3D virtual image with virtual lighting to track movement of sensor-equipped medical instrument

Abstract

To provide enhanced real-time position and real-time orientation information about one or more components of an ENT instrument.SOLUTION: A position sensor of an instrument provides a signal indicating a real-time position and a real-time orientation of a distal portion of the instrument in response to an electromagnetic field. A processor drives a display screen to display an image of an anatomical region of a patient. The processor processes signals from the position sensor to determine the real-time position and orientation of the distal portion of the instrument within the patient, and then provides a first indicator on the image to indicate the real-time position of the distal portion of the instrument within the patient. The processor also provides a second indicator on the image, indicating the real-time orientation of the distal portion of the instrument within the patient. The second indicator includes virtual illumination of an anatomical structure within the image. The virtually illuminated anatomical structure includes a structure toward which the distal portion of the instrument is oriented.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] (Priority) This application claims priority to U.S. Provisional Patent Application No. 63 / 539,118, entitled "3D Virtual Image with Virtual Lighting to Track Movement of Sensor-Equipped Medical Instrument," filed September 19, 2023, the disclosure of which is incorporated by reference in its entirety herein. [Background technology]

[0002] Image-guided surgery (IGS) is a technique that uses a computer to obtain real-time correlation of the location of an instrument inserted in a patient's body to a set of preoperatively obtained images (e.g., CT or MRI scans, 3D maps, etc.), such that the computer system overlays the current location of the instrument onto the preoperatively obtained images. An example of an electromagnetic IGS navigation system that may be used in an IGS procedure is the TRUDI® navigation system manufactured by Acclarent, Inc. of Irvine, California. In some IGS procedures, a digital tomographic scan (e.g., CT or MRI, 3D maps, etc.) of the surgical field is obtained prior to the surgical procedure. A specially programmed computer is then used to convert the digital tomographic scan data into a digital map. During the surgical procedure, the procedure is performed using special instruments that have sensors (e.g., electromagnetic coils that emit electromagnetic fields and / or respond to externally generated electromagnetic fields) while the sensors send data to the computer indicating the current location of each surgical instrument. The computer correlates the data received from the sensors with the digital map created from the preoperative tomographic scan. The tomographic scan images are displayed on a video monitor along with indicators (e.g., crosshairs or illuminated dots, etc.) showing the real-time location of each surgical instrument relative to the anatomical structures shown in the scan images. Thus, by viewing the video monitor, the surgeon knows the exact location of each sensor-equipped instrument, even if the surgeon cannot directly visualize the instrument itself at its current location within the body.

[0003] In some cases, it may be desirable to dilate a patient's anatomical passages. This may include dilating a sinus ostium (e.g., to treat sinusitis), dilating the larynx, dilating the Eustachian tube, dilating other passages in the ear, nose, or throat, and the like. One method of dilating an anatomical passage includes placing an inflatable balloon in the anatomical passage with a guidewire and catheter, and then inflating the balloon with a fluid (e.g., saline) to dilate the anatomical passage. For example, an expandable balloon may be positioned in the ostium of a sinus and then inflated to dilate the ostium by remodeling the bone adjacent to the ostium, without the need for incision of the mucosa or removal of any bone. The dilated ostium may then improve drainage from and ventilation of the affected sinus.

[0004] It may also be desirable to ablate tissue within a patient's ear, nose, or throat. For example, such ablation may be desirable to remodel tissue (e.g., to reduce the size of the nasal turbinates), to provide denervation (e.g., to disable the posterior nasal nerve), and / or for other purposes. Some such ablation therapies may include radiofrequency (RF) ablation with alternating current (AC) electrical energy, and / or irreversible electroporation (IRE) with pulsed-field direct current (DC) electrical energy. To accomplish ablation, an end effector with one or more needle electrodes or other types of tissue-contacting electrodes may be activated with monopolar or bipolar electrical energy. Such ablation procedures may be performed in conjunction with or separate from the dilation procedures.

[0005] Some such procedures may be known as functional endoscopic sinus surgery (FESS). Such procedures may be performed using a variety of instruments such as microburrs, shavers, drills, microdebriders, etc. Similarly, surgical dissection instruments may be used for removal of intranasal lesions, polyps, and fibroids. In some such procedures, the endoscope may provide at least some visualization of the operative field. However, given the boundaries of the nasal cavity, it may be desirable to provide additional navigational guidance to the instruments via an IGS navigation system. Instruments such as those listed above may also be used in otological situations, such as during neurological / lateral skull-based procedures. In such procedures, options for providing endoscopic visualization may be even more limited than endonasal.

[0006] It may be desirable to provide enhanced real-time position and real-time orientation information for one or more components of an ENT instrument. Although several systems and methods for positioning ENT instruments within anatomical passageways have been made and used, it is believed that no one prior to the inventors has made or used the invention as recited in the appended claims. [Brief description of the drawings]

[0007] The drawings and detailed description which follow are intended to be merely illustrative and are not intended to limit the scope of the invention as contemplated by the inventors. [Figure 1] 1 shows a schematic diagram of an exemplary surgical navigation system in use with a patient seated in an exemplary medical procedure chair. [Diagram 2] 2 is a schematic diagram of an example of an instrument that may be used with the surgical navigation system of FIG. 1. [Diagram 3] 3 shows a flowchart illustrating an example of a process that may be performed using the instrument of FIG. 2 and the surgical navigation system of FIG. [Figure 4A]4 illustrates an example of an image that may be rendered via a display screen of the surgical navigation system of FIG. 1 during execution of the process of FIG. 3 while the instrument of FIG. 2 is in a first position relative to a patient. [Figure 4B] 4 illustrates an example of an image that may be rendered via a display screen of the surgical navigation system of FIG. 1 during execution of the process of FIG. 3 while the instrument of FIG. 2 is in a second position relative to the patient. [Diagram 5] 4 shows an example set of images that may be rendered via the display screen of the surgical navigation system of FIG. 1 during execution of the process of FIG. 3. [Figure 6] 3 shows a flowchart illustrating an example of another process that may be performed using the instrument of FIG. 2 and the surgical navigation system of FIG. 1. [Figure 7A] 7 illustrates an example of an image that may be rendered via a display screen of the surgical navigation system of FIG. 1 during execution of the process of FIG. 6 while the instrument of FIG. 2 is in a first position relative to a patient. [Figure 7B] 7 illustrates an example of an image that may be rendered via the display screen of the surgical navigation system of FIG. 1 during execution of the process of FIG. 6 while the instrument of FIG. 2 is in a second position relative to the patient. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0008] The following description of a specific embodiment of the present invention should not be used to limit the scope of the present invention. Other embodiments, features, aspects, embodiments, and advantages of the present invention will become apparent to those skilled in the art from the following description, which is one of the best modes contemplated for carrying out the present invention by way of example. As will be understood, the present invention is capable of other different and obvious aspects, none of which departs from the present invention. Thus, the drawings and description should be regarded as illustrative in nature, and not restrictive.

[0009] For clarity of this disclosure, the terms "proximal" and "distal" are defined herein relative to a surgeon or other operator gripping a surgical instrument having a distal surgical end effector. The term "proximal" refers to the location of an element disposed closer to the surgeon, and the term "distal" refers to the location of an element disposed closer to the surgical end effector of the surgical instrument and farther from the surgeon. Furthermore, to the extent that spatial terms such as "upper," "lower," "vertical," "horizontal," and the like are used herein with reference to the drawings, it will be understood that such terms are used for illustrative descriptive purposes only and are not intended to be limiting or absolute. In that regard, it will be understood that surgical instruments such as those disclosed herein may be used in a variety of orientations and positions that are not limited to those shown and described herein.

[0010] As used herein, the terms "about" and "approximately" of any numerical value or range are intended to indicate a suitable dimensional tolerance that enables a portion or collection of components to function for its intended purpose as described herein.

[0011] I. Exemplary Image-Guided Surgical Navigation System When performing a medical procedure within the head (H) of a patient (P), it may be desirable to have information regarding the location of an instrument within the head (H) of the patient (P), especially when the instrument is in a location where it is difficult or impossible to obtain an endoscopic view of the working elements of the instrument within the head (H) of the patient (P). Figure 1 shows an example of an IGS navigation system (50) that allows for performing a medical procedure within the head (H) of a patient (P) using image guidance. In addition to or instead of having the components and operabilities described herein, the IGS navigation system (50) may be configured and operable according to at least some of the teachings of the techniques in U.S. Pat. No. 7,720,521, entitled "Methods and Devices for Performing Procedures within the Ear, Nose, Throat and Paranasal Sinuses" (filed May 18, 2010), the disclosure of which is incorporated by reference in its entirety, and U.S. Pat. No. 11,065,061, entitled "Systems and Methods for Performing Image Guided Procedures within the Ear, Nose, Throat and Paranasal Sinuses" (issued July 20, 2021), the disclosure of which is incorporated by reference in its entirety.

[0012] The IGS navigation system (50) of this embodiment includes a magnetic field generator assembly (60) including a set of magnetic field generators (64) integrated into a horseshoe-shaped frame (62). The magnetic field generators (64) are operable to generate alternating magnetic fields of different frequencies around the head (H) of the patient (P). Instruments may be inserted into the head (H) of the patient (P). Such instruments may include one or more position sensors, as described in more detail below. In this embodiment, the frame (62) is mounted on a chair (70) and the patient (P) is seated in the chair (70) such that the frame (62) is positioned adjacent to the head (H) of the patient (P). By way of example only, the chair (70) and / or the magnetic field generator assembly (60) may be constructed and operative in accordance with at least a portion of the teachings of U.S. Patent No. 10,561,370, entitled "Apparatus to Secure Field Generating Device to Chair," issued February 18, 2020, the disclosure of which is incorporated herein by reference in its entirety. In some other variations, the patient (P) lies on a table and the magnetic field generator assembly (60) is positioned on or near the table.

[0013] The IGS navigation system (50) of this embodiment further includes a processor (52) that controls a magnetic field generator (64) and other elements of the IGS navigation system (50). For example, the processor (52) is operable to drive the magnetic field generator (64) to generate an alternating electromagnetic field and to process signals from the instrument to determine the location of a navigation sensor in the instrument within the head (H) of the patient (P). The processor (52) includes a processing unit (e.g., a set of electronic circuitry arranged to evaluate and execute software instructions using combinatorial logic or other similar circuitry) in communication with one or more memories. The processor (52) of this embodiment is mounted in a console (58) that includes a motion control (54) that includes a keypad and / or a pointing device such as a mouse or trackball. A physician interacts with the processor (52) using the motion control (54) while performing a surgical procedure.

[0014] Although not shown, the instrument may include a navigation sensor responsive to its placement within the alternating magnetic field generated by the magnetic field generator 64. A coupling unit (not shown) may be secured to a proximal end of the instrument and configured to provide communication of data and other signals between the console 58 and the instrument. The coupling unit may provide for wired or wireless communication of the data and other signals.

[0015] In some variations, the navigation sensor of the instrument may comprise at least one coil at or near the distal end of the instrument. When such a coil is positioned in an alternating electromagnetic field generated by the magnetic field generator (64), the alternating magnetic field may generate an electric current in the coil, which may be communicated as a signal along a conductive path in the instrument and further via the coupling unit to the processor (52). This phenomenon may enable the IGS navigation system (50) to determine the location of the distal end of the instrument in three-dimensional space (i.e., in the head (H) of the patient (P)). To accomplish this, the processor (52) executes an algorithm that calculates the coordinates of the location of the distal end of the instrument from the position-related signals of the coils in the instrument. Thus, the navigation sensor may function as a position sensor by generating a signal indicative of the real-time position of the sensor in three-dimensional space.

[0016] The processor (52) calibrates and operates the IGS navigation system (50) using software stored in the memory of the processor (52). Such operations include driving the magnetic field generator (64), processing data from the instruments, processing data from the motion control (54), and driving the display screen (56). In some implementations, the operations may also include monitoring and enforcing one or more safety features or functions of the IGS navigation system (50). The processor (52) is further operable to provide real-time video via the display screen (56) showing a video camera image of the patient's head (H), a CT scan image of the patient's head (H), and / or a position of the distal end of the instruments relative to a computer-generated three-dimensional model of the anatomical structures within and adjacent to the patient's nasal cavity. The display screen (56) can display such images simultaneously and / or overlaid on one another during a surgical procedure. Such display images may also include graphical representations of instruments inserted into the patient's head (H), allowing the operator to see a virtual rendering of the instrument in its actual location in real time. By way of example only, the display screen (56) may provide images in accordance with at least some of the teachings of U.S. Pat. No. 10,463,242, entitled "Guidewire Navigation for Sinuplasty," issued Nov. 5, 2019, the disclosure of which is incorporated herein by reference in its entirety. If the operator is also using an endoscope, endoscopic images may also be provided on the display screen (56).

[0017] Images provided via the display screen (56) may assist the operator in guiding the operation of steering and otherwise manipulating the instrument within the patient's head (H). It should also be understood that other components of surgical instruments and other types of surgical instruments may incorporate navigational sensors such as those described above, as described below.

[0018] II. Examples of ENT Instruments with Position Sensors FIG. 2 illustrates an example of an instrument (100) that may be used with the navigation system (50). The instrument (100) of this example includes a shaft (102) having an end effector (110) at a distal end of the shaft (102). The end effector (110) is configured to be inserted into the ear, nose, or throat of a patient (P) and perform some type of operation within the patient (P). In some variations, the end effector (110) includes an expandable dilator operable to dilate an anatomical passageway (e.g., a sinus ostium, an Eustachian tube, an airway, etc.) within the ear, nose, or throat of the patient (P). In some other variations, the end effector (110) includes one or more electrodes operable to provide ablative remodeling, denervation, or other effect of tissue. In still other variations, the end effector (110) includes a rotating mechanism, such as a micro-burr, a shaver blade, a drill bit, a micro-debrider, or the like. The end effector (110) may also include mechanisms for providing endoscopic visualization, illumination, irrigation, suction, and / or other effects. As yet another variation, the end effector (110) may include one or more channels through which one or more other instruments may pass. Other suitable forms, features, and operations that may be provided in or via the end effector (110) will be apparent to those of ordinary skill in the art in view of the teachings herein. Some variations of the instrument (100) may also include a guidewire.

[0019] The instrument (100) further includes a position sensor (112) on the end effector (110). While the position sensor (112) is integrated into the end effector (110) in this example, other variations may provide the position sensor (112) within a guidewire, guide rail, or other element movably disposed within the end effector (110), or within a guide sheath or other element movably disposed about the end effector (110). Although only one position sensor (112) is shown, the instrument (100) may include two or more position sensors (112), with the position sensor (112) located at any suitable location(s) along the length of the shaft (102) and / or within the end effector (110). In some variations in which the shaft (102) includes a steerable or otherwise deformable region, one or more position sensors (112) may be located distal to the steerable or otherwise deformable region, while one or more other position sensors (112) may be located proximate the steerable or otherwise deformable region, thereby facilitating the determination of the bending angle formed by the steerable or otherwise deformable region. The position sensor (112) in this embodiment comprises one or more coils configured to provide a position-indicative signal in response to an alternating electromagnetic field generated by the magnetic field generator (64). The signal provided by the position sensor (112) in response to such an alternating electromagnetic field may indicate the position of the position sensor (112) in three-dimensional space. Additionally, the signal provided by the position sensor (112) in response to such an alternating electromagnetic field may indicate the orientation of the position sensor (112) in three-dimensional space.

[0020] In this embodiment, the instrument (100) is coupled to the processor (52) via a cable (120) for communicating position-indicating signals from the position sensor (112) to the processor (52). In some other variations, the instrument (100) is wirelessly coupled to the processor (52). In either case, the processor (52) is operable to process signals from the position sensor (112) and thereby determine a real-time position and real-time orientation of the end effector (110) within three-dimensional space (e.g., within the head (H) of the patient (P)). The processor (52) is further operable to provide real-time animation via a display screen (56) showing the position of the end effector (110) relative to a video camera image of the patient's head (H), a CT scan image of the patient's head (H), and / or a computer-generated three-dimensional model of the anatomical structures within and adjacent to the patient's nasal cavity. The display screen (56) can display such images simultaneously and / or overlaid on one another during a surgical procedure. Such displayed images may also include a graphical representation of the instrument (100) such that the operator can view a virtual rendering of the instrument (100) in its actual position in real time. In some cases, the real-time position of the end effector (110) is represented on the display screen (56) by crosshairs, a dot, a circle, or other forms of visual indication.

[0021] III. Examples of User Interface Features for Use with an IGS Navigation System As described above, the processor (52) can drive the display screen (56) to provide a visual display of the real-time position of the end effector (110) relative to one or more images of the head (H) of the patient (P). In some cases, it may be beneficial for the operator to receive more real-time information via the display screen (56) beyond the real-time position of the end effector (110) in three-dimensional space. In particular, when the operator is attempting to navigate the end effector (110) along a tortuous path (e.g., within the nasal cavity), the operator may benefit from an enhanced view that provides an intuitive visual of the real-time orientation of the end effector (110) within the patient (P). The operator may also benefit from an enhanced view that provides a real-time indication of the proximity between the end effector (110) and one or more identified anatomical regions. The following description provides examples of such enhancements that may be provided via the display screen (56). Although the examples are provided in the context of the end effector (110) being used in an ear, nose, or throat procedure, the following teachings may be readily applied to other procedures within the head (H) of a patient (P) (e.g., intracranial navigation for navigation toward a thrombus or aneurysm, etc.) Similarly, the following teachings may be readily applied in any other anatomical context, such that the following teachings are not limited to the context of procedures performed in the head (H) of a patient (P).

[0022] A. Example of real-time position and real-time orientation feedback via virtual lighting As mentioned above, it may be beneficial to provide the operator with an enhanced view via the display screen (56) that provides an intuitive visual of the real-time orientation of the end effector (110) within the patient (P). To that end, FIGS. 3-5 show examples of how the processor (52) may drive the display screen (56) to provide an intuitive visual display of the position and orientation of the end effector (110) via virtual light projection. In particular, FIG. 3 shows an example of a process that begins with the processor (52) receiving real-time data from a position sensor (112) (block 200). As mentioned above, some variations of the instrument (100) may include two or more position sensors (112) such that the processor (52) may receive real-time data from two or more such position sensors (112) (block 200). The processor (52) may then use the real-time data from the position sensor (112) to determine a real-time position and real-time orientation of the instrument (100) in three-dimensional space (block 202). More specifically, the processor (52) may determine a real-time position and real-time orientation of the end effector (110) on the head (H) of the patient (P) (block 202).

[0023] Once the real-time position of the end effector (110) has been determined, the processor (52) may drive the display screen (56) to provide a visual display of the real-time position of the end effector (110) relative to one or more images of the patient (P) (block 204). Similarly, once the real-time orientation of the end effector (110) has been determined, the processor (52) may drive the display screen (56) to provide a visual display of the real-time orientation of the end effector (110) relative to one or more images of the patient (P) (block 206). This additional display of the real-time orientation of the end effector (110) may be more beneficial to the operator than simply displaying the real-time position of the end effector (110) because the display of the real-time orientation of the end effector (110) may more clearly convey to the operator where the end effector (110) will continue to move as the operator forces the end effector (110) further into the patient (P). Armed with knowledge of the real-time orientation of end effector (110), the operator may rotate end effector (110), steer end effector (110) (e.g., by articulating or bending shaft (102), etc.), or provide some other form of manipulation to reorient end effector (110) as needed to continue to urge end effector (110) along the desired path.

[0024] 4A-4B illustrate one example of how the processor (52) may drive the display screen (56) to provide (blocks 204, 206) a visual indication of the real-time position and real-time orientation of the end effector (110) relative to one or more images of the patient (P). In particular, FIG. 4A illustrates an example of an image (300) that may be rendered on the display screen (56), the image (300) including a three-dimensional virtual representation (310) of the head (H) of the patient (P). The image (300) includes a first indicator (320) that represents the real-time position of the end effector (110) and a second indicator (330) that represents the real-time orientation of the end effector (110). In the illustrated example, the first indicator (320) is in the form of crosshairs that intersect at a location that corresponds to the real-time position of the end effector (110). Alternatively, the first indicator (320) may take any other suitable form, including but not limited to an "X", a circle, a dot, or the like.

[0025] The second indicator (330) is in the form of virtual illumination in this embodiment. In particular, the second indicator (330) is shown as light reflecting off anatomical walls (as presented in the virtual representation (310)) that intersect with a central longitudinal axis projecting distally from the distal end of the end effector (110). In other words, the second indicator (330) provides a visual appearance similar to that provided if a light source were positioned at the distal end of the end effector (110) (even though the end effector (110) lacks an actual light source), with light from the simulated light source projecting directly toward (and reflecting from) the same anatomical structures to which the distal end of the end effector (110) is oriented. In this embodiment, the virtual illumination provided via the second indicator (330) is similar to that which would be provided by an incoherent light source, with the virtual illumination being substantially concentrated within a central illumination region, with the illumination gradually diffusing from that central illumination region. Thus, image (300) may be similar to an image that may be provided if instrument (100) were an endoscope and end effector (110) included a camera and an incoherent light source, with the camera capturing a likeness of image (300). To the extent that an operator of instrument (100) has experience operating an endoscope and viewing corresponding real-time endoscopic images, the format of image (300) and the virtual illumination of second indicator (330) may provide such an operator with an intuitive sense of the real-time orientation of end effector (110). Additionally, the virtual illumination of second indicator (330) may provide the operator with a better and more intuitive understanding of the contours and other surface features of anatomical structures (e.g., within the nasal cavity), particularly to the extent that the virtual illumination provides shadows and other effects that would be experienced through actual illumination within anatomical cavities and passageways.

[0026] The second indicator (330) provides virtual illumination similar to illumination provided by an incoherent light source in this embodiment, although the virtual illumination provided by the second indicator (330) may take any other suitable form. By way of example only, the virtual illumination provided by the second indicator (330) may be in the form of structured illumination providing a grid pattern or some other type of pattern. As another example, the virtual illumination provided by the second indicator (330) may be similar to illumination provided by one or more coherent light sources. Alternatively, the virtual illumination provided by the second indicator (330) may take any other suitable form.

[0027] As shown in Fig. 4A, the end effector (110) is positioned at the patient's (P) nostril and oriented towards the patient's (P) nasal cavity. Thus, the first indicator (320) is positioned at the virtual representation (312) of the patient's (P) nostril. Meanwhile, the second indicator (330) is positioned within the virtual representation (314) of the patient's (P) nasal cavity. Once the second indicator (330) is positioned within the virtual representation (314) of the patient's (P) nasal cavity, the operator knows that further advancement of the end effector (110) will urge the end effector (110) into the patient's (P) actual nasal cavity.

[0028] 4B shows the image (300) after the operator has urged the end effector (110) into the nasal cavity. As shown, a first indicator (320) indicates the real-time position of the end effector (110) within the virtual representation (314) of the patient's (P) nasal cavity, and a second indicator (330) indicates that the end effector (110) is oriented toward a region deeper within the patient's (P) nasal cavity.

[0029] Although FIGS. 4A-4B depict an analogy to an endoscopic view (i.e., a virtually illuminated virtual endoscopic view) from the end effector (110) in a three-dimensional virtual representation (310) of the head (H) of the patient (P), the real-time position and real-time orientation of the end effector (110) may be indicated in other ways via the display screen (56). For example, FIG. 5 shows another example of two images (350, 370) that may be rendered on the display screen (56). The image (350) includes a top view of a cross section (352) of the head (H) of the patient (P) along a horizontal plane. In some variations, the image (350) includes a preoperative image, such as a CT scan image, an MRI scan image, or the like. A first indicator (354) in the image (350) indicates the real-time position of the end effector (110). A second indicator (356) in the image (350) indicates the real-time orientation of the end effector (110). In the illustrated example, the first indicator (354) is in the form of crosshairs intersecting at a location corresponding to the real-time position of the end effector (110). Alternatively, the first indicator (354) may take any other suitable form, including but not limited to an "X", a circle, a dot, etc. The second indicator (356) is in the form of a virtual light. Thus, the indicators (354, 356) in the image (350) are configured and operable, respectively, like the indicators (320, 330) of the image (300).

[0030] The image (370) includes a perspective three-dimensional view of a virtual representation (372) of the head (H) of the patient (P) with a cross-section along the same horizontal plane as that of the image (350). A first indicator (374) in the image (370) indicates the real-time position of the end effector (110). A second indicator (376) in the image (370) indicates the real-time orientation of the end effector (110). In the example shown, the first indicator (374) is in the form of crosshairs intersecting at a location corresponding to the real-time position of the end effector (110). Alternatively, the first indicator (374) may take any other suitable form, including but not limited to an "X", a circle, a dot, etc. The second indicator (376) is in the form of a virtual light. Thus, indicators (374, 376) in image (370) are constructed and operative, respectively, like indicators (320, 330) in image (300).

[0031] Although each image (350, 370) provides a cross-sectional view with an anatomical wall separating one cavity (e.g., maxillary sinus) from another (e.g., urethral meatus), there may be some instances where the virtual illumination from the indicators (356, 376) may effectively pass through an anatomical wall from one cavity to another, especially if those cavities are connected to one another via passageways not necessarily seen in the cross-sectional views of the images (350, 370). For example, in the view provided in the images (350, 370) of FIG. 5, the virtual illumination of the indicators (356, 376) originates from within the maxillary sinus ostium, and that virtual illumination may "bleed" slightly into the meatus region due to the presence of the maxillary sinus ostium, which provides a passageway through the lateral nasal wall between the maxillary sinus ostium and the meatus, even though the maxillary sinus ostium is below the cross-sectional plane of the images (350, 370). This "bleeding" of virtual light from indicators (356, 376) may vary with intensity as end effector (110) approaches the maxillary sinus ostium. The "bleeding" of virtual light from indicators (356, 376) may thus further indicate to the operator that end effector (110) is approaching a passageway (e.g., maxillary sinus ostium) that connects two cavities (e.g., maxillary sinus ostium and urethral orifice) that are shown as otherwise separated (e.g., separated by the lateral nasal wall). In other words, the "bleeding" of virtual light from indicators (356, 376) may further enhance visual feedback to the operator of the real-time position and real-time orientation of end effector (110) beyond the feedback provided by indicators (356, 376) alone.

[0032] In this example, both images (350, 370) are rendered simultaneously on the display screen (560) and updated simultaneously in real time as the end effector (110) moves within the patient (P). In some variations, both images (350, 370) and images (300) are rendered all at the same time on the display screen (560) and updated all at the same time in real time as the end effector (110) moves within the patient (P). Furthermore, the display screen (560) may further simultaneously render one or more other cross-sectional views (e.g., taken along a coronal plane and / or taken along a sagittal plane), etc., in addition to or instead of providing the images (300, 350, 370) described above. Such other cross-sectional views may be provided with indicators in a manner similar to that described above with respect to the indicators (354, 356, 374, 376) in the images (350, 370). Regardless of whether or how many cross-sectional views are provided via the display screen (560), the cross-sectional plane of such a field of view may move in real time with the end effector (110) as it moves within the head (H) of the patient (P), such that the position of the cross-sectional plane remains at the same depth within the head (H) as the end effector (110) moves within the head (H).

[0033] B. Example of sustained illumination of identified anatomical regions. As discussed above, it may be beneficial to provide the operator with an enhanced view via the display screen (56) that provides a real-time indication of proximity between the end effector (110) and one or more identified anatomical regions. In some cases, the one or more identified anatomical regions may represent intended targets that the operator desires to reach with the end effector (110). In some other cases, the one or more identified anatomical regions may represent areas that the operator desires to avoid with the end effector (110) (e.g., due to the risk that the end effector (110) may unintentionally damage the anatomical structure). Figures 6-7B illustrate examples of how the processor (52) may drive the display screen (56) to provide a persistent indication of proximity between the end effector (110) and one or more identified anatomical regions. In particular, Figure 6 illustrates an example process that begins with the processor (52) receiving (block 400) an identification of an anatomical zone or structure. In some cases, the anatomical zone is identified by the operator. In some other cases, the anatomical zone is identified automatically. For example, processor (52) may utilize artificial intelligence image processing techniques to identify one or more anatomical regions to intentionally target with end effector (110) and / or one or more anatomical regions to intentionally avoid with end effector (110). As another example, processor (52) may utilize artificial intelligence image processing techniques to suggest one or more anatomical regions to intentionally target with end effector (110) and / or one or more anatomical regions to intentionally avoid with end effector (110). The operator can then manually select from these suggestions or otherwise modify the suggestions from processor (52).

[0034] Regardless of how the identified anatomical zones are identified, after the processor (52) receives the identified anatomical zones (block 400), the processor (52) may receive real-time data from the position sensor (112) indicating a real-time position of the end effector (110) (block 402). The processor (52) may then compare the real-time position of the end effector (110) to the positions of the identified anatomical zones to determine whether the end effector (110) is within a particular vicinity of the identified anatomical zones (block 404). The particular vicinity may vary based on a number of factors, including, but not limited to, the operator's manual selection, the nature / sensitivity of the identified anatomical zones, the nature of the end effector (110) (e.g., whether the end effector (110) includes a rotating cutting member or an atraumatic tip, etc.), and / or other factors that will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0035] If the processor (52) determines (block 404) that the end effector (110) has not reached a particular vicinity of the identified anatomical zone, the processor (52) drives the display screen (56) to illuminate (block 406) an indicator (420) in the image (410) with a first color. FIG. 7A shows an example of what the image (410) may look like. In this example, the image (410) includes a top view of a cross section (412) of the head (H) of the patient (P) along a horizontal plane. In some variations, the image (410) includes a preoperative image, such as a CT scan image, an MRI scan image, or the like. The indicator (420), in this example in the form of a dot, is positioned at or near a location that corresponds to the identified anatomical zone. In this example, the identified anatomical zone is the orbit, so the indicator (420) is positioned in an area of ​​bone immediately below the location of the orbit. Also, in this example, since the orbit is an identified anatomical zone, this identified anatomical zone is identified as an anatomical zone that the operator wishes to avoid with the end effector (110). However, as noted above, in some cases, the anatomical zone may be an anatomical zone that the operator wishes to intentionally reach with the end effector (110). Additionally, while only one anatomical zone is identified in this example, there may be other scenarios in which two or more anatomical zones are identified, and such identified anatomical zones may be indicated in the image (410) via respective indicators (420).

[0036] By way of mere further example, the indicator (420) may be illuminated (block 406) in a green color in a scenario in which the processor (52) has determined (block 404) that the end effector (110) has not reached a particular vicinity of an identified anatomical zone. Alternatively, the indicator (420) may be illuminated in any other suitable color and / or may provide visual feedback in any other suitable form (e.g., different blinking frequencies, different illumination intensities, etc.). Returning to FIG. 6, while illuminating the indicator (420) in the image (410) in a first color (block 406), the processor (52) continues to receive real-time data from the position sensor (112) indicative of a real-time position of the end effector (110) (block 402) and determine whether the end effector (110) is within a particular vicinity of an identified anatomical zone (block 404). Accordingly, the processor (52) may persistently illuminate an indicator (420) in the image (410) in a first color during the time the end effector (110) remains outside a particular vicinity of the identified anatomical zone (block 406).

[0037] If the processor (52) determines (block 404) that the end effector (110) has reached a particular vicinity of an identified anatomical zone, the processor (52) drives the display screen (56) to illuminate (block 408) the indicator (420) in the image (410) in a second color, as shown in Figure 7B. By way of example only, the indicator (420) may be illuminated in green in Figure 7A and in red in Figure 7B. Illumination (block 408) of the indicator (420) in a second color (or second illumination pattern, etc.) may provide an immediate visual indication to the operator that the end effector (110) has come within a particular vicinity of an identified anatomical zone. If the identified anatomical zone represents an anatomical structure that the operator wishes to avoid, the operator may, in response to seeing the indicator (420) illuminated in a second color (block 408), stop the advancement of the end effector (110) and / or redirect the movement of the end effector (110) to move the end effector (110) out of proximity of the identified anatomical structure. If the identified anatomical zone represents an anatomical structure that the operator wishes to intentionally reach with the end effector (110), the operator may actuate the end effector (110) or perform some other action in response to seeing the indicator (420) illuminated in a second color (block 408).

[0038] 7B (block 408) may continue as the processor (52) continues to receive real-time data from the position sensor (112) indicating the real-time position of the end effector (110) (block 402) and determine (block 404) that the end effector (110) is within a particular vicinity of the identified anatomical zone. If the processor (52) determines (block 404) that the end effector (110) has moved out of the particular vicinity of the identified anatomical zone, the indicator (420) may transition from the second color back to the first color.

[0039] In some cases, the processor (52) may provide one or more secondary responses (block 409) in addition to illuminating the indicator with a second color (block 408) in response to determining that the end effector (110) has come within a particular vicinity of the identified anatomical zone (block 404). Such secondary responses may include an audible alert. Additionally or alternatively, such secondary responses may include deactivating the end effector (110) or preventing activation of the end effector (110) until the processor (52) determines that the end effector (110) has left a particular vicinity of the identified anatomical zone (block 404). Alternatively, the secondary response may take any other suitable form. It should be understood that providing one or more secondary responses (block 409) in addition to illuminating the indicator with a second color (block 408) is merely optional, and thus some versions may omit such one or more secondary responses.

[0040] Although indicators (320, 330, 354, 356, 377, 376) are described above in a context separate from that in which indicator (420) is described, it should be understood that the above teachings may be readily combined such that indicator (420) may be utilized in the same image (300, 350, 370) in which any of indicators (320, 330, 354, 356, 377, 376) appears. In other words, the teachings described above with respect to indicators (320, 330, 354, 356, 377, 376) do not exclude the teachings described above with respect to indicator (420).

[0041] IV. Combination Examples The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to limit the scope of any claims that may be presented at any time in this application or any subsequent application of this application. No disclaimer is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings herein may be configured and applied in many other ways. It is also contemplated that in some variations, certain features mentioned in the following examples may be omitted. Thus, none of the aspects or features mentioned below should be considered critical unless later expressly so indicated by the inventors or their successors. If a claim presented in this application or any subsequent application related to this application includes additional features other than those mentioned below, those additional features should not be considered as added for any reason regarding patentability. EXAMPLES

[0042] The system includes: (a) a magnetic field generator assembly operable to generate an electromagnetic field around an anatomical region of a patient; (b) an instrument including a position sensor and a distal portion, the distal portion sized for insertion into a patient, the position sensor configured to respond to the electromagnetic field to provide signals indicative of a real-time position and a real-time orientation of the distal portion of the instrument within the patient; (c) a display screen; and (d) a processor configured to: (i) drive the display screen to display an image of the anatomical region of the patient; and (ii) process signals from the position sensor to determine a position and orientation of the instrument within the patient. and a processor configured to: (iii) determine a real-time position and real-time orientation of a distal portion of the instrument within the patient; and (iv) provide a second indicator on the image, the second indicator indicating the real-time position of the distal portion of the instrument within the patient, the second indicator including virtual illumination of an anatomical structure within the image, the virtual illuminated anatomical structure including a structure to which the distal portion of the instrument is oriented. EXAMPLES

[0043] The system of example 1, wherein the anatomical region of the patient includes the patient's head and the distal portion of the instrument is sized to be inserted into the patient's head. EXAMPLES

[0044] The system of any one of Examples 1 to 2, wherein the position sensor includes one or more coils. EXAMPLES

[0045] A system as described in any of Examples 1 to 3, wherein the distal portion of the instrument includes an end effector, the end effector operable to affect tissue. EXAMPLES

[0046] The system of example 4, wherein the end effector comprises an expandable expander. EXAMPLES

[0047] The system of example 4, wherein the end effector comprises one or more electrodes. EXAMPLES

[0048] The system of example 4, wherein the end effector comprises a rotating element selected from the group consisting of a micro-burr, a shaver blade, a drill bit, and a micro-debrider. EXAMPLES

[0049] The system of example 4, wherein the end effector includes an endoscopic visualization element. EXAMPLES

[0050] 5. The system of example 4, wherein the end effector includes a lighting element. EXAMPLES

[0051] The system of Example 4, wherein the end effector includes an irrigation opening configured to communicate irrigation fluid. EXAMPLES

[0052] The system of example 4, wherein the end effector includes a suction opening configured to communicate suction. EXAMPLES

[0053] The system of example 4, wherein the end effector includes a channel configured to slidably receive another instrument. EXAMPLES

[0054] The system of any of Examples 1 to 12, wherein the processor is further configured to (i) drive the display screen to display an image of the patient's anatomical region in the form of a three-dimensional virtual representation of the patient's anatomical region, (ii) provide a first indicator on the three-dimensional virtual representation of the patient's anatomical region, and (iii) provide a second indicator on the three-dimensional virtual representation of the patient's anatomical region. EXAMPLES

[0055] The system of Example 13, wherein the processor is further configured to (i) modify a viewpoint of the three-dimensional virtual representation of the patient's anatomical region in response to a signal from the position sensor indicating repositioning of a distal portion of the instrument within the patient, (ii) provide a first indicator on the three-dimensional virtual representation of the patient's anatomical region having the modified viewpoint, and (iii) provide a second indicator on the three-dimensional virtual representation of the patient's anatomical region having the modified viewpoint. EXAMPLES

[0056] The system of any of Examples 1 to 14, wherein the processor is further configured to (i) drive the display screen to display an image of the patient's anatomical region in the form of a cross-sectional image of the patient's anatomical region, (ii) provide a first indicator on the cross-sectional image of the patient's anatomical region, and (iii) provide a second indicator on the cross-sectional image of the patient's anatomical region. EXAMPLES

[0057] The system of Example 15, wherein the processor is further configured to modify a cross-sectional plane position of the cross-sectional image of the patient's anatomical region in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient, (ii) provide a first indicator on the cross-sectional image of the patient's anatomical region having the modified cross-sectional plane position, and (iii) provide a second indicator on the cross-sectional image of the patient's anatomical region having the modified cross-sectional plane position. EXAMPLES

[0058] The system of any of Examples 1 to 16, wherein the processor is further configured to (i) drive the display screen to simultaneously display two or more images of the patient's anatomical region, (ii) simultaneously provide a first indicator on the two or more images of the patient's anatomical region, and (iii) simultaneously provide a second indicator on the two or more images of the patient's anatomical region. EXAMPLES

[0059] 18. The system of any one of embodiments 1 to 17, wherein the virtual illumination provides a representation of illumination from incoherent light. EXAMPLES

[0060] A system described in any of Examples 1 to 18, wherein the virtual lighting is configured to simulate lighting from a virtual light source positioned at the distal tip of the instrument. EXAMPLES

[0061] A system described in any of Examples 1-19, wherein a distal portion of the instrument lacks an actual light source. EXAMPLES

[0062] A system as described in any of Examples 1 to 20, wherein the processor is further configured to (i) persistently illuminate a third indicator on the image with a first lighting characteristic in response to determining that the distal portion of the instrument is outside a particular vicinity of the identified anatomical structure, and (ii) persistently illuminate a third indicator on the image with a second lighting characteristic in response to determining that the distal portion of the instrument is within a particular vicinity of the identified anatomical structure. EXAMPLES

[0063] 22. The system of example 21, wherein the first lighting characteristic comprises a first color and the second lighting characteristic comprises a second color. EXAMPLES

[0064] The system of any of Examples 21-22, wherein the first lighting characteristic includes a first flash frequency and the second lighting characteristic includes a second flash frequency. EXAMPLES

[0065] 24. The system of any one of Examples 21 to 23, wherein the first lighting characteristic includes a first lighting intensity and the second lighting characteristic includes a second lighting intensity. EXAMPLES

[0066] 1. A method comprising: (a) driving a display screen to display an image of an anatomical region of a patient; (b) processing signals from a position sensor of the instrument to determine a real-time position and a real-time orientation of a distal portion of the instrument within the patient; (c) providing a first indicator on the image, the first indicator indicating the real-time position of the distal portion of the instrument within the patient; and (d) providing a second indicator on the image, the second indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the second indicator including virtual illumination of an anatomical structure within the image, the virtually illuminated anatomical structure including a structure to which the distal portion of the instrument is oriented. EXAMPLES

[0067] The method of example 25, wherein the anatomical region of the patient includes the patient's head, and the distal portion of the instrument is inserted into the patient's head. EXAMPLES

[0068] 27. The method of any of Examples 25-26, wherein the displayed image includes a three-dimensional virtual representation of an anatomical region of the patient, a first indicator is provided on the three-dimensional virtual representation of the anatomical region of the patient, and a second indicator is provided on the three-dimensional virtual representation of the anatomical region of the patient. EXAMPLES

[0069] The method of Example 27, further comprising: (a) modifying a viewpoint of the three-dimensional virtual representation of the patient's anatomical region in response to a signal from the position sensor indicating a repositioning of a distal portion of the instrument within the patient; (b) providing a first indicator on the three-dimensional virtual representation of the patient's anatomical region having the modified viewpoint; and (c) providing a second indicator on the three-dimensional virtual representation of the patient's anatomical region having the modified viewpoint. EXAMPLES

[0070] The method of any of Examples 25 to 28, wherein the displayed image includes a cross-sectional image of an anatomical region of the patient, a first indicator is provided on the cross-sectional image of the anatomical region of the patient, and a second indicator is provided on the cross-sectional image of the anatomical region of the patient. EXAMPLES

[0071] The method of Example 29, further comprising: (a) modifying a cross-sectional plane position of a cross-sectional image of the patient's anatomical region in response to a signal from the position sensor indicating a repositioning of a distal portion of the instrument within the patient; (b) providing a first indicator on the cross-sectional image of the patient's anatomical region having the modified cross-sectional plane position; and (c) providing a second indicator on the cross-sectional image of the patient's anatomical region having the modified cross-sectional plane position. EXAMPLES

[0072] The method of any of Examples 25-30, further comprising: (a) driving a display screen to simultaneously display two or more images of the patient's anatomical region; (b) simultaneously providing a first indicator on the two or more images of the patient's anatomical region; and (c) simultaneously providing a second indicator on the two or more images of the patient's anatomical region. EXAMPLES

[0073] 32. The method according to any one of embodiments 25 to 31, wherein the virtual illumination provides a representation of illumination from incoherent light. EXAMPLES

[0074] The method of any of Examples 25 to 32, wherein the virtual illumination simulates illumination from a virtual light source positioned at the distal tip of the instrument. EXAMPLES

[0075] The method of any of Examples 25 to 33, wherein a distal portion of the instrument is devoid of an actual light source. EXAMPLES

[0076] The method of any of Examples 25 to 33, further comprising: (a) persistently illuminating a third indicator on the image with a first lighting characteristic in response to determining that a distal portion of the instrument is outside a particular vicinity of the identified anatomical structure; and (b) persistently illuminating a third indicator on the image with a second lighting characteristic in response to determining that a distal portion of the instrument is within a particular vicinity of the identified anatomical structure. EXAMPLES

[0077] 36. The method of example 35, wherein the first lighting characteristic comprises a first color and the second lighting characteristic comprises a second color. EXAMPLES

[0078] A method according to any of Examples 35 to 36, wherein the first lighting characteristic comprises a first flash frequency and the second lighting characteristic comprises a second flash frequency. EXAMPLES

[0079] 38. The method of any of Examples 35 to 37, wherein the first illumination characteristic comprises a first illumination intensity and the second illumination characteristic comprises a second illumination intensity. EXAMPLES

[0080] 1. A system comprising: (a) a magnetic field generator assembly operable to generate an electromagnetic field around an anatomical region of a patient; (b) an instrument including a position sensor and a distal portion, the distal portion sized to be inserted into the patient, the position sensor configured to provide a signal indicative of a real-time position and a real-time orientation of the distal portion of the instrument within the patient in response to the electromagnetic field; (c) a display screen; and (d) a processor configured to: (i) drive the display screen to display an image of the patient's anatomical region; (ii) process signals from the position sensor to determine a real-time position of the distal portion of the instrument within the patient; (iii) in response to determining that the distal portion of the instrument is outside a particular vicinity of an identified anatomical structure, persistently illuminate a first indicator on the image with a first illumination characteristic; and (iv) in response to determining that the distal portion of the instrument is within a particular vicinity of the identified anatomical structure, persistently illuminate the first indicator on the image with a second illumination characteristic. EXAMPLES

[0081] 39. The system of embodiment 39, wherein the first lighting characteristic includes a first color and the second lighting characteristic includes a second color. EXAMPLES

[0082] The system of any of Examples 39-40, wherein the first lighting characteristic includes a first flash frequency and the second lighting characteristic includes a second flash frequency. EXAMPLES

[0083] The system of any of Examples 39-41, wherein the first lighting characteristic includes a first lighting intensity and the second lighting characteristic includes a second lighting intensity. EXAMPLES

[0084] A system described in any of Examples 39 to 42, wherein the first indicator is positioned within a region of the image corresponding to an identified anatomical structure. EXAMPLES

[0085] The system of any of Examples 39 to 43, wherein the processor is further configured to provide a second indicator on the image, the second indicator indicating a real-time position of the distal portion of the instrument within the patient. EXAMPLES

[0086] The system of any of Examples 39 to 44, wherein the processor is further configured to: (i) process signals from the position sensor to determine a real-time orientation of the distal portion of the instrument within the patient; and (ii) provide a third indicator on the image, the third indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the third indicator including virtual illumination of an anatomical structure in the image, the virtual illuminated anatomical structure including a structure to which the distal portion of the instrument is oriented. EXAMPLES

[0087] A method comprising: (a) driving a display screen to display an image of an anatomical region of a patient; (b) processing signals from a position sensor to determine a real-time position of a distal portion of an instrument within the patient; (c) determining whether the distal portion of the instrument is within a particular vicinity of an identified anatomical structure; (d) persistently illuminating a first indicator on the image with a first lighting characteristic while the distal portion of the instrument is outside the particular vicinity of the identified anatomical structure; and (e) persistently illuminating a first indicator on the image with a second lighting characteristic when the distal portion of the instrument reaches the particular vicinity of the identified anatomical structure, thereby indicating that the distal portion of the instrument is within the particular vicinity of the identified anatomical structure. EXAMPLES

[0088] 47. The method of example 46, further comprising receiving an operator input indicating the identified anatomical structure. EXAMPLES

[0089] The method of any of Examples 46-47, further comprising automatically identifying the identified anatomical structure. EXAMPLES

[0090] 49. The method of any of Examples 46-48, wherein the first lighting characteristic comprises a first color and the second lighting characteristic comprises a second color. EXAMPLES

[0091] A method as described in any of Examples 46 to 48, wherein the first lighting characteristic includes a first flash frequency and the second lighting characteristic includes a second flash frequency. EXAMPLES

[0092] 51. The method of any of Examples 46-50, wherein the first lighting characteristic comprises a first lighting intensity and the second lighting characteristic comprises a second lighting intensity. EXAMPLES

[0093] 52. The method of any of Examples 46 to 51, wherein the first indicator is positioned within a region of the image corresponding to the identified anatomical structure. EXAMPLES

[0094] The method of any of Examples 46-52, wherein the anatomical region of the patient includes the patient's head and the distal portion of the instrument is inserted into the patient's head. EXAMPLES

[0095] The method of any of Examples 46 to 53, further comprising providing a second indicator on the image, the second indicator indicating a real-time position of the distal portion of the instrument within the patient. EXAMPLES

[0096] The system of any of Examples 46 to 54, further comprising: (a) processing a signal from the position sensor to determine a real-time orientation of a distal portion of the instrument within the patient; and (b) providing a third indicator on the image, the third indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the third indicator including virtual illumination of an anatomical structure in the image, the virtual illuminated anatomical structure including a structure to which the distal portion of the instrument is oriented.

[0097] V.Other It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Thus, the above teachings, expressions, embodiments, examples, etc. should not be considered in isolation with respect to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

[0098] It is understood that all or part of any patent, publication, or other disclosure referred to as being incorporated herein by reference is incorporated herein only to the extent that the incorporated content does not conflict with existing definitions, opinions, or other disclosures set forth in this disclosure. As such, and to the extent necessary, the disclosure explicitly set forth herein shall prevail over any conflicting statements incorporated herein by reference. Any content, or portions thereof, that is referred to as being incorporated herein by reference but that conflicts with current definitions, opinions, or other disclosures set forth herein shall be incorporated only to the extent that there is no conflict between the incorporated content and the current disclosures.

[0099] The device variations described above may be designed to be disposed of after a single use, or they may be designed to be used multiple times. The variations may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of disassembly of the device, followed by cleaning or replacement of certain parts, and then reassembly. In particular, some device variations may be disassembled and any number of certain parts or components of the device may be selectively replaced or removed in any combination. After cleaning and / or replacement of certain parts, some device variations may be reassembled for subsequent use, either at a reconditioning facility or by the user immediately prior to the procedure. Those skilled in the art will appreciate that reconditioning of a device may utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

[0100] By way of example only, the variants described herein can be sterilized before and / or after treatment. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high-energy electron beams. The radiation can kill bacteria on the device and in the container. The sterilized device can then be stored in the sterile container for later use. The device can also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

[0101] Although various embodiments of the present invention have been shown and described, further adaptations of the methods and systems described herein may be realized by those skilled in the art through appropriate modifications without departing from the scope of the present invention. Although some of such possible modifications have been mentioned, other modifications will be apparent to those skilled in the art. For example, the examples, embodiments, geometries, materials, dimensions, proportions, steps, etc. discussed above are illustrative and not required. Thus, it is understood that the scope of the present invention should be considered in terms of the following claims and is not limited to the details of construction and operation shown and described in the specification and drawings.

[0102] [Embodiment] (1) A system comprising: (a) a magnetic field generator assembly operable to generate an electromagnetic field about an anatomical region of a patient; (b) an instrument including a position sensor and a distal portion, the distal portion sized to be inserted into a patient, the position sensor configured to provide a signal indicative of a real-time position and a real-time orientation of the distal portion of the instrument within the patient in response to the electromagnetic field; (c) a display screen; and (d) a processor, the processor comprising: (i) driving the display screen to display an image of the anatomical region of the patient; (ii) processing signals from the position sensor to determine the real-time position and the real-time orientation of the distal portion of the instrument within the patient; (iii) providing a first indicator on the image, the first indicator indicating the real-time location of the distal portion of the instrument within the patient; and (iv) providing a second indicator on the image, the second indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the second indicator including a virtual illumination of an anatomical structure in the image, the virtually illuminated anatomical structure including a structure around which the distal portion of the instrument is oriented. (2) The system of embodiment 1, wherein the anatomical region of the patient includes the patient's head, and the distal portion of the instrument is sized to be inserted into the patient's head. (3) The system of embodiment 1, wherein the position sensor comprises one or more coils. (4) The system of embodiment 1, wherein the distal portion of the instrument includes an end effector, the end effector operable to affect tissue. (5) The system of embodiment 4, wherein the end effector comprises one or more features selected from the group consisting of an expandable dilator, one or more electrodes, a micro-burr, a shaver blade, a drill bit, a microdebrider, an illumination element, an irrigation opening, a suction opening, and a channel configured to slidably receive another instrument.

[0103] (6) The processor: (i) driving the display screen to display an image of the anatomical region of the patient in the form of a three-dimensional virtual representation of the anatomical region of the patient; (ii) providing the first indicator on the three-dimensional virtual representation of the anatomical region of the patient; (iii) providing the second indicator on the three-dimensional virtual representation of the anatomical region of the patient. (7) The processor: (i) modifying a viewing perspective of the three-dimensional virtual representation of the anatomical region of the patient in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient; (ii) providing the first indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified perspective; (iii) providing the second indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified viewpoint. (8) The processor: (i) driving the display screen to display an image of the anatomical region of the patient in the form of a cross-sectional image of the anatomical region of the patient; (ii) providing the first indicator on the cross-sectional image of the anatomical region of the patient; (iii) the system of claim 1, further configured to provide the second indicator on the cross-sectional image of the anatomical region of the patient. (9) The processor: (i) driving the display screen to simultaneously display two or more images of the anatomical region of the patient; (ii) providing the first indicator simultaneously on the two or more images of the anatomical region of the patient; (iii) the system of embodiment 1, further configured to simultaneously provide the second indicator on the two or more images of the anatomical region of the patient. (10) The system of embodiment 9, wherein the virtual illumination provides a representation of illumination from incoherent light.

[0104] (11) The system of embodiment 1, wherein the virtual lighting is configured to simulate lighting from a virtual light source positioned at a distal tip of the instrument. (12) The system of embodiment 1, wherein the distal portion of the instrument lacks an actual light source. (13) The processor, (i) in response to determining that the distal portion of the instrument is outside a particular vicinity of an identified anatomical structure, continuously illuminating a third indicator on the image with a first illumination characteristic; (ii) the system of embodiment 1, further configured to persistently illuminate the third indicator on the image with a second lighting characteristic in response to determining that the distal portion of the instrument is within a particular vicinity of the identified anatomical structure. (14) The system of embodiment 13, wherein the first lighting characteristic includes a first color and the second lighting characteristic includes a second color. (15) The system of embodiment 13, wherein the first lighting characteristic includes a first flash frequency and the second lighting characteristic includes a second flash frequency.

[0105] (16) The system of embodiment 13, wherein the first lighting characteristic includes a first lighting intensity and the second lighting characteristic includes a second lighting intensity. (17) A system comprising: (a) a magnetic field generator assembly operable to generate an electromagnetic field about an anatomical region of a patient; (b) an instrument including a position sensor and a distal portion, the distal portion sized to be inserted into a patient, the position sensor configured to provide a signal indicative of a real-time position and a real-time orientation of the distal portion of the instrument within the patient in response to the electromagnetic field; (c) a display screen; and (d) a processor, the processor comprising: (i) driving the display screen to display an image of the anatomical region of the patient; (ii) processing signals from the position sensor to determine the real-time position of the distal portion of the instrument within the patient; (iii) in response to determining that the distal portion of the instrument is outside a particular vicinity of an identified anatomical structure, continuously illuminating a first indicator on the image with a first illumination characteristic; (iv) the system is configured to persistently illuminate the first indicator on the image with a second illumination characteristic in response to determining that the distal portion of the instrument is within a particular vicinity of the identified anatomical structure. (18) A method comprising the steps of: (a) driving a display screen to display an image of an anatomical region of a patient; (b) processing signals from an instrument position sensor to determine the real-time position and real-time orientation of the instrument's distal portion within the patient; (c) providing a first indicator on the image, the first indicator indicating the real-time location of the distal portion of the instrument within the patient; and (d) providing a second indicator on the image, the second indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the second indicator including virtual illumination of an anatomical structure in the image, the virtually illuminated anatomical structure including a structure about which the distal portion of the instrument is oriented. (19) The displayed image includes a three-dimensional virtual representation of the anatomical region of the patient, the first indicator is provided on the three-dimensional virtual representation of the anatomical region of the patient, and the second indicator is provided on the three-dimensional virtual representation of the anatomical region of the patient, the method further comprising: (a) modifying a viewpoint of the three-dimensional virtual representation of the anatomical region of the patient in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient; (b) providing the first indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified perspective; 20. The method of claim 18, further comprising: (c) providing the second indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified perspective. (20) The displayed image includes a cross-sectional image of the anatomical region of the patient, the first indicator is provided on the cross-sectional image of the anatomical region of the patient, and the second indicator is provided on the cross-sectional image of the anatomical region of the patient, the method further comprising: (a) modifying a cross-sectional plane position of the cross-sectional image of the anatomical region of the patient in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient; (b) providing the first indicator on the cross-sectional image of the anatomical region of the patient having the modified cross-sectional plane location; 20. The method of claim 18, further comprising: (c) providing the second indicator on the cross-sectional image of the anatomical region of the patient having the modified cross-sectional plane position.

Claims

1. 1. A system comprising: (a) a magnetic field generator assembly operable to generate an electromagnetic field about an anatomical region of a patient; (b) an instrument including a position sensor and a distal portion, the distal portion sized to be inserted into a patient, the position sensor configured to provide a signal indicative of a real-time position and a real-time orientation of the distal portion of the instrument within the patient in response to the electromagnetic field; (c) a display screen; and (d) a processor, the processor comprising: (i) driving the display screen to display an image of the anatomical region of the patient; (ii) processing signals from the position sensor to determine the real-time position and the real-time orientation of the distal portion of the instrument within the patient; (iii) providing a first indicator on the image, the first indicator indicating the real-time location of the distal portion of the instrument within the patient; and (iv) providing a second indicator on the image, the second indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the second indicator including virtual illumination of an anatomical structure in the image, the virtually illuminated anatomical structure including a structure around which the distal portion of the instrument is oriented.

2. The system of claim 1 , wherein the anatomical region of the patient includes a head of the patient, and the distal portion of the instrument is sized to be inserted into the head of the patient.

3. The system of claim 1 , wherein the position sensor comprises one or more coils.

4. The system of claim 1 , wherein the distal portion of the instrument includes an end effector, the end effector operable to affect tissue.

5. 5. The system of claim 4, wherein the end effector comprises one or more features selected from the group consisting of an expandable dilator, one or more electrodes, a micro-burr, a shaver blade, a drill bit, a microdebrider, an illumination element, an irrigation opening, a suction opening, and a channel configured to slidably receive another instrument.

6. The processor, (i) driving the display screen to display an image of the anatomical region of the patient in the form of a three-dimensional virtual representation of the anatomical region of the patient; (ii) providing the first indicator on the three-dimensional virtual representation of the anatomical region of the patient; 10. The system of claim 1, further configured: (iii) to provide the second indicator on the three-dimensional virtual representation of the anatomical region of the patient.

7. The processor, (i) modifying a viewpoint of the three-dimensional virtual representation of the anatomical region of the patient in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient; (ii) providing the first indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified viewpoint; 7. The system of claim 6, further configured: (iii) to provide the second indicator on the three-dimensional virtual representation of the anatomical region of the patient with the modified viewpoint.

8. The processor, (i) driving the display screen to display an image of the anatomical region of the patient in the form of a cross-sectional image of the anatomical region of the patient; (ii) providing the first indicator on the cross-sectional image of the anatomical region of the patient; The system of claim 1 , further configured to: (iii) provide the second indicator on the cross-sectional image of the anatomical region of the patient.

9. The processor, (i) driving the display screen to simultaneously display two or more images of the anatomical region of the patient; (ii) providing the first indicator simultaneously on the two or more images of the anatomical region of the patient; 2. The system of claim 1, further configured to: (iii) simultaneously provide the second indicator on the two or more images of the anatomical region of the patient.

10. The system of claim 9 , wherein the virtual illumination provides a representation of illumination from incoherent light.

11. The system of claim 1 , wherein the virtual lighting is configured to simulate lighting from a virtual light source positioned at a distal tip of the instrument.

12. The system of claim 1 , wherein the distal portion of the instrument is devoid of an actual light source.

13. The processor, (i) in response to determining that the distal portion of the instrument is outside a particular vicinity of an identified anatomical structure, continuously illuminating a third indicator on the image with a first illumination characteristic; 2. The system of claim 1, further configured: (ii) in response to determining that the distal portion of the instrument is within a particular vicinity of the identified anatomical structure, persistently illuminating the third indicator on the image with a second illumination characteristic.

14. The system of claim 13 , wherein the first lighting characteristic comprises a first color and the second lighting characteristic comprises a second color.

15. The system of claim 13 , wherein the first lighting characteristic comprises a first flash frequency and the second lighting characteristic comprises a second flash frequency.

16. The system of claim 13 , wherein the first lighting characteristic comprises a first lighting intensity and the second lighting characteristic comprises a second lighting intensity.

17. 1. A system comprising: (a) a magnetic field generator assembly operable to generate an electromagnetic field about an anatomical region of a patient; (b) an instrument including a position sensor and a distal portion, the distal portion sized to be inserted into a patient, the position sensor configured to provide a signal indicative of a real-time position and a real-time orientation of the distal portion of the instrument within the patient in response to the electromagnetic field; (c) a display screen; and (d) a processor, the processor comprising: (i) driving the display screen to display an image of the anatomical region of the patient; (ii) processing signals from the position sensor to determine the real-time position of the distal portion of the instrument within the patient; (iii) in response to determining that the distal portion of the instrument is outside a particular vicinity of an identified anatomical structure, continuously illuminating a first indicator on the image with a first illumination characteristic; (iv) the system is configured to persistently illuminate the first indicator on the image with a second illumination characteristic in response to determining that the distal portion of the instrument is within a particular vicinity of the identified anatomical structure.

18. 1. A method comprising: (a) driving a display screen to display an image of an anatomical region of a patient; (b) processing signals from an instrument position sensor to determine the real-time position and real-time orientation of the instrument's distal portion within the patient; (c) providing a first indicator on the image, the first indicator indicating the real-time location of the distal portion of the instrument within the patient; and (d) providing a second indicator on the image, the second indicator indicating the real-time orientation of the distal portion of the instrument within the patient, the second indicator including virtual illumination of an anatomical structure in the image, the virtually illuminated anatomical structure including a structure around which the distal portion of the instrument is oriented.

19. the displayed image includes a three-dimensional virtual representation of the anatomical region of the patient, the first indicator is provided on the three-dimensional virtual representation of the anatomical region of the patient, and the second indicator is provided on the three-dimensional virtual representation of the anatomical region of the patient, the method further comprising: (a) modifying a viewpoint of the three-dimensional virtual representation of the anatomical region of the patient in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient; (b) providing the first indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified perspective; and 20. The method of claim 18, further comprising: (c) providing the second indicator on the three-dimensional virtual representation of the anatomical region of the patient having the modified perspective.

20. The displayed image includes a cross-sectional image of the anatomical region of the patient, the first indicator is provided on the cross-sectional image of the anatomical region of the patient, and the second indicator is provided on the cross-sectional image of the anatomical region of the patient, and the method further comprises: (a) modifying a cross-sectional plane position of the cross-sectional image of the anatomical region of the patient in response to a signal from the position sensor indicating a repositioning of the distal portion of the instrument within the patient; (b) providing the first indicator on the cross-sectional image of the anatomical region of the patient having the modified cross-sectional plane location; and 20. The method of claim 18, further comprising: (c) providing the second indicator on the cross-sectional image of the anatomical region of the patient having the modified cross-sectional plane location.

Images