered light can be arranged inside the housing. The more diffuse the light generated and falling on the surface of an implant, the fewer reflections occur. This can also be achieved by suitable adaptation of an inner surface of the housing, for example by designing it with a matte, highly rough surface. Suitable for this purpose, for example, is a lining made of a plastic that is as light as possible, preferably white, and has a suitable surface roughness, or light, preferably white fabric panels. In this context, light-absorbing elements can be provided, which are arranged in a lateral and / or rear region of the at least one camera.This allows the quality of the images to be further improved, which leads to even more reliable recognition of the identifiers through image analysis.

[0027] Other types of indirect lighting are also possible, for example by generating sufficiently diffuse light using a sufficiently strong light source or, if necessary, several light sources and suitable means, for example by scattering on rough surfaces.

[0028] In another variant, it can be provided that two polarizing filters are arranged between the at least one camera and the at least one light source. This also allows reflections on the implant surfaces to be excellently reduced. The polarizing filters can be rotated at an angle of 10° to 85°, preferably 50° to 82°, in particular 60° to 80°, to one another. The settings can be made such that, on the one hand, the amount of light falling on the camera is optimized, but, on the other hand, reflections on the implant surfaces are reduced, in particular minimized. In this way, a balanced consensus is found between the light hitting the camera and the reduction or minimization of reflections.

[0029] The housing is preferably designed with a drawer which holds the surgical set. The drawer can be designed such that the surgical set can be inserted into a recess in the drawer. This can ensure that the surgical set is correctly positioned. For this purpose, the recess is designed essentially to correspond to an outer diameter of the surgical set, with the surgical set resting with a head-end edge in the drawer. The implants are arranged loosely or detachably attached to the surgical set. In the sense of the invention, an implant is any part that can be inserted on and / or in the human or animal body during surgery, in particular for treating a fracture or the like. These can also be relatively small individual parts such as bone screws or screws for attaching bone plates.However, they can also be bone plates, intramedullary nails, wires or other, usually metallic, parts that are used to treat fractures, for corrective surgery or for other purposes.

[0030] The housing is preferably designed with exterior panels that allow the interior to be completely sealed. Completely sealing the interior of the housing can be important to prevent reflections. If light were to enter from outside, this could lead to unwanted reflections on the implant surfaces.

[0031] The housing can be designed in such a way that it has an opening for the surgical set, which can be closed by a drawer that holds the surgical set. The drawer can be mounted on suitable guide rails so that it can be opened and closed easily. Apart from the opening for the drawer, the interior of the housing can otherwise be completely sealed off from any external light. The only possibility of light entering the area of ​​the opening thus remains. To prevent this from happening during operation, suitable seals can be provided in the area of ​​the opening and / or the drawer.

[0032] The further object of the invention is achieved if, in a method of the type mentioned at the outset, implants are provided which are coated at least in regions on an implant surface, and a device according to the invention is used.

[0033] A method according to the invention achieves the advantage that precise documentation of implants inserted during an operation can be carried out using simple means. A device according to the invention is used for this purpose. Such a device is suitably configured to carry out the method. Since the implant surfaces are also coated, the advantages of a device according to the invention become particularly apparent. With a method according to the invention, the reflections on the implant surfaces are thus reduced, in particular minimized, to ensure sufficient recognition of the identifiers. For this purpose, the at least one light source and the at least one camera are suitably positioned. This applies accordingly if multiple light sources and / or multiple cameras are provided.

[0034] In a further aspect, the invention relates to the use of surface-coated implants for documenting the use of one or more implants inserted during a surgery using image recognition. It has been shown that, with surface-coated implants, images can be captured with a camera and subsequently recognized with suitable image processing software with high quality, thus enabling accurate documentation of the use of implants.

[0035] The advantages of the inventive concept are particularly applicable when surface-coated implants are inspected in a device according to the invention. In particular, a method according to the invention is used. On the one hand, a suitable positioning of the at least one light source and the at least one camera can reduce a proportion of disruptive reflections of incident light. If surface-coated implants are provided at the same time, this additionally contributes to a reduction in unwanted light reflections. Conversely, this allows higher light intensities to be used without causing unwanted reflections that would compromise the recognizability of the identifiers.

[0036] Further features, advantages, and effects of the invention will become apparent from the following exemplary embodiments. Reference is made to the drawings, which show:

[0037] Fig. 1 is a schematic representation of a device with an extended drawer;

[0038] Fig. 2 is a schematic representation of the device of Fig. 1 with the drawer inserted; Fig. 3 is a first variant of a device according to the invention;

[0039] Fig. 4 Implants of a surgical set;

[0040] Fig. 5 Lighting conditions during a recording with a device according to Fig. 3;

[0041] Fig. 6 shows a further variant of a device according to the invention;

[0042] Fig. 7 shows an implant and lighting conditions during a recording with a device according to Fig. 6;

[0043] Fig. 8 individual implant screws in a camera image;

[0044] Fig. 9 shows an enlarged section of the photograph in Fig. 8;

[0045] Fig. 10 and Fig. 11 a schematic representation of a further variant of a device according to the invention.

[0046] Fig. 1 shows a highly schematic view of a device 1 according to the invention. The device 1 comprises a housing 2 on the outside, which is at least substantially, preferably completely, closed except for an opening for a drawer 7 (to be explained later), so that in principle no light can enter the housing interior 3. The drawer 7 is mounted, in particular displaceably mounted, in the housing 2. For this purpose, the housing 2 has a sufficient opening through which the drawer 7 can be pulled out. A surgical set 6 with implants arranged thereon can be inserted into the drawer 7. The drawer 7 can then be pushed into the housing interior 3, with one end face of the drawer 7 closing off the housing 2. For this purpose, the drawer 7 can also be designed with a sufficiently widened edge, which rests against the housing 2 on the outside and at the same time ensures that the drawer 7 cannot be moved any further.A retracted state of the drawer 7 is shown in Fig. 2.

[0047] The situations illustrated in Fig. 1 and Fig. 2 generally represent that the drawer 7 with the surgical set 6 and implants 8 arranged thereon is located completely within the housing 2 and that the housing is essentially closed off in such a way that no light can penetrate into the housing interior 3 from the outside. The device 1 does not necessarily have to be equipped with a drawer 7. It is also possible for the surgical set 6 to be introduced into the housing interior 3 from above. In this case, a cover is provided which, as the outer housing part, closes off the head of the housing 2. Other ways of introducing the surgical set 6 into the housing interior 3 are also conceivable. It is important that after the surgical set 6 with the implants 8 applied to or arranged on it has been introduced, essentially no light can enter the housing interior 3.These statements on a possible design of the housing 2 apply generally and also specifically to the following design variants.

[0048] Fig. 3 shows a first variant of a device 1 according to the invention. In addition to the housing 2 enclosing the housing interior 3, including the drawer 7 therein, which carries the surgical set 6 and implants 8, several cameras 5 and light sources 4 are provided. Polarizing filters 11 are located in front of both the light sources 4 and the cameras 5. The polarizing filters 11 are adjusted such that a significant proportion of the light initially emitted by the light sources 4, linearly polarized by the polarizing filters 11, which falls onto the implants 8 and is reflected by them, is eliminated. This eliminates disturbing reflections at the cameras 5. However, in order to obtain a sufficiently significant image, the polarizing filters 11 are not rotated relative to one another in a state that results in a dark image (90° position of the polarizing filters 11), but at an angle of less than 90°, for example 50° to 75°.An optimum can be found relatively easily by varying the respective polarizing filters 11. The cameras 5 are connected to an image processing unit (not shown), which can be integrated within the housing 2 of the device 1. The image processing unit can process images captured by the cameras 5 so that identifiers 10 applied to implant surfaces 9 can be recognized and stored. However, the image processing unit can also be arranged outside the housing 2, for example, as a separate unit.

[0049] Fig. 4 shows a corresponding image, with two implants 8 arranged on a base. As can be seen, relatively small identifiers 10 on the implants 8 can be clearly identified. The images recorded by the cameras 5 can be evaluated by image processing so that each implant 8 is uniquely identified. This process is carried out before and after an operation. From the evaluation of the corresponding images, the identification of those implants 8 that were inserted during the operation results from the difference being calculated. It is conceivable that an implant 8 is lost during the operation and then mistakenly assigned to the patient. This is not critical, however, because the implant 8 is not on or in the patient. All implants 8 on or in the patient are documented and can be traced even years later.It is particularly advantageous if the implants 8 are surface-coated. This is clearly demonstrated by the example in Fig. 5 for various screws, which can be seen in the top right of Fig. 5. While surface-coated implants 8 or screws and their identifiers 10 exhibiting a certain roughness can be easily identified using camera recordings and image recognition, this is partially or entirely no longer possible for a non-surface-coated screw, since it reflects light too strongly even under the given conditions.

[0050] Fig. 6 shows a further variant of the device 1 according to the invention. In this case, the light sources 4 as well as the cameras 5 are again positioned stationary in the housing interior 3. However, the light sources 4 are positioned in terms of their radiation characteristics such that they are facing away from the fields of view of the cameras 5, so that no light emitted by the light sources 4 can directly hit a camera 5. Furthermore, individual components (not shown in detail) are provided in the housing interior 3, which ensure that the light emitted by the light sources 4 is very strongly scattered. For this purpose, it can also be provided that an inner surface of the housing 2 is suitably designed, for example by a very rough surface. This ensures that the light, which is more or less directed by the light sources 4, is very strongly scattered, whereby reflections on the implant surfaces 9 are at least largely avoided.This is illustrated by way of example in Fig. 7 for an implant 8, on which the identifier 10 is clearly visible, allowing unambiguous identification of the implant 8 before the operation and, if it is not inserted, after the operation. Evaluation is again performed using an image processing unit, which operates as described above and can be integrated into the housing 2.

[0051] With the device 1 according to Fig. 6, it is also expedient if it is used in conjunction with surface-coated implants 8. As can be seen in Fig. 8, non-surface-coated implants 8, here in the form of screws, still have a strong tendency to reflect even with diffusely incident light. This can be avoided with surface-coated implants 8. While, as the enlarged section in Fig. 9 shows, the identifier 10 is barely visible for a non-surface-coated screw, this is easily possible for the surface-coated implants 8 or screws. Figs. 10 and 11 show a particularly preferred variant of a device 1 according to the invention. In contrast to the previously explained embodiments, the device 1 is equipped with movable cameras 5, usually two or three cameras 5, which are arranged on the head side of the device 1.The cameras 5 are connected to a servo motor 12, which moves the cameras 5 synchronously along a longitudinal axis X of the device 1. At predetermined positions, the cameras 5 take images of a surgical set 6 and implants 8 stored therein. As can be seen in Fig. 10, individual light sources 4, designed in the form of an LED strip, are arranged below a plane onto which the surgical set 6 is inserted, and emit light upwards. The surgical set 6 can, for example, be introduced into the housing interior 3 using a drawer 7, as previously explained for the other embodiments. The implant surfaces 9 are thus illuminated indirectly from below. Fig. 11 also shows that a core of the housing interior 3 is insulated from the light sources 4 by a light-scattering means 13, for example a so-called photo cloth.This not only achieves indirect illumination of the implant surfaces 9, but also scatters available light before entering the core of the housing interior 3, resulting in diffuse illumination of the surfaces of the implants 8. This reduces reflections. If the implants 8 are also surface-coated, reflections can be minimized to such an extent that error-free recognition based on the images captured by the cameras 5 is possible, even with very complex identifiers.

Claims

Patent claims 1. A device (1) for documenting the use of one or more implants (8) used in an operation, which implants have an identifier (10) on an implant surface (9) and wherein the implant(s) are provided for an operation and can be used in the operation, comprising a housing (2) with a housing interior (3) in which at least one light source (4) and at least one camera (5) are positioned for recording images of a plurality of implants (8) of a surgical set (6) before and after an operation, as well as an image evaluation device for evaluating the images recorded by the at least one camera (5) before and after the operation to determine the implant(s) (8) used during the operation, characterized in that the at least one light source (4) and the at least one camera (5) are configured such thatthat reflections on the implant surfaces (9) are reduced to ensure sufficient recognition of the identifiers., 2. Device (1) according to claim 1, characterized in that several light sources (4) are provided.

3. Device (1) according to claim 1 or 2, characterized in that the at least one light source (4) is a point-shaped light source (4).

4. Device (1) according to one of claims 1 to 3, characterized in that several cameras (5) are provided, the fields of view of which preferably overlap.

5. Device (1) according to one of claims 1 to 4, characterized in that the at least one light source (4) and / or the at least one camera (5) is arranged stationary.

6. Device (1) according to one of claims 1 to 5, characterized in that the at least one light source (4) is positioned for indirect illumination of the implants (8).

7. Device (1) according to claim 6, characterized in that the at least one light source (4) is positioned with a radiation direction opposite to a field of view of the at least one camera (5).

8. Device (1) according to claim 6 or 7, characterized in that components for generating scattered light are arranged in the housing interior (3).

9. Device (1) according to one of claims 6 to 8, characterized in that light-absorbing elements are provided which are arranged in a lateral and / or rear region of the at least one camera (5).

10. Device (1) according to one of claims 1 to 4, characterized in that two polarizing filters (11) are arranged between the at least one camera (5) and the at least one light source (4).

11. Device (1) according to claim 10, characterized in that the polarizing filters (11) are rotated relative to one another at an angle of 10° to 85°, preferably 50° to 82°, in particular 60° to 80°.

12. Device (1) according to one of claims 1 to 11, characterized in that the housing (2) is designed with a drawer (7) into which the surgical set (6) can be inserted.

13. Device (1) according to one of claims 1 to 12, characterized in that the housing (2) is formed with outer housing parts with which the housing interior (3) can be completely closed.

14. A method for documenting the use of one or more implants (8) used in an operation, which implants have an identifier (10) on an implant surface (9) and wherein the implant or implants (8) can be provided for an operation and used in this operation, characterized in that implants (8) are provided which are coated at least in regions on an implant surface (9) and a device (1) according to one of claims 1 to 13 is used.

15. Use of surface-coated implants (8) for documenting the use of one or more implants (8) used in an operation by means of image recognition.

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