The present application discloses a method, device, equipment and medium for determining the guiding coordinates of a replacement body, and the present application belongs to the field of surgical navigation technology. The method includes: constructing a three-dimensional image coordinate
system of the target to be replaced based on a two-dimensional image; obtaining the three-dimensional force line of the target to be replaced in the three-dimensional image coordinate
system; determining the three-dimensional image of the target to be replaced in the three-dimensional image coordinate
system based on the three-dimensional force line; obtaining a three-dimensional image of the replacement body, matching the three-dimensional image of the replacement body and the three-dimensional image of the target to be replaced in the three-dimensional image coordinate system according to a preset rule to obtain a three-dimensional image of the replaced target; obtaining the three-dimensional image coordinates of the replacement body in the three-dimensional image of the replaced target, and guiding the replacement of the replacement body based on the three-dimensional image coordinates. Through this technical solution, the accuracy of navigation can be improved, and the navigation cost is low, and there is no need for planning during the replacement process, which improves the replacement efficiency.