Device and method for contactless registration between a robot and a patient and medical imaging

Abstract

The device (10) for contactless registration between a robotic arm (17) and a patient (12) and medical imaging comprises: - a means (27) for projecting a mobile laser line (21) onto a region of interest (22) of the patient's body, and - a means (25) for capturing, for each position of the mobile laser line, geometric coordinates (X, Y) of points of the laser line in the region of interest in a first geometric reference frame (29) associated with the capturing means. The robotic arm (17) bears the projecting means and the capturing means, the arm moving the capturing means and delivering second geometric coordinates (x, y, z, a, b, c) of the capturing means in a second geometric reference frame (28) associated with a fixed point of the robotic arm, - a means (13) for determining the geometric coordinates of the points of the laser line in the region of interest in the second geometric reference frame with a view to delivering a point cloud of the region of interest in the second reference frame, and - a means (13) for matching a point cloud of the medical imaging and the point cloud of the region of interest in the second reference frame.

Description

[0001] DEVICE AND METHOD FOR CONTACTLESS RECALIBRATION BETWEEN A ROBOT, A PATIENT AND MEDICAL IMAGING

[0002] TECHNICAL FIELD OF THE INVENTION

[0003] The present invention relates to a device and a method for contactless registration between a robot, a patient and medical imaging. It applies, in particular to the field of surgery with robotic assistance and more particularly to contactless and non-invasive registration between a robotic arm (active or passive), a patient to be operated on and at least one medical imaging (from magnetic resonance imaging, acronym MRI, or a scanner, for example) of a part of the patient's body to be operated on.

[0004] STATE OF THE ART

[0005] The approaches described in this section are approaches that could be pursued, but not necessarily approaches that have been conceived or pursued previously. Therefore, unless otherwise indicated, it should not be assumed that any of the approaches described in this section constitute prior art solely because of their inclusion in this section.

[0006] During a surgical procedure using a robotic aiming assistance device, it is necessary to perform geometric registration between the robotic assistance device, the intervention area on the patient's body, and their medical imaging. Registration makes it possible to connect the different geometric coordinate systems in order to allow them to interact. Different registration techniques exist today. There are so-called "invasive" and "non-invasive" techniques for human anatomy. One of the non-invasive techniques is described in document FR 2 963 693. It uses a laser pointer to scan the surface of the anatomy by a succession of light point emissions on the part of the patient's body to be operated on and to locate, in three dimensions, their geometric coordinates in the robot's frame of reference.This type of technique has the disadvantage of being time-consuming, due to the time it takes for the laser pointer to cover the entire area of ​​interest (between 15 and 25 minutes per recalibration attempt). In addition, the precision obtained depends heavily on the manipulations carried out by the operator.

[0007] Document CN 116245920 describes a method and device for recording a point cloud between a patient's face, equipment and a support. This method and device use two fixed cameras independent of any robotic arm and a moving laser line on the patient's face, to create this point cloud in three dimensions.

[0008] Document CN 114098985 describes a method and device for spatial matching between a patient and a medical image of the patient, equipment and a support. This method and device use two fixed cameras independent of any robotic arm, and a moving operating table to create this three-dimensional point cloud. This movement of the operating table can cause parasitic vibrations of the patient's face, which are detrimental to the geometric positioning accuracy of the points in the point cloud.

[0009] Since the cameras are independent of any robot or robotic arm, the devices described in these two documents require the addition of a navigation camera and a registration of the point cloud recording cameras. This additional registration increases the imprecision of the geometric positions of the points captured by the cameras in the geometric reference frame of medical imaging and in that of the operating room and the possible robot or robotic arm.

[0010] PRESENTATION OF THE INVENTION

[0011] The general concept of the invention consists of a contactless registration preferably using a robotic arm carrying a registration unit forming, on the area of ​​interest of the patient's body, a point from a laser pointer as well as a line whose width is preferably adjustable in this area of ​​interest. The robotic arm operates automatically, under the control of software, or is used by the operator in so-called "cooperative" mode, free or under constraint, in order to scan the area of ​​interest to be registered with the surface extracted from the medical imaging of said anatomy.

[0012] The cooperative mode, free or under constraint, makes it possible to measure, at any time, the position and orientation of the registration unit in the geometric reference frame of the robotic arm. This registration unit provides the coordinates of each point of the area of ​​interest in its geometric reference frame, a calculation unit can determine the coordinates of each point of the area of ​​interest in the geometric reference frame of the robotic arm. The free cooperative mode allows the operator to move the registration unit by following the path that seems to best cover the area of ​​interest in medical imaging, without risking hitting the patient's body. The cooperative mode under constraint restricts the movement capabilities of the registration unit to make it follow a line, straight or curved, or a surface, for example flat, cylindrical or spherical.

[0013] The present invention aims to remedy all or part of the drawbacks of the state of the art.

[0014] To this end, according to a first aspect, the present invention aims at a contactless registration device between a robotic arm, a patient and medical imaging, which comprises:

[0015] - a means of projecting a moving laser line onto an area of ​​interest on the patient's body, and

[0016] - a means for capturing, for each position of the mobile laser line, geometric coordinates of points of the laser line on the area of ​​interest in a first geometric reference frame linked to the capture means; in which the robotic arm is configured to move the capture means, and to provide second geometric coordinates of the capture means in a second geometric reference frame linked to a fixed point of the robotic arm, the device further comprising:

[0017] - a means for determining the geometric coordinates of the points of the laser line on the area of ​​interest in the second geometric reference frame to provide a point cloud of the area of ​​interest in this second reference frame, and

[0018] - a means of matching a point cloud of medical imaging and the point cloud of the area of ​​interest in the second reference frame.

[0019] Thus, to create the point cloud of the area of ​​interest, the robotic arm or the operator moves a registration unit comprising the projection means and the capture means, while the robotic arm carries this registration unit. During or following this movement, the coordinates of the points of the area of ​​interest are measured in the first geometric reference frame and the coordinates of the registration unit are measured in the second geometric reference frame, so that the coordinates of the points of the point cloud of the area of ​​interest can be calculated, in three dimensions, in this second reference frame. Once the cloud matching has been carried out, the coordinates of all the contents of the medical imaging, including points of the organs located inside the body, are located in the second reference frame.As a result, a navigation camera can position in medical imaging everything that is in its optical field, for example after a registration step to determine the position, in its own geometric reference frame, of at least three specific points by implementing a pointer equipped with a navigation reference.

[0020] Furthermore, since the projection means is moved simultaneously with the capture means, the geometric position of each point of the point cloud of the area of ​​interest is precisely measured. A single movement of the projection means and the capture means thus makes it possible to capture the three-dimensional geometric coordinates of the entire area of ​​interest to be registered with the surface extracted from the medical imaging of said anatomy. The same movement of the capture means can then be precisely repeated several times, for example in one direction then in the other, to improve the measurement accuracy of the geometric coordinates of the point cloud of the area of ​​interest.

[0021] The implementation of the present invention allows geometric registration between the robot, the area of ​​interest on the patient's body and the medical imaging. This registration is carried out without contact with the patient's body, therefore in a non-invasive manner. The implementation of the invention considerably reduces the time required to carry out a point cloud acquisition of the anatomical surface of interest. Typically, it goes from 15 to 20 minutes, in the prior art using laser pointer registration, to less than five minutes. This time saving allows a reduction in the operating room occupancy time and the anesthesia duration and its harmful consequences for the patient, especially if the registration must be renewed during the surgical procedure, in the event that the registration is lost, for example if the robot has moved. The invention also reduces the dependence of the registration accuracy on the operator and improves the operator's user experience.In optional embodiments, the robotic arm is configured to operate in a cooperative mode during operation of the capture means.

[0022] In embodiments, the robotic arm is configured to operate in a constrained cooperative mode during operation of the capture means.

[0023] In embodiments, the mode of operation of the robotic arm constrains the movement of the capturing means along a line.

[0024] In embodiments, the mode of operation of the robotic arm constrains the movement of the capture means within a surface.

[0025] In embodiments, the mode of operation of the robotic arm constrains the rotational movement of the capture means around an axis of rotation of the last joint of the robotic arm.

[0026] Thus, to create the point cloud of the area of ​​interest, the operator moves the robot arm, which operates in cooperative mode, free or under constraint, and uses capture to follow a line, straight or curved, or a surface, for example flat, cylindrical or spherical. Thanks to the operation of the robotic arm in cooperative mode under constraint, this movement can be precisely repeated several times, for example in one direction then in the other, to improve the accuracy of capturing the geometric coordinates of the points of the laser line on the area of ​​interest.

[0027] In embodiments, the laser line projection means further comprises means for adjusting the laser line projection angle and / or the laser line length.

[0028] The laser line is thus dimensioned on the scanned surface in order to avoid illuminating elements external to the patient, for example a stereotaxic frame. This avoids artifacts from capturing geometric coordinates of points of the laser line on the area of ​​interest.

[0029] In embodiments, the device according to the invention further comprises a laser pointer for measuring the distance between the geometric coordinate capture unit and the area of ​​interest.

[0030] This adjustment is made taking into account that a distance that is too small can pose difficulties in terms of the distance measurement area covered by the capture means and in terms of sterility of the operating field. Conversely, a distance that is too large increases the uncertainty of distance measurement.

[0031] In embodiments, the robot is an aim assist robot.

[0032] Thus, the robot's reference frame, aligned both with the area of ​​interest and with the medical imaging, allows the robotic arm to position very precisely (to within one millimeter) and stably in real space, a surgical instrument guide allowing the surgeon to aim, via the insertion of the surgical instrument into the guide carried by the robot, an anatomical area in real space from a target area and an entry area that he will have previously identified in the patient's medical imaging. In embodiments, the device that is the subject of the invention further comprises a navigation camera, and a registration unit provided with a reference fixed relative to the registration unit.

[0033] This navigation camera can thus determine the geometric coordinates of the capture means, in its geometric reference frame, and therefore of the area of ​​interest still in this reference frame.

[0034] According to a second aspect, the present invention aims at a method of contactless registration between a robot, a patient and medical imaging, which comprises:

[0035] - a step of projecting, by a projection means, a mobile laser line onto an area of ​​interest of the patient's body, and

[0036] - a step of capturing, by a capturing means, for each position of the mobile laser line, geometric coordinates of points of the laser line on the area of ​​interest in a first geometric reference frame linked to the capturing means; in which, the robot arm carrying the projection means and the capturing means, during the capturing step, this arm operates in cooperative mode and performs a step of providing second geometric coordinates of the capturing means in a second geometric reference frame linked to a fixed point of the robotic arm, the method further comprising:

[0037] - a step of determining the geometric coordinates of the points of the laser line on the area of ​​interest in the second geometric reference frame to provide a point cloud of the area of ​​interest in this second reference frame, and

[0038] - a step of matching a point cloud of the medical imaging and the point cloud of the area of ​​interest in the second reference frame. The advantages, aims and particular characteristics of this method being similar to those of the device which is the subject of the invention, they are not recalled here. In embodiments, the method which is the subject of the invention further comprises a step of pre-positioning the robotic arm and displaying the laser line in the first reference frame.

[0039] For example, pre-positioning assistance is performed in free cooperative mode to obtain the highest point of the area of ​​interest (typically, the bridge of the nose). From this point, a point in the patient's anatomy is projected (the distance from the highest point of which can be adjusted) to create a center of rotation for the circular displacement constraint. This pre-positioning also allows for what is called "pre-matching" to help the matching software converge more quickly.

[0040] In embodiments, the method that is the subject of the invention further comprises a step of displaying a map of distances between each point of the three-dimensional point cloud of the area of ​​interest and the point of the medical imaging point cloud matched with this point of the three-dimensional point cloud of the area of ​​interest during the matching step. In embodiments, during the display step, for each point of the displayed map, the color of this point is a function of said distance.

[0041] In embodiments, this mapping is displayed directly on the three-dimensional point cloud of the area of ​​interest and / or on the point cloud of the medical imaging.

[0042] Thanks to these provisions, the operator can visualize the errors made during the matching step and validate it, or not. This also makes it possible to identify areas on which information can be added by making a new scan of geometric coordinates focused on these areas. The operator thus has the capacity to make several scans and merge them to improve the quality of the entire scan.

[0043] In embodiments, the method which is the subject of the invention further comprises a step of creating a geometric zone prohibited for the robotic arm from the point cloud of the area of ​​interest and / or from the medical imaging aligned with the point cloud of the area of ​​interest.

[0044] This ensures better patient safety by creating a “NoGo” zone around the patient’s body.

[0045] In optional embodiments, the method which is the subject of the invention comprises a synchronization step, for each position of the moving laser line:

[0046] - the instant of capture of geometric coordinates of points of the laser line on the area of ​​interest in a first geometric reference frame during the capture step and

[0047] - the time at which the second geometric coordinates of the capture means are measured in a second geometric reference system which are provided during the provisioning step.

[0048] BRIEF DESCRIPTION OF THE FIGURES

[0049] Other advantages, aims and particular characteristics of the invention will emerge from the following non-limiting description of at least one particular embodiment of the device and method which are the subject of the present invention, with reference to the appended drawings, in which: Figure 1 represents, schematically and in side view, a particular embodiment of the device which is the subject of the invention, during a positioning step of the method which is the subject of the invention, Figure 2 represents, schematically and in side view, the device illustrated in Figure 1, during a scanning step of the method which is the subject of the invention, in a first example of a constrained operating mode of a robotic arm, Figure 3 represents, partially, schematically and in longitudinal view, the movements of a registration unit in a second example of a constrained operating mode of a robotic arm, Figure 4 represents, partially,schematically and in longitudinal view, the movements of a registration unit in a third example of constrained operating mode of a robotic arm, Figure 5 represents, partially, schematically and in longitudinal view, the movements of a registration unit in a fourth example of constrained operating mode of a robotic arm, Figure 6 represents an example of a point cloud resulting from a three-dimensional laser scan obtained by the implementation of a device that is the subject of the invention, Figure 7 represents an example of a point cloud resulting from a surface extraction of a three-dimensional medical imagery, Figure 8 represents, in the form of a flowchart, steps of a particular embodiment of the method that is the subject of the invention, Figure 9 represents, schematically, a particular embodiment of a central unit of the device that is the subject of the invention,Figure 10 represents an image displayed during a pre-positioning step, and Figure 11 represents a map displayed at the end of point cloud matching.

[0050] DESCRIPTION OF EMBODIMENTS

[0051] This description is given without limitation, each characteristic of an embodiment being able to be combined with any other characteristic of any other embodiment in an advantageous manner.

[0052] Please note, from now on, that the figures are not to scale.

[0053] As understood from the present description, various inventive concepts may be implemented by one or more methods or devices described below, several examples of which are provided herein. The actions or steps performed in carrying out the method or device may be ordered in any suitable manner. Accordingly, it is possible to construct embodiments in which the actions or steps are performed in a different order than illustrated, which may include performing certain acts simultaneously, even if they are presented as sequential acts in the illustrated embodiments.

[0054] The indefinite articles "a" and "an", as used in the description, are to be understood to mean "at least one", unless otherwise clearly stated.

[0055] The expression "and / or", as used herein, shall be understood to mean "either or both" of the elements so conjoined, i.e., elements which are present conjunctively in some cases and disjunctively in other cases. Multiple elements listed with "and / or" shall be interpreted in the same way, i.e., "one or more" of the elements so conjoined. Other elements may optionally be present, other than the elements specifically identified by the "and / or" clause, whether or not they are related to those specifically identified elements.Thus, by way of non-limiting example, a reference to "A and / or B", when used in conjunction with open language such as "comprising" may refer, in one embodiment, to A only (optionally including elements other than B); in another embodiment, to B only (optionally including elements other than A); in yet another embodiment, to both A and B (optionally including other elements); etc.

[0056] As used herein in the description, "or" shall be understood inclusively.

[0057] As used herein, the term "at least one," in reference to a list of one or more elements, is to be understood to mean at least one element selected from one or more elements in the list of elements, but not necessarily including at least one of each element specifically listed in the list of elements and not excluding any combination of elements in the list of elements. This definition also allows for the optional presence of elements other than the specifically identified elements in the list of elements to which the term "at least one" refers, whether or not related to those specifically identified elements.Thus, by way of non-limiting example, "at least one of A and B" (or, equivalently, "at least one of A or B", or, equivalently, "at least one of A and / or B") may refer, in one embodiment, to at least one, optionally including more than one, A, without B present (and optionally including elements other than B); in another embodiment, to at least one, optionally including more than one, B, without A present (and optionally including elements other than A); in yet another embodiment, to at least one, optionally including more than one, A, and at least one, optionally including more than one, B (and optionally including other elements); etc.

[0058] In the description below, all transitional expressions such as "comprising", "including", "bearing", "having", "containing", "involving", "holding", "consisting of", and the like, are to be understood as open, i.e., as meaning including but not limited to. Only the transitional expressions "consisting of" and "consisting essentially of" are to be understood as closed or semi-closed transitional expressions, respectively.

[0059] Throughout the description, the terms "upper" and "top" refer to what is at the top when the device of the present invention is in an operational configuration. The terms "lower" and "bottom" refer to what is at the bottom when the device of the present invention is in an operational configuration. The term "inner" refers to what is inside the device. The term "outer" refers to what is outside the device. The term "side" is what is seen from one side of an operating table, "longitudinal" is what is seen from one end of the operating table, and "lateral" is what goes toward one side of the operating table. For example, the longitudinal axis of a rectangular operating table is the axis of symmetry of the largest sides of the rectangle, and a lateral plane is perpendicular to this longitudinal axis.The term "along" or "on" in relation to a movement of an object relative to a line or surface means that a point on that object moves on that line or surface and that a fixed direction relative to the object and passing through that point remains perpendicular to that line or surface during that movement. For example, an optical axis of a projection means moving "along" or "on" an arc of a circle or on a spherical surface remains oriented towards the centre of that circle or sphere and at a constant distance from that centre.

[0060] In Figure 1, which is not to scale, we see a device 10 for contactless recalibration between a robot 11, a patient 12 and medical imaging stored in memory, for example in a memory accessible by a central unit 13 of the robot 11. The patient 12 is positioned on a surgical table 14, for a surgical operation. The robot comprises a mobile carriage 15 provided with wheels 16, and supporting an anthropomorphic robotic arm 17 comprising joints 18. Of course, another type of arm can be used to constitute the device which is the subject of the invention. In embodiments, the carriage 11 is provided with jacks (not shown) actuating feet (not shown) for support on the ground, which fix the carriage 11 in position and stabilize it during the movements of the robotic arm 17.

[0061] The robotic arm 17 supports, at its free end, a contactless recalibration unit 19 comprising a means 27 for projecting a laser line 21 formed on the area of ​​interest on the patient 12, here the head 22 of the patient 12. The unit 19 is also provided with a means 25 for capturing distances of the points of the laser line 21 and a handle 24 with which the operator 23 can manipulate this unit 19. The distance sensor 25 comprises, for example, an image sensor and a means for measuring distance by triangulation, according to known techniques. The capture means 25 provides geometric coordinates of points of the laser line on the area of ​​interest in a first geometric reference frame linked to the capture means 25. It is noted that this first reference frame is not necessarily centered on a point of the registration unit 19, nor oriented in a preferred direction of this registration unit, for example the optical axis of the projection means 27.On the other hand, it is linked to this recalibration unit, the latter being fixed in relation to this first geometric reference during the movements of the robotic arm 17.

[0062] In this first mode of operation of the device, the laser line is in a plane perpendicular to the plane of figure 1, so that the projection of the laser line is represented by a line in broken lines starting from the projection means 27 and ending at the points of the laser line.

[0063] In the embodiment described here, the recalibration unit 19 also comprises a means for projecting a laser point 20, also called a laser pointer, configured to measure a distance, in a known manner. In other embodiments, no laser pointer is used.

[0064] The registration unit 19 can be installed by the operator 23 at the free end of the arm 17 as a “tool”. Alternatively, the registration unit 19 is integrated at this end of the arm 17. The advantage of the integration is to avoid having to remove and replace the registration unit 19 during a surgical procedure, in case the registration is lost during this procedure. This integration also avoids assembly errors by the operator 23 when installing the registration unit 19 at the end of the arm 17, these assembly errors being able to lead to registration inaccuracies.

[0065] In Figure 2, we find the same elements as in Figure 1 during a planar scanning step on the area of ​​interest, here the head 22 of the patient 12, by a laser line projected by the projection means 27. The arrow 26 represents a direction of scanning of the user's head by the laser line 21.

[0066] The recalibration device comprises the robot 11 provided with the arm 17 carrying the projection means 27 and the capture means 25 integrated in the recalibration unit 19. The arm 17 of the robot 11 is configured to operate in automatic mode (under the control of software) or in free cooperative mode or under constraints, at least during the operation of the capture means 25 and to provide second geometric coordinates of the capture means 25 in a geometric reference frame linked to a fixed point of the robotic arm.

[0067] The operator can perform pre-positioning of the capture means in cooperative mode, the arm then moving the capture means in automatic mode during scanning of the area of ​​interest by the capture means to provide point coordinates of the projected laser line.

[0068] In free cooperative mode, the operator can be guided by an image displayed on a display screen (not shown) via a measurement field indicator.

[0069] In constrained cooperative mode, activated at least during operation of the capture means 25, the registration unit 19 carried by the robotic arm 17 can be free to move throughout the space surrounding the area of ​​interest.

[0070] In embodiments, the constrained cooperative mode of the robotic arm 17 constrains the movement of the capture means 25 along a line (see Figures 3 and 4) during operation of the projection means 27 and the capture means 25.

[0071] In embodiments, the constrained cooperative mode of the robotic arm 17 constrains the movement of the capture means 25 in rotation about an axis of rotation of the last joint of the robotic arm (see FIG. 5) during the operation of the projection means 27 and the capture means 25.

[0072] In embodiments, such as that illustrated in Figure 2, the constrained cooperative mode of the robotic arm (17) constrains the movement of the capture means 25 in a surface during the operation of the projection means 27 and the capture means 25. In the first constrained movement mode of the robotic arm shown in Figure 2, this surface is planar, for example parallel to the plane of the support surface of the patient 12 on the operating table 14.

[0073] The cooperative mode is implemented by means of at least one force sensor placed at the end of the robotic arm 17, or directly in the joints of the robotic arm, if it is a so-called "active" arm. In this cooperative mode under constraint, the arm can apply constraints to the movements made by its free end, on which the resetting unit 19 is here fixed. According to a first example implemented in the first operating mode shown in Figures 1 and 2, the only movements authorized, in cooperative mode under constraint, at the free end of the robotic arm 17 are made along a flat surface preferably perpendicular to a plane of symmetry of the area of ​​interest, for example the face of the patient 12. Alternatively, the flat surface is parallel to the support surface of the patient 12 on the operating table 14.

[0074] According to a second example implemented in the second operating mode represented in figure 3, the only movements authorized, in cooperative mode under constraint, at the free end of the robotic arm 17 are made along an arc of a circle located in a lateral vertical plane and centered on a point located under the area of ​​interest, for example in an area halfway between the ears of the patient 12 and in the plane of symmetry of the head of the patient 12.

[0075] According to a third example implemented in the third operating mode represented in figure 4, the only movements authorized, in cooperative mode under constraint, at the free end of the robotic arm 17 are made along an arc of a circle located in a longitudinal vertical plane and centered on a point located under the area of ​​interest, for example in an area halfway between the ears of the patient 12 and in the plane of symmetry of the head of the patient 12.

[0076] According to a fourth example implemented in the third operating mode shown in Figure 5, the only movements authorized, in cooperative mode under constraint, to the resetting unit 19 located at the free end of the robotic arm 17 are in rotation around an axis 33 of rotation of the last articulation 32 of the robotic arm 17.

[0077] This rotation constraint can be used in complex cases in which the robotic arm does not have the possibility to move around the area of ​​interest, for example when the patient 12 is lying on his stomach and the face is turned towards the operating table 14 or towards one of the sides of the operating table 14.

[0078] According to a fifth example, the only movements authorized for the resetting unit 19, in cooperative mode under constraint, are made in a cylindrical surface, for example on the surface of a cylinder whose directrix is ​​an arc of a circle centered on point 30 (see figure 3) and the generators, segments of straight lines perpendicular to the directrix.

[0079] According to a sixth example, the only movements authorized to the recalibration unit 19, in cooperative mode under constraint, are made in a spherical surface, for example on the surface of a sphere centered on point 30 (see figure 3).

[0080] The central unit 13 of the robot 11 constitutes a means of matching a cloud 35 (see figure 6) of points 36 in three dimensions of the medical imaging and the cloud 40 (see figure 7) of points 41 of the area of ​​interest. This central unit 13 is configured to carry out the registration between the medical imaging and the patient's face in the geometric reference frame of the robotic arm 17.

[0081] In a first step, the central unit 13 performs a determination of the geometric coordinates of the points of the laser line on the area of ​​interest in the second geometric reference frame 28 (x, y, z, a, b, c) linked to a fixed point of the robotic arm, to provide a cloud 40 of points 41 of the area of ​​interest in this second reference frame 28 from, for each point of the laser line, the geometric coordinates of this point in the first geometric reference frame 29 (X, Y) linked to the registration unit 19 (and therefore linked to the image capture means 25) and the coordinates of the origin of this first geometric reference frame 29 in the second geometric reference frame 28.

[0082] Then, the central unit 13 performs the matching of the points of the cloud 35 of points 36 of the medical imaging and the cloud 40 of points 41 of the area of ​​interest in the second reference frame. Once this matching has been performed by the central unit 13, it can match the geometric coordinates in the real space of the robotic arm 17 and the geometric coordinates of points of the medical imaging in a third geometric reference frame 34 linked to the medical imaging. This central unit 13 is represented in the cart 15, but it can be located on another cart, for example a navigation cart, or remotely, for example on a server in communication with the cart 15.

[0083] Preferably, the recalibration means 13 is configured not to carry out recalibration when the robotic arm 17 is not operating in cooperative mode.

[0084] In variants of the embodiment illustrated in Figures 1 and 2, the robotic arm 17 is independent of the carriage, for example by being fixed to the ground.

[0085] In the second example of movement constrained by the cooperative mode of operation of the arm 17 of the robot 11, this movement is carried out along an arc of a circle located in a lateral vertical plane (the plane of FIG. 3) and being centered on a point 30 below, relative to the registration unit 19, the area of ​​interest, that is to say the face of the patient 22. To fix the position of this central point 30, the registration unit 19 is positioned so that the laser line is located in the plane of symmetry of the face and the optical axis of the camera 25 is in a vertical plane.

[0086] Preferably, a step of pre-positioning the robotic arm 17 by displaying in real time the laser line in the first reference frame on a display screen (see the laser line 90 in Figure 10). Pre-positioning assistance is carried out in free cooperative mode in order to obtain the highest point of the area of ​​interest (typically, the bridge of the nose). From this point, a point is projected into the patient's anatomy (the distance from the highest point of which can be adjusted) in order to create a center of rotation of the circular displacement constraint. This pre-positioning also makes it possible to do what is called "pre-matching" in order to help the matching software implemented by the central unit 13 to converge more quickly.

[0087] Thus, the distance between the registration unit 19 and this face (for example the end of its nose) is measured by using the central unit 13. Then, the center of the arc of a circle to be followed by the registration unit 19 is defined at a predetermined distance below this face, for example 20 centimeters below the end of the nose). Alternatively, the laser pointer described above is used to measure the distance between the registration unit and the area of ​​interest.

[0088] In Figure 3, the resetting unit 19 is shown in two positions during its movement along the arc of the circle.

[0089] The advantage of this second mode of operation is that the projected laser line is always substantially perpendicular to the skin of the patient's face 12, whereas, in the first embodiment, the laser line has a greater angle of incidence on the sides of the face.

[0090] In the third example of movement constrained by the cooperative mode of operation of the arm 17 of the robot 11, this movement is carried out along an arc of a circle lying in a longitudinal vertical plane (the plane of FIG. 4) and being centered on a point 31 below, relative to the registration unit 19, the area of ​​interest, i.e. the face of the patient 22. To fix the position of this central point 31, the same procedure as that described for the second example of movement can be used, by choosing, with the laser line, the plane in which the center 31 must be located (under the tip of the nose, FIG. 4).

[0091] In Figure 4, the resetting unit 19 is shown in two positions during its movement along the arc of the circle.

[0092] The advantage of this third mode of operation is that the projected laser line is always substantially perpendicular to the patient's skull 12, whereas, in the first embodiment, the laser line has a greater angle of incidence on the patient's skull.

[0093] In Figure 5, the fourth example implemented in the third operating mode in cooperative mode under constraint is shown, in which the only movements authorized for the resetting unit 19, at the free end of the robotic arm 17, are in rotation around an axis 33 of rotation of the last articulation 32 of the robotic arm 17.

[0094] The first geometric reference frame 29 (X, Y) linked to the registration unit 19 is represented in figures 1 to 5, in each position of the registration unit 19. The location of a point in the first geometric reference frame 29 comprises only two coordinates on an orthogonal reference frame, one on an X axis (worth, for different points of the area of ​​interest, X1 then X2 in figure 3, X3 then X4 in figure 4 and X5 in figure 5) and the other on a Y axis (worth, for the same points of the area of ​​interest, Y1 then Y2 in figure 3, Y3 then Y4 in figure 4 and Y5 in figure 5) when the X, Y plane is the projection plane of the laser line.

[0095] The coordinates (x, y, z, a, b, c) of the origin of the first geometric reference frame 29 in the second geometric reference frame 28 linked to a fixed point of the robotic arm 17 are represented in figures 1 to 5, in each position of the recalibration unit 19. These coordinates represent the position along three orthogonal axes (x, y, z) of the origin of the first geometric reference frame 29 and the orientation along three angles (a, b, c) of the X axis of the first geometric reference frame 29 in the second geometric reference frame 28. These coordinates being (x1, y1, z1, a1, b1, c1) then (x2, y2, z2, a2, b2, c2) in figure 3, (x3, y3, z3, a3, b3, c3) then (x4, y4, z4, a4, b4, c4) in figure 4 and (x5, y5, z5, a5, b5, c5) in figure 5.

[0096] With these two sets of coordinates of each point of the area of ​​interest, in the first reference frame 29, on the one hand, and the origin and orientation of the first reference frame 29 in the second reference frame 28, on the other hand, the central unit 13 can determine the coordinates of each point 36 of the cloud 35 of points resulting from the scan in the second geometric reference frame 28. It is with this cloud 35 of points 36 that the central unit 13 performs the matching described below. Then, the central unit calculates the transformation matrix of the coordinates of the points of the medical imaging, identified in the third geometric reference frame 34 linked to this imaging, into coordinates of these points in the second geometric reference frame 28.With these latter coordinates, the robotic arm 17 can navigate around the area of ​​interest and a joint visualization of the medical imaging, the robotic arm, a tool, an implant or a tool holder that it carries can be displayed on a navigation screen.

[0097] Figure 6 represents an example of a cloud 35 of points 36 resulting from a three-dimensional laser scan obtained by implementing the device that is the subject of the invention. The cloud 35 of points 36 results from a three-dimensional surface extraction captured by the unit 19 by implementing the projection of a laser line 21 and the distance sensor 25. Each point 36 of this cloud 35 is located according to a geometric reference linked to the conditions for capturing the three-dimensional image and therefore to the position of the robot 11.

[0098] Figure 7 represents an example of a cloud 40 of points 41 extracted from medical imaging. Each point 41 of this cloud 40 is located according to a geometric reference linked to the conditions for carrying out the medical imaging.

[0099] In order for the robot 11 to be able to virtually position the medical imagery 40 in space relative to the real space of the patient 12, a matching operation (also called “registration”) of the clouds 35 and 40 of points 36 and 41 is carried out by the central unit 13. The medical imagery 40 is thus located in the geometric reference frame of the robot 11.

[0100] To this end, the implementation of the device 10 follows the following steps of the method 50 illustrated in figure 8.

[0101] During a step 51, the robot 11, comprising the carriage 15 and the robotic arm 17, is placed opposite the area of ​​interest, that is to say the surgical intervention area on the body of the patient 12 (the head in figures 1 to 5). The carriage 15 no longer moves after step 51, until the end of the surgical intervention. At the end of step 51, the robot, and in particular its robotic arm 17, is started.

[0102] During a step 52, the robotic arm 17 performs automatic positioning so that its free end is located near the area of ​​interest, in a position where the operator 23 can easily install the registration unit 19 if it is not integrated into the arm 17. During this step 52, the robotic arm 17 moves from a so-called “storage” position in which it is stored above the carriage 15 to a deployed position allowing easy installation of the registration unit 19 at the free end of the arm 17. If the unit 19 is integrated into the arm 17, the position reached by the arm 17 is a position allowing the operator 23 to grasp the handle 24 to move it, in free cooperative mode, to the area of ​​interest to be scanned.

[0103] During a step 53, in the event that the recalibration unit 19 is not integrated into the arm 17, it is installed at the free end of the robotic arm 17.

[0104] During a step 54, the operator 23 performs a rough pre-positioning of the contactless registration unit 19 parallel to the area of ​​interest, using the handle 24 of the registration unit 19. Alternatively, this rough positioning is performed automatically by the robotic arm 17. For this purpose, the pre-positioning assistance described above with regard to FIG. 10 is implemented.

[0105] During an optional step 55, the laser pointer provides a distance between the registration unit 19 and the area of ​​interest. Based on this initially measured distance, automatically or manually, this distance is adjusted by moving the registration unit 19. This adjustment is carried out taking into account that too small a distance can pose difficulties in terms of the distance measurement area covered by the registration unit 19 and in terms of sterility of the operating field. Conversely, too large a distance increases the uncertainty in measuring the distances. Typically, the adjusted distance is of the order of 40 centimeters.

[0106] During a step 56, the projection angle of the plane laser light beam is adjusted, which provides a light line on the patient's skin in the area of ​​interest. The length of the laser beam line is adjusted via a user interface (not shown), for example a touch screen carried by a carriage other than the carriage 15. This light line is thus sized on the scanned surface in order to avoid illuminating elements external to the patient and to the possible stereotaxic frame. Alternatively, the laser pointer is used to define the ends of the projection field to be covered.

[0107] During a step 57, the laser registration unit is switched on and the coordinates, in the first geometric reference frame 28 of the robot, of the starting position of the scanning of the area of ​​interest with the laser light line are recorded, via a control button (not shown) on the handle of the registration unit or the user interface.

[0108] During a step 58, if the operator wishes to perform the scan with a constrained cooperative mode, he switches the robotic arm 17 to constrained cooperative mode. Otherwise, the robotic arm 17 remains in free cooperative mode.

[0109] During a step 59, the operator 23 moves the registration unit 19 carried by the robotic arm 17, relative to the area of ​​interest, in order to perform the scan (or scanning) of this area of ​​interest and provide the central unit 13 with: the measurement of the coordinates, in the first reference frame 29 linked to the registration unit 19, of each point of the area of ​​interest illuminated by the light line and the measurement of second geometric coordinates (x1, y1, z1, a1, b1, c1) of the capture means in a second geometric reference frame 28 linked to a fixed point of the robotic arm 17. This is the configuration at the start of step 59 which is illustrated in figure 2.

[0110] Preferably, during step 59, the speed of movement of the registration unit 19 and therefore of the mobile laser line, is limited to a predetermined speed. Additionally or alternatively, the duration between image captures by the camera 25 is controlled by this speed, so that the surface density of points of the cloud 40 of points 41 captured is substantially constant on the patient's face. Preferably, the central unit 13 performs frequency synchronization between the recovery of the positions and orientations of the registration unit 19 in the second reference frame 28 linked to a fixed point of the robotic arm and the acquisition of the coordinates of the points of the laser line in the first reference frame 29 linked to the registration unit 19.

[0111] From a software architecture perspective, the laser scanning process involves three distinct, usually asynchronous, tasks, each executed by a separate software component:

[0112] - A task dedicated to obtaining the position and orientation of the registration unit 19 in the second reference frame, i.e. obtaining the positions of the different joints of the robotic arm 17, at regular intervals (for example every 8 milliseconds),

[0113] - A task responsible for acquiring the coordinates of the laser line points in the first frame of reference, at a higher frequency (e.g., every millisecond), and

[0114] - A task that combines the data obtained from the two previous tasks to construct a complete three-dimensional point cloud of the scanned area of ​​interest.

[0115] The accuracy of the final measured acquisition strongly depends on the synchronization between these tasks, as the laser line point cloud is transformed into a global coordinate system using the position of the different joints of the robotic arm 17.

[0116] The principle of data synchronization is summarized in the following diagram:

[0117] Since coordinate measurements on the laser line are more frequent than those of the robot arm joint positions, only one laser line is used per robot position update, usually the last line received at the time the robot arm joint position is acquired. Previous laser lines, which were not yet associated with one of the robot arm joint positions, are not used.

[0118] This approach ensures that each position data of the robot's robotic arm joints is associated with the laser line points captured at the nearest instant in time, which minimizes synchronization errors. In the example described, the maximum delay between the laser coordinate measurement and the position of the robotic arm's joint positions used for its transformation into the second reference frame is limited to the sampling period of the laser sensor (i.e., in the example described, 1 millisecond).

[0119] An even more precise synchronization feature is provided for the robotic arm joint sensors and cameras, which offer the ability to trigger their measurements using an external hardware input signal. By using a synchronized trigger signal for these measurements, synchronization can be significantly improved. For example, a general-purpose input / output (GPI / O) signal from the CPU 13 can be triggered and sent simultaneously to the robotic arm joint sensors and the camera, ensuring that their measurements are acquired simultaneously. The software then retrieves the measurements after triggering. This synchronization mode eliminates synchronization errors caused by software communication delays and other latencies by relying on hardware-triggered signals, which are more accurate and reliable in terms of synchronization.

[0120] Preferably, during step 59, a complete round trip is carried out on the path followed by the registration unit 19. This increases the positioning accuracy of the points of the captured point cloud. The return can be carried out in cooperative mode under constraint along this path memorized by the central unit 13 during a movement in free cooperative mode or, if the outward journey has already been carried out in cooperative mode under constraint forcing the registration unit to follow a line, straight or curved, by simple return caused manually by the operator.

[0121] During a step 60, a central unit 13 performs an extraction of a point cloud (3D surface similar to the cloud 35 of points 36) as output data of the laser scan. It is noted that this three-dimensional output data of the laser scan can be used in so-called “open” surgery, that is to say by exposing to air the bony part of the area concerned of the patient's body, for example a part of the spine, a knee or a hip) without “intraoperative” imaging (during the operation), but with “preop” (preoperative) imaging.

[0122] During a step 61, the central unit 13 performs an extraction of a cloud of points from the medical imaging, similar to the cloud 40 of points 41.

[0123] During a step 62, the central unit 3 uses a point cloud matching algorithm, for example of the ICP type (acronym for “iterative closest point”) in order to calculate the transition matrix between the real space reference frame of the area of ​​interest (in geometric coordinates of the robot 10) and the reference frame of the associated medical imaging. The point clouds are thus made to coincide, in the geometric reference frame of the robot, minimizing the error between these two clouds. In the case where the head of the patient 12 is held in position in a stereotaxic frame which has been positioned before the medical imaging is carried out, the matching is carried out on the points of the point clouds which represent this stereotaxic frame or, at the same time on the points of the point cloud which represents the patient's skin and this stereotaxic frame.This increases the accuracy of the registration, as the patient's skin is flexible and may have deformed between the capture of the medical image and the scanning of the laser line.

[0124] Preferably, before using this algorithm, the operator performs a quick “manual” coarse registration step. This step accelerates the convergence of the automatic ICP algorithm. To this end, the operator identifies, in the point clouds of the laser scan and medical imaging, equivalent anatomical areas (or points) in each cloud. A first so-called “coarse” registration is then carried out on this basis. The ICP algorithm uses this coarse registration as input data.

[0125] Preferably, a confidence index is assigned to the finally obtained matching, for example by measuring an average distance between matched points, and, in the case where the confidence index is too low (for example, this average distance is greater than a predetermined limit value), steps 55 to 61 are carried out again. Two examples of confidence index are described below:

[0126] 1. An average global RMS index (root mean square error) over the entire cloud. The RMS value (e.g., 0.26 mm) obtained is displayed on the user interface, with a two-color code (green acceptable, red unacceptable). If the index is green, the operator can continue the procedure. A red index on the user interface requires the operator to repeat a surface laser scan.

[0127] 2. A point index (distance between two points matched between the two point clouds) which can be represented as a point map whose color represents this distance, displayed directly on the 3D extraction of the medical imaging or on the 3D surface obtained via the laser scan. If the rate of points further away than a predetermined limit distance (e.g. one millimeter) exceeds a limit value (e.g. 10%) or if a distance between corresponding points exceeds another predetermined limit distance (e.g. three millimeters), a red index on the user interface forces the operator to repeat a surface laser scan.

[0128] During a step 63, the central unit 13 causes the display of the mapping described above, directly on the 3D extraction of the medical imaging or on the 3D surface obtained via the laser scan. Figure 11 represents, in black dots on a white background, such an image initially in false colors. The precision scale 92, at the bottom left of the image represented in Figure 12, shows that the matching represented there is precise.

[0129] During a step 64, the central unit 13 creates a prohibited zone (“NoGo” zone) for the robotic arm 17 and its instrument holder from the scanned 3D surface and / or the 3D reconstruction of the medical imaging registered with the laser-scanned 3D surface. This “NoGo” Zone prohibits collisions between the robotic arm 17 and the body of the patient 12 at least in the zone of interest (the complete volume of the head 22 in the case shown in Figures 1 and 2).

[0130] Once the robotic arm is in place, its free end is, in turn, located in the space of a navigation camera, for example by implementing at least one navigation reference. To this end, a registration between the robotic arm and the navigation camera must be carried out, in the following manner. A navigation reference is positioned at the free end of the robotic arm, like a tool to be carried or by being integrated into this end of the arm. The robotic arm then moves automatically to different known positions in space. These different positions are recorded by the camera and located in its geometric reference frame. The link can then be made between the positions seen by the camera and the positions of the joints (via the joint encoders) of the robotic arm.Alternatively, in order to avoid the time required to mount the navigation reference (which can lead to poor mounting and therefore inaccuracies) and to move the arm to different positions, a navigation reference can be permanently placed on the carriage of the robotic arm. Knowing by design the location of this reference relative to the base of the robotic arm (and therefore to its reference frame), the camera will only have to locate this reference in order to carry out the matching with the reference frame of the robotic arm. The coordinates of the points in the area of ​​interest, in three dimensions, can then be matched with the coordinates of the robotic arm and with the previously stored medical imagery.

[0131] In one embodiment (not shown), the recalibration method which is the subject of the invention carries out the same steps as those described with regard to FIG. 8 except that the robotic arm 17 operates in automatic mode, under the control of software. Alternatively, the robotic arm only operates in automatic mode from step 58.

[0132] Although, in the embodiments of the device that is the subject of the invention described above, the distance sensor 25 is mounted on the robotic arm 17, in other embodiments, this distance sensor is mounted on a carriage other than the robotic arm. Of course, the geometric reference frame of this distance sensor is then fixed and the transformation matrix of coordinates in this reference frame into coordinates in the reference frame of the robot is then preliminarily determined.

[0133] The central processing unit 13 includes, as illustrated in FIG. 9, a computer system 71 and instructions for implementing the technologies described above in hardware, software, or a combination of hardware and software, which are represented schematically, for example as boxes and circles, at the same level of detail that is commonly used by those of ordinary skill in the art to which this disclosure relates to communicate about computer architecture and computer system implementations.

[0134] The computer system 71 includes an input / output (I / O) subsystem 74 that may include a bus and / or one or more other communication mechanisms for communicating information and / or instructions between components of the computer system 71 over electronic signal paths, whether wired or not. The input / output subsystem 74 may include an input / output controller, a memory controller, and at least one input / output port. The electronic signal paths are shown schematically in the drawings, for example, as lines, one-way arrows, or two-way arrows.

[0135] At least one processor 72, or computing device, is coupled to the I / O subsystem 74 to process information and instructions. The processor 72 may include, for example, a general-purpose microprocessor or microcontroller and / or a special-purpose microprocessor or a graphics processing unit (GPU) or a digital signal processor or an ARM processor. The processor 72 may include an integrated arithmetic logic unit (ALU) or may be coupled to a separate ALU.

[0136] The computer system 71 includes one or more memories 75 that is coupled to the I / O subsystem 74 for electronically digitally storing data and instructions to be executed by the processor 72. The memory 75 may include volatile memory such as various forms of random access memory. The memory 75 may also be used to store temporary variables or other intermediate information during the execution of the instructions to be executed by the processor 72. Such instructions, when stored in a non-transitory computer-readable storage medium accessible to the processor 72, may transform the computer system 71 into a special purpose machine that is customized to perform the operations specified in the instructions.

[0137] The computer system 71 further includes non-volatile memory such as a read-only memory (ROM) 76 or other static storage device coupled to the I / O subsystem 74 for storing information and instructions for the processor 72. The ROM 76 may include various forms of programmable ROM (PROM). A persistent memory (or storage unit) 73 may include various forms of non-volatile random access memory (NVRAM) or solid state storage, magnetic disk, or optical disk and may be coupled to the I / O subsystem 74 for storing information and instructions. The memory 73 is an example of a non-transitory computer-readable medium that may be used to store instructions and data that, when executed by the processor 72, cause execution of computer-implemented methods for performing the techniques of this document.

[0138] The instructions in memory 75, ROM 76, or memory 73 may comprise one or more sets of instructions that are organized into modules, methods, objects, functions, routines, or calls. The instructions may be organized as one or more computer programs, operating system services, or application programs, including mobile applications.The instructions may include an operating system and / or system software; one or more libraries to support multimedia, programming, or other functions; data protocol instructions or stacks to implement TCP / IP, HTTP, or other communication protocols; file format processing instructions to parse or render encoded files; user interface instructions to render or interpret commands for a graphical user interface (GUI), command-line interface, or text-based user interface; or application software. The instructions may implement a web server, a web application server, or a web client.The instructions may be organized as a presentation layer, an application layer, and a data storage layer, an object store, a graph database, a flat file system, or other data storage. The computer system 71 may be coupled via the I / O subsystem 74 to at least one output device 77. In one embodiment, the output device 77 is a digital computer display. Exemplary displays that may be used in various embodiments include a touchscreen or a light-emitting diode (LED) display or a liquid crystal display (LCD) or an e-paper display. The computer system 71 may include one or more other types of output devices 77, instead of or in addition to a display device.

[0139] At least one input device 78 is coupled to the I / O subsystem 74 to communicate signals, data, command selections, or gestures to the processor 72. Examples of input devices 78 include touch screens, microphones, alphanumeric and other keys, keyboards, graphics tablets, image scanners, joysticks, clocks, switches, buttons, dials, sliders. For the implementation of the invention, at least one input device 78 is a digital camera 88, for example with a CMOS sensor, as discussed above.

[0140] Another type of input device is a controller 79, which may perform cursor control or other automated control functions such as navigating a graphical interface on a display screen, alternatively or in addition to input functions. The controller 79 may be a touchpad, a mouse, or cursor direction keys to communicate directional information and command selections to the processor 72 and to control movement of the cursor on the screen. The input device may have at least two degrees of freedom in two axes, a first axis (e.g., x) and a second axis (e.g., y), which allows the device to specify positions in a plane. Another type of input device is a wired, wireless, or optical controller.An input device 78 may include a combination of several different input devices, such as a video camera and a depth sensor.

[0141] In another embodiment, the computer system 71 may include an Internet of Things (IoT) device in which one or more of the output device 77, the input device 78, and the control device 79 are omitted. Or, in such an embodiment, the input device 78 may include one or more cameras, motion sensors, microphones, measuring devices, or encoders, and the output device 77 may include a special-purpose display such as a single-line LED or LCD display, one or more indicators, a display panel, an actuator, or a servomotor.

[0142] The output device 77 may include hardware, software, firmware, and interfaces to generate position report packets, notifications, pulse or heartbeat signals, or other recurring data transmissions that specify a position of the computer system 71 , alone or in combination with other application-specific data, directed to the host 80 or server 81 .The computer system 71 may implement the techniques described herein using custom hardwired logic, at least one ASIC (Application-specific integrated circuit) or FPGA (Field-programmable gate array), firmware, and / or program instructions or logic that, when loaded and used or executed in combination with the computer system, cause or program the computer system to operate as a special-purpose machine. In one embodiment, the techniques described herein are executed by the computer system 71 in response to the processor 72 executing at least one sequence of at least one instruction contained in the main memory 75.These instructions may be read into main memory 75 from another storage medium, such as memory 73. Execution of the instruction sequences contained in main memory 75 causes processor 72 to execute the process steps described herein. In other embodiments, hard-wired circuits may be used instead of or in combination with software instructions.

[0143] The term "storage medium," as used herein, means any non-transitory medium that stores data and / or instructions that enable a machine to operate in a specific manner. These storage media may include non-volatile media and / or volatile media. Non-volatile media include, for example, optical or magnetic disks, such as memory 73. Volatile media include dynamic memory, such as memory 75.

[0144] Storage media are distinct from transmission media, but can be used in conjunction with them. Transmission media are involved in the transfer of information between storage media. For example, transmission media include coaxial cables, copper wires, and optical fibers, including the wires that make up an I / O subsystem 74 bus. Transmission media can also take the form of acoustic or light waves, such as those generated during radio and infrared data communications.

[0145] Various forms of media may be involved in transporting at least one sequence of at least one instruction to the processor 72 for execution. For example, the instructions may initially be transported on a magnetic disk or solid-state drive of a remote computer. The remote computer may load the instructions into its dynamic memory and send the instructions over a communications link such as a fiber optic cable or coaxial cable or a telephone line using a modem. A modem or router local to the computer system 71 may receive the data over the communications link and convert the data into a format that can be read by the computer system 71.For example, a receiver such as a radio frequency antenna or an infrared detector may receive the data carried in a wireless or optical signal and suitable circuitry may provide the data to the I / O subsystem 74, for example by placing the data on a bus. The I / O subsystem 74 transports the data to the memory 75, from which the processor 72 retrieves and executes the instructions. The instructions received by the memory 75 may optionally be stored on the memory 73 before or after execution by the processor 72.

[0146] The computer system 71 also includes a communication interface 82 coupled to a bus 74. The communication interface 82 provides a bidirectional data communication coupling to the one or more network links 83 that are directly or indirectly connected to at least one communication network, such as a network 84 or a public or private cloud on the Internet. For example, the communication interface 82 may be an Ethernet network interface, an Integrated Services Digital Network (ISDN) card, a cable modem, a satellite modem, or a modem for providing a data communication connection to a corresponding type of communication line, for example, an Ethernet cable or a metal cable of any type or a fiber optic line or a telephone line.The network 84 broadly represents a local area network (LAN), a wide area network (WAN), an Internet network, or any combination thereof. The communications interface 82 may include a LAN card to provide a data communications connection to a compatible LAN, or a cellular radiotelephone interface that is wired to send or receive cellular data according to cellular radiotelephone wireless network standards, or a satellite radio interface that is wired to send or receive digital data according to satellite wireless network standards. In any such implementation, the communications interface 82 sends and receives electrical, electromagnetic, or optical signals over signal paths that carry digital data streams representing various types of information.

[0147] The network link 83 typically provides electrical, electromagnetic, or optical data communication directly or via at least one network to other data devices, using, for example, satellite, cellular, Wi-Fi®, or Bluetooth® technology. For example, the network link 83 may provide a connection through a network 84 to a host computer 80.

[0148] Further, the network link 83 may provide a connection via the network 84 or to other computing devices via interconnecting devices and / or computers that are operated by an Internet Service Provider (ISP) 85. The ISP 85 provides data communication services via a global packet data communication network represented by the Internet 86. A server computer 81 may be coupled to the Internet 86. The server 81 broadly represents any computer, data center, virtual machine or virtual computing instance with or without a hypervisor, or computer running a containerized program system such as DOCKER® or KUBERNETES®. The server 81 may represent an electronic digital service that is implemented using more than one computer or instance and that is accessed and used by transmitting web service requests,Uniform Resource Locator (URL) strings with parameters in Hypertext Transfer Protocol (HTTP) payloads, Application Programming Interface (API) calls, application service calls, or other service calls. The computer system 71 and the server 81 may form elements of a distributed computing system that includes other computers, a processing partition, or a server farm. The server 81 may include one or more sets of instructions that are organized as modules, methods, objects, functions, routines, or calls. The instructions may be organized as one or more computer programs, operating system services, or application programs,including mobile applications. The instructions may include an operating system and / or system software; one or more libraries to support multimedia, programming, or other functions; instructions or data protocol stacks to implement TCP / IP (for Transmission control protocol / Internet protocol), HTTP, or other communication protocols; file format processing instructions to parse or render files encoded using HTML (for Hypertext markup language), XML (for Extensible markup language), JPEG (for Joint Photography Experts Group), MPEG (for Moving picture experts group),translated as "moving image expert group") or PNG (for "Portable Networks Graphie"); user interface instructions for rendering or interpreting commands for a graphical user interface (GUI), a command-line interface, or a text-based user interface; application software such as an office suite, Internet access applications, design and manufacturing applications, graphics applications, audio applications, software engineering applications, educational applications, games, or miscellaneous applications. The server 81 may include a web application server that hosts a presentation layer, an application layer, and a data storage layer such as a relational database system using a structured query language (SQL) or no SQL,an object store, a graph database, a flat file system, or any other data storage.

[0149] The computer system 71 may send messages and receive data and instructions, including program code, via the network(s), the network link 83, and the communications interface 82. In the Internet example, a server 81 may transmit requested code for an application program via the Internet 86, the ISP 85, the local area network 84, and the communications interface 82. The received code may be executed by the processor 72 as it is received, and / or stored in memory 73, or other non-volatile memory for later execution.

[0150] The execution of instructions as described in this section may implement a process in the form of an instance of a running computer program consisting of program code and its current activity. Depending on the operating system (OS), a process may consist of multiple threads that execute instructions simultaneously. In this context, a computer program is a passive collection of instructions, while a process may be the actual execution of those instructions. Multiple processes may be associated with the same program; for example, having multiple instances of the same program open often means that more than one process is running. Multitasking may be implemented to allow multiple processes to share the processor 72.Although each processor 72 or processor core executes only one task at a time, the computer system 71 may be programmed to implement multitasking to allow each processor to switch between currently executing tasks without having to wait for each task to complete.

Claims

CLAIMS 1. Device (10) for contactless recalibration between a robotic arm (17), a patient (12) and medical imaging, which comprises: - a means (27) for projecting a mobile laser line (21) onto an area of ​​interest (22) of the patient's body, and - a means (25) for capturing, for each position of the mobile laser line, geometric coordinates (X1, Y1) of points of the laser line on the area of ​​interest in a first geometric reference frame (29) linked to the capture means; characterized in that the robotic arm (17) is configured to move the capture means, and to provide second geometric coordinates (x1, y1, z1, a1, b1, c1) of the capture means in a second geometric reference frame (28) linked to a fixed point of the robotic arm, the device further comprising: - a means (13) for determining the geometric coordinates of the points of the laser line on the area of ​​interest in the second geometric reference frame to provide a cloud (40) of points (41) of the area of ​​interest in this second reference frame, and - a means (13) for matching a cloud (35) of points (36) of the medical imaging and the cloud of points of the area of ​​interest in the second reference frame.

2. Device (10) according to claim 1, wherein the robotic arm (17) is configured to operate in cooperative mode during operation of the capture means.

3. Device (10) according to claim 2, wherein the robotic arm (17) is configured to operate in cooperative mode under constraints during operation of the capture means.

4. Device (10) according to claim 3, wherein the operating mode of the robotic arm (17) constrains the movement of the capture means (25) along a line.

5. Device (10) according to claim 3, wherein the mode of operation of the robotic arm (17) constrains the movement of the capture means (25) in a surface.

6. Device (10) according to claim 3, in which the operating mode of the robotic arm (17) constrains the movement of the capture means (25) in rotation around an axis of rotation of the last articulation of the robotic arm (17).

7. Device (10) according to one of claims 1 to 6, in which the means (27) for projecting the laser line (21) further comprises means for adjusting the projection angle of the laser line and / or the length of the laser line.

8. Device (10) according to one of claims 1 to 7, which further comprises a laser pointer for measuring the distance between the geometric coordinate capture unit and the area of ​​interest.

9. Device (10) according to one of claims 1 to 8, in which the robot (17) is an aiming assistance robot.

10. Method (50) for contactless registration between a robotic arm (17), a patient (12) and medical imaging, which comprises: - a step (59) of projecting, by a projection means (27), a mobile laser line (21) onto an area of ​​interest (22) of the patient's body, and - a step (59, 60) of capturing, by a means (25) of capturing, for each position of the mobile laser line, geometric coordinates (X1, Y1) of points of the laser line on the area of ​​interest in a first geometric reference frame (29) linked to the capturing means; characterized in that the arm (17) of the robot moves the capturing means during the capturing step and performs a step of providing second geometric coordinates (x1, y1, z1, a1, b1, c1) of the capturing means in a second geometric reference frame (28) linked to a fixed point of the robotic arm, the method further comprising: - a step of determining the geometric coordinates of the points of the laser line on the area of ​​interest in the second geometric reference frame to provide a cloud (40) of points (41) of the area of ​​interest in this second reference frame, and - a step (62) of matching a cloud (35) of points (36) of the medical imaging and the cloud of points of the area of ​​interest in the second reference system.

11. Method (50) according to claim 10, during the capturing step, the robotic arm (17) operates in cooperative mode.

12. Method (50) according to one of claims 10 or 11, which further comprises a step (52) of pre-positioning the robotic arm and displaying the laser line in the first reference frame.

13. Method (50) according to one of claims 10 to 12, which further comprises a step (56) of adjusting the projection angle of the laser line (21) and / or the length of the laser line.

14. Method (50) according to one of claims 10 to 13, which further comprises a step (55) of adjusting the distance between a means (27) for projecting the laser line (21) and the area of ​​interest (22).

15. Method (50) according to one of claims 10 to 14, which further comprises a step (63) of displaying a mapping of distances between each point of the cloud (40) of points (41) in three dimensions of the area of ​​interest and the point of the cloud (35) of points (36) of the medical imaging matched with this point of the cloud (40) of points (41) in three dimensions of the area of ​​interest during the matching step (62).

16. Method (50) according to claim 15, wherein, during the display step, for each point of the displayed map, the color of this point is a function of said distance.

17. Method (50) according to one of claims 15 or 16, in which this mapping is displayed directly on the cloud (40) of points (41) in three dimensions of the area of ​​interest and / or on the cloud (35) of points (36) of the medical imaging.

18. Method (50) according to one of claims 10 to 17, which further comprises a step (64) of creating a geometric zone prohibited for the robotic arm (17) from the cloud (35) of points (36) of the zone of interest (22) and / or the medical imaging (40) aligned with the cloud of points of the zone of interest.

19. Method (50) according to one of claims 10 to 18, which comprises a synchronization step, for each position of the moving laser line: - the instant of capture of geometric coordinates (X1, Y1) of points of the laser line on the area of ​​interest in a first geometric reference frame (29) during the capture step (59, 60) and - the instant at which the second geometric coordinates (x1, y1, z1, a1, b1, c1) of the capture means are measured in a second geometric reference frame (28) which are provided during the provisioning step.

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