Oct imaging-based positioning and navigation method for orthopedic surgical robot

Description

OCT imaging-based positioning and navigation method for orthopedic surgical robots

[0001] For all purposes, this application claims priority to Chinese Application No. 202311338474.2, filed on October 16, 2023, which is incorporated herein by reference in its entirety. Technical Field

[0002] The present invention relates to an OCT imaging-based positioning and navigation method for an orthopedic surgical robot. The orthopedic surgical robot comprises an OCT imaging device, a surgical tool robotic arm for mounting surgical tools, and an imaging device robotic arm for mounting the OCT imaging device. Background Art

[0003] Infrared navigation is a positioning and navigation technology that locates various surgical instruments and surgical areas based on the detection of small reflective balls. In order to achieve precise intraoperative navigation, the infrared positioning and navigation system usually needs to be aligned with the intraoperative three-dimensional image, intraoperative CT, and preoperative CT before it can start navigating the surgical robot. This can easily lead to both the doctor and the patient being exposed to a large amount of radiation during the operation. At the same time, steps such as the push-in and push-out scanning of the intraoperative three-dimensional CT machine will also complicate the surgical process, and the patient's movement, breathing, or other movements during the operation cannot be detected in time, which will reduce the accuracy of navigation and affect the final surgical effect. Optical Coherence Tomography (OCT) is a type of optical tomography technology that can provide real-time two-dimensional or three-dimensional images with micron resolution and millimeter penetration depth. Due to its advantages such as providing depth information, non-invasiveness, fast imaging, and high resolution, it is widely used in intraoperative navigation in ophthalmic surgery.

[0004] Summary of the Invention

[0005] The technical problem to be solved by the present invention is to provide an OCT imaging-based positioning and navigation method for an orthopedic surgical robot, by which the amount of radiation received by the patient during the operation can be significantly reduced.

[0006] This technical problem is solved by a positioning and navigation method based on OCT imaging for an orthopedic surgical robot. The orthopedic surgical robot includes an OCT imaging device having an OCT imaging probe, a surgical tool robot arm for mounting surgical tools, and an imaging device robot arm for mounting the OCT imaging device. According to the present invention, the positioning and navigation method includes the following steps:

[0007] S1: Scanning the area to be operated on using an OCT imaging probe to acquire an OCT image of the area to be operated on;

[0008] S2: performing a first registration of the OCT image with the preoperative medical image to obtain preoperative planning information;

[0009] S3: Scanning the surgical tool robotic arm or the surgical tool with the OCT imaging probe to obtain a precise registration matrix for registration between the imaging device robotic arm and the surgical tool robotic arm;

[0010] S4: Scanning the area to be operated on in real time using the OCT imaging probe to update the positional relationship between the area to be operated on and the robotic arm of the imaging device;

[0011] S5: Using the precise registration matrix, the real-time coordinates of the surgical tool robot arm in the OCT coordinate system and the real-time position of the surgical tool in the OCT coordinate system are updated in real time;

[0012] S6: Controlling the surgical tool robotic arm and / or surgical tool to perform the surgical operation based on the real-time coordinates and the real-time posture and in accordance with the registered surgical planning information. Because the method according to the present invention eliminates the need for intraoperative scanning of the patient by medical imaging equipment, the patient's radiation exposure is significantly reduced, which is more beneficial to the patient's health.

[0013] In an extension scheme according to the present invention, it is stipulated that in step S2, surgical planning information in the preoperative medical image is converted into surgical planning information in the OCT coordinate system with the help of the first registration matrix, wherein the first registration matrix is ​​calculated based on the three-dimensional coordinate point cloud of the OCT image and the three-dimensional coordinate point cloud of the medical image.

[0014] In a further extended scheme according to the present invention, it is stipulated that before step S3, a second registration matrix between the imaging device robot arm and the surgical tool robot arm is obtained based on the positional relationship between the imaging device robot arm and the surgical tool robot arm, wherein the second registration matrix is ​​calculated by the coordinates of the imaging device robot arm in the robot coordinate system and the coordinates of the surgical tool robot arm in the robot coordinate system.

[0015] In a further extended scheme according to the present invention, it is stipulated that, with the aid of the second registration matrix, the coordinates of the field of view of the OCT imaging probe in the imaging device robotic arm coordinate system are converted into coordinates in the surgical tool robotic arm coordinate system so as to move the surgical tool robotic arm into the field of view area, wherein the field of view area is preferably located in an area near the area to be operated on that can be scanned by the OCT imaging device.

[0016] In a further development of the present invention, it is provided that the fine registration matrix is ​​acquired by scanning a first marker identifiable by an OCT imaging probe provided on a surgical tool robot arm or a surgical tool.

[0017] In a further development of the present invention, in step S4, the OCT imaging probe scans a second marker located on the surgical area, which is identifiable by the OCT imaging probe, to obtain the real-time coordinates of the surgical area in the OCT coordinate system. This prevents surgical planning errors caused by inevitable slight movements of the patient or operating table.

[0018] In a further extended scheme according to the present invention, it is stipulated that in step S5, the real-time coordinates of the surgical tool robot in its surgical tool robot coordinate system are obtained by the surgical tool robot system itself, and the real-time posture of the surgical tool in the surgical tool robot coordinate system is obtained based on the size and shape of the surgical tool, and then the real-time coordinates and real-time posture are converted into the real-time coordinates of the surgical tool robot in the OCT coordinate system and the real-time posture of the surgical tool in the OCT coordinate system with the help of a precise registration matrix.

[0019] In a further development of the present invention, an imaging device with the same field of view as the OCT imaging probe is provided. This imaging device recognizes a marker identifying the area to be operated on, thereby obtaining the original coordinates of the area to be operated on in the OCT imaging device coordinate system. Based on this, an imaging position directly above the area to be operated on is calculated, and the imaging device robotic arm is then moved to this imaging position. This allows the imaging device robotic arm to be automatically moved to the imaging position, improving the automation level of the orthopedic surgical robot.

[0020] In a further development of the present invention, it is provided that the preoperative medical image is acquired by a medical imaging device, and surgical planning information is recorded on a three-dimensional model of the preoperative medical image. BRIEF DESCRIPTION OF THE DRAWINGS

[0021] The features and advantages of the present invention are further described below with reference to the accompanying drawings, in which:

[0022] FIG1 is a non-limiting embodiment of an orthopedic surgical robot capable of implementing a positioning and navigation method based on OCT imaging;

[0023] FIG2 is a flow chart of a positioning and navigation method based on OCT imaging for an orthopedic surgical robot according to the present invention.

[0024] With reference to the accompanying drawings, in which the same reference numerals refer to the same components throughout the several views, the drawings primarily illustrate various elements, such as the positional relationships, connection relationships, fit relationships, and size relationships between components and members, and are not intended to limit the dimensions and specific implementation forms of these elements. DETAILED DESCRIPTION

[0025] The term "registration matrix" is understood according to the present invention to mean a matrix that transforms coordinates in two coordinate systems, for example A and B. The term "pose" is understood according to the present invention to mean two positions and postures in the same coordinate system.

[0026] It should be understood that the present disclosure may employ various alternative variations and step sequences, unless expressly specified otherwise. It should also be understood that the specific devices and processes illustrated in the accompanying drawings and described in the following specification are merely illustrative and non-limiting embodiments or aspects.

[0027] The technical term "orthopedic surgery" in the present disclosure includes but is not limited to laminectomy, discectomy, vertebroplasty, discectomy, lamina resection, lumbar fusion, etc. The ordinal numbers "first" and "second" only indicate different components and do not limit the order.

[0028] FIG1 shows a non-limiting embodiment of an orthopedic surgical robot 1 for executing a positioning and navigation method based on OCT imaging according to the present disclosure. In this figure, only the main mechanical components related to executing the positioning and navigation method based on OCT imaging are shown. The orthopedic surgical robot 1 according to the present disclosure mainly includes a robotic arm device 2, a positioning and navigation device based on OCT imaging (only the executive component of its imaging device, i.e., the OCT imaging probe 3, is shown in this figure) and a control device (not shown) for controlling the movement of the robotic arm device 2 and the positioning and navigation device. The orthopedic surgical robot 1 generally also has a trolley device (not shown) for carrying the robotic arm device 2.

[0029] In one non-limiting embodiment of the present disclosure, a robotic arm device 2 includes an imaging device robotic arm 21 for mounting an imaging device and at least one surgical tool robotic arm 22 for mounting a surgical tool 23. Each robotic arm is preferably implemented as a multi-axis robotic arm as shown in FIG1 , and the imaging device includes an OCT imaging probe 3 for positioning navigation based on OCT imaging and an imaging device 4 for providing visualization of the surgical area for surgeons and nurses. In this embodiment, the OCT imaging probe 3 and the imaging device 4 are arranged at the free end of the imaging device robotic arm 21 so that they have the same field of view and are in communication with a control device (not shown) to maintain the imaging device in a working position and orientation during surgery. A surgical tool 23 for performing orthopedic surgery can be detachably mounted on the free end of the surgical tool robotic arm 22 near the surgical area, and the OCT imaging probe 3 and the imaging device 4 can be fixedly mounted on the free end of the imaging device robotic arm 21. The robotic arm device 2 can also serve as a mechanical actuator for the surgical tool 23 and the OCT imaging probe 3 and imaging device 4, respectively. In order to avoid medical staff from changing surgical tools 23 back and forth during surgery and thus improve the degree of automation of the surgical robot 1 , in this embodiment, the robotic arm device 2 preferably has one imaging device robotic arm and two surgical tool robotic arms 22 .

[0030] The surgical tools 23 respectively mounted on the surgical tool robotic arms 22 can be implemented as surgical tools for surgical operations, such as bone knives, screw drivers, drills, retractors, bone forceps, bone hammers, or other types of surgical tools, and can also be implemented as implanters for inserting implants, such as screw drivers. In a non-limiting embodiment of the present disclosure, one of the surgical tools 23 can be designed as a first implanter for inserting a first implant, such as a first screw, into the body, such as a first nailing device, and the other surgical tool 23 can be optionally designed as a surgical tool in the form of a drilling tool for drilling a hole or a second implanter for inserting a second implant, such as a second screw, into the body, such as a second nailing device.

[0031] As shown in the dotted circle in FIG. 1 , a first marker 5 that can be identified by the OCT imaging probe 3 and used for fine registration may be provided on one of the surgical tools 23 .

[0032] Of course, depending on the complexity of the surgical situation, the surgical tool robot arm 22 can also be designed to have more than two surgical tool robots working in conjunction with each other to complete the surgery more efficiently. Conversely, to reduce the load on the control device for data analysis and processing, the surgical tool robot arm 22 can also be designed as a single multifunctional surgical tool robot arm, which, for example, can be equipped with both a drill for drilling and a nailing tool for nailing in spinal surgery. The free end of this multifunctional surgical tool robot arm is equipped with an interface for connecting different surgical tools 23. This is different from the surgical robot 1 with two surgical tool robots. This orthopedic surgical robot 1 with only one surgical tool robot arm requires medical personnel to participate in order to replace the surgical tools 23 during the surgical operation. Therefore, in the case of only one surgical tool robot arm, the degree of automation of the surgical robot 1 is not as high as that in the case of two surgical tool robots.

[0033] The surgical tool manipulator 22 positions and orients the corresponding surgical tool 23 of the orthopedic surgical robot 1 according to the commands issued by the surgical planning module and tracking device of the orthopedic surgical robot 1, so as to automatically complete at least two types of operation functions in orthopedic surgery, such as automatic drilling and automatic nail placement. The surgical operation function can also be osteotomy, joint replacement, bone distraction, debridement, insertion and removal of Kirschner wires or other surgical operation functions. For example, in order to achieve functions such as drilling and nail placement, the surgical tool manipulator 22 first monitors and guides the operation of the surgical tool manipulator 22 in real time through the OCT positioning navigation system based on the trajectory for drilling and / or nail placement obtained by preoperative planning, thereby ensuring precise control of the surgical tool manipulator 22 to complete the drilling and / or nail placement work, especially in the non-limiting embodiment of the present disclosure, ensuring precise control of the nail placement of one of the surgical tool manipulator arms 22 and the drilling-before-nail placement of the other surgical tool manipulator 22.

[0034] The control device can be communicatively coupled with the robotic arm device 2 and the positioning and navigation device based on OCT imaging, and mainly includes a data analysis and processing module, a surgical planning module and a robotic arm control module, wherein the control device can be implemented as a computer device with a computer-readable storage medium.

[0035] FIG2 shows an OCT imaging-based positioning and navigation method for an orthopedic surgical robot 1 according to the present invention, the positioning and navigation method comprising the following steps:

[0036] S1: Scanning the area to be operated on by the OCT imaging probe 3 to acquire an OCT image of the area to be operated on;

[0037] S2: performing a first registration of the OCT image with the preoperative medical image to obtain preoperative planning information;

[0038] S3: Scanning the surgical tool robotic arm 22 or the surgical tool 23 by the OCT imaging probe 3 to obtain a precise registration matrix for registration between the imaging device robotic arm 21 and the surgical tool robotic arm 22;

[0039] S4: Scanning the area to be operated on in real time by the OCT imaging probe 3 to update the positional relationship between the area to be operated on and the imaging device robotic arm 21;

[0040] S5: updating the real-time coordinates of the surgical tool robot arm 22 in the OCT coordinate system and the real-time position and posture of the surgical tool 23 in the OCT coordinate system in real time with the help of the precise registration matrix;

[0041] S6: Based on the real-time coordinates and real-time posture, and in accordance with the registered surgical planning information, the surgical tool robot arm 22 and / or surgical tool 23 are controlled to perform the surgical operation. Thus, the method of the present invention can achieve a high navigation accuracy of approximately 0.15 mm, while also eliminating the need for medical imaging equipment to scan the patient during surgery, reducing the patient's exposure to radiation and improving the patient's health.

[0042] In step S2, the surgical planning information in the preoperative medical image can be converted into surgical planning information in the OCT coordinate system with the help of a first registration matrix. The first registration matrix can preferably be calculated based on the three-dimensional coordinate point cloud of the OCT image and the three-dimensional coordinate point cloud of the medical image. The preoperative medical image is collected by a medical imaging device, and the attending physician responsible for the patient before the operation can establish surgical planning information on the three-dimensional model of the preoperative medical image.

[0043] Before step S3, a second registration matrix between the imaging device robotic arm 21 and the surgical tool robotic arm 22 is obtained based on the positional relationship between the imaging device robotic arm 21 and the surgical tool robotic arm 22, wherein the second registration matrix is ​​calculated by the coordinates of the imaging device robotic arm 21 in the robot coordinate system and the coordinates of the surgical tool robotic arm 22 in the robot coordinate system, wherein, with the help of the second registration matrix, the coordinates of the field of view of the OCT imaging probe 3 in the imaging device robotic arm 21 coordinate system are converted into coordinates in the surgical tool robotic arm coordinate system, so as to move the surgical tool robotic arm 22 to the field of view area, wherein the field of view area is located in the area near the area to be operated on that can be scanned by the OCT imaging device.

[0044] In step S3 , the precise registration matrix is ​​acquired by scanning the first marker 5 identifiable by the OCT imaging probe 3 disposed on the surgical tool robot 22 or the surgical tool 23 .

[0045] In step S4, the OCT imaging probe 3 scans a second marker identifiable by the OCT imaging probe 3 and disposed on the area to be operated on, so as to obtain the real-time coordinates of the area to be operated on in the OCT coordinate system.

[0046] In step S5, the real-time coordinates of the surgical tool robot 22 in its surgical tool robot coordinate system are obtained by the surgical tool robot system itself, and the real-time posture of the surgical tool 23 in the surgical tool robot coordinate system is obtained based on the size and shape of the surgical tool 23, and then the real-time coordinates and real-time posture are converted into the real-time coordinates of the surgical tool robot 22 in the OCT coordinate system and the real-time posture of the surgical tool 23 in the OCT coordinate system with the help of the precise registration matrix.

[0047] In order to reduce the degree of medical staff's participation in orthopedic surgical robot surgery and thereby increase the degree of automation of the orthopedic surgical robot 1 used to implement the method disclosed herein, especially to allow the orthopedic surgical robot to automatically move the imaging device robotic arm 21 to the imaging position without the need for medical staff, an imaging device 4 having the same field of view as the OCT imaging probe 3 can also be provided, which can preferably be implemented as a long-distance microscope device, such as a camera, which can identify marks on the surgical film for marking the surgical area, such as ArUco marks, so as to obtain the original position coordinates of the area to be operated on in the OCT imaging device coordinate system. Based on this, the orthopedic surgical robot automatically moves the imaging device robotic arm 21 to an imaging position directly above the area to be operated on.

[0048] Since the area to be operated on is tracked by the OCT imaging device, the posture relationship between the surgical tool 23 and the area to be operated on can be updated in real time. According to the positioning and navigation method disclosed in the present invention, the registration only requires the surgical tool robot arm / surgical tool coordinate system and the OCT imaging device robot arm 21 coordinate system to be registered, thereby eliminating the intraoperative medical imaging device coordinate system to the surgical tool robot arm coordinate system. This makes the registration method simpler and reduces the radiation of the surgical object to the medical imaging device during the operation.

[0049] Although examples of the present disclosure are provided in the foregoing description, those skilled in the art may modify and change these examples without departing from the scope and spirit of the present disclosure. For example, it should be understood that the features of the embodiments herein may be applicable to other embodiments described herein. Therefore, the description is intended to illustrate rather than to limit. The disclosure is defined by the appended claims, and all changes to the disclosure that fall within the meaning and equivalent scope of the claims will be included within their scope.

Claims

1. A positioning and navigation method based on OCT imaging for an orthopedic surgical robot, the orthopedic surgical robot comprising an OCT imaging device having an OCT imaging probe, an imaging device mechanical arm for mounting the OCT imaging device, and at least one surgical tool mechanical arm for mounting surgical tools, characterized in that: The positioning and navigation method comprises the following steps: S1: Scanning the surgical area with an OCT imaging probe to acquire an OCT image of the surgical area; S2: performing a first registration of the OCT image with the preoperative medical image to obtain preoperative planning information; S3: scanning the surgical tool robotic arm or the surgical tool through the OCT imaging probe to obtain a precise registration matrix for registration between the imaging device robotic arm and the surgical tool robotic arm; S4: Scanning the area to be operated on in real time through the OCT imaging probe to update the positional relationship between the area to be operated on and the imaging device robotic arm; S5: Using the precise registration matrix, the real-time coordinates of the surgical tool robot arm in the OCT coordinate system and the real-time position and posture of the surgical tool in the OCT coordinate system are updated in real time; S6: Based on the real-time coordinates and the real-time posture and in accordance with the registered surgical planning information, control the surgical tool robot arm and / or the surgical tool to perform a surgical operation.

2. The positioning and navigation method according to claim 1, characterized in that: In step S2, the surgical planning information in the preoperative medical image is converted into surgical planning information in the OCT coordinate system with the help of the first registration matrix.

3. The positioning and navigation method according to claim 2, characterized in that: The first registration matrix is ​​calculated based on the three-dimensional coordinate point cloud of the OCT image and the three-dimensional coordinate point cloud of the medical image.

4. The positioning and navigation method according to claim 1 or 2, characterized in that: Before step S3, a second registration matrix between the imaging device robot arm and the surgical tool robot arm is obtained according to the positional relationship between the imaging device robot arm and the surgical tool robot arm.

5. The positioning and navigation method according to claim 4, characterized in that: The second registration matrix is ​​calculated from the coordinates of the imaging device robot arm in the robot coordinate system and the coordinates of the surgical tool robot arm in the robot coordinate system.

6. The positioning and navigation method according to claim 4, characterized in that: With the help of the second registration matrix, the coordinates of the field of view of the OCT imaging probe in the imaging device robot coordinate system are converted into coordinates in the surgical tool robot coordinate system, so as to move the surgical tool robot into the field of view.

7. The positioning and navigation method according to claim 6, characterized in that: The visual area is located in an area near the area to be operated on and can be scanned by an OCT imaging device.

8. The positioning and navigation method according to claim 1 or 2, characterized in that: In step S3, the precise registration matrix is ​​acquired by scanning a first marker identifiable by an OCT imaging probe disposed on a surgical tool robot arm or a surgical tool.

9. The positioning and navigation method according to claim 1 or 2, characterized in that: In step S4, the OCT imaging probe is used to scan a second marker identifiable by the OCT imaging probe and disposed on the area to be operated on, so as to obtain the real-time coordinates of the area to be operated on in the OCT coordinate system.

10. The positioning and navigation method according to claim 1 or 2, characterized in that: In step S5, the real-time coordinates of the surgical tool robot in its surgical tool robot coordinate system are obtained by the surgical tool robot system itself, and the real-time posture of the surgical tool in the surgical tool robot coordinate system is obtained based on the size and shape of the surgical tool, and then the real-time coordinates and real-time posture are converted into the real-time coordinates of the surgical tool robot in the OCT coordinate system and the real-time posture of the surgical tool in the OCT coordinate system with the help of a precise registration matrix.

11. The positioning and navigation method according to claim 1 or 2, characterized in that: An imaging device having the same field of view as the OCT imaging probe is provided, through which a mark that can be recognized by the imaging device and is used to identify the area to be operated on is identified, so as to obtain the original position coordinates of the area to be operated on in the coordinate system of the OCT imaging device, and based on this, an imaging position directly above the area to be operated on is calculated, and then the imaging device robotic arm is moved to the imaging position.