Surgical Navigation With Impedance Sensing for 3D Tool Registration
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Solution Overview
Problem
Existing surgical navigation systems face challenges in accurately confirming the three-dimensional location of a surgical tool, suffer from mis-registration due to patient repositioning, and lack real-time registration and alerts for anatomical transitions, especially when working near critical nervous system components.
Innovation Solution
A surgical system using a robotic arm with a control unit and impedance sensing, where a medical device emits warning signals based on varying electrical characteristics of tissues, allowing real-time registration and alerting surgeons to anatomical transitions, and adjusting the tool's trajectory to avoid sensitive areas.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If fluoroscopic or CT images are periodically updated during the surgical procedure, then the registration accuracy is improved, but the exposure to ionizing radiation increases
Solution Approach 1:
The system performs pre-acquisition of high-quality fluoroscopic or CT images before the surgical procedure and uses these pre-acquired images for navigation throughout the procedure. This preliminary action eliminates the need for periodic updates during surgery, thereby maintaining registration accuracy while avoiding additional ionizing radiation exposure to the patient and surgeon.
2Loss of information
If multiple views of patient anatomy are displayed, then the navigation information is improved, but the difficulty of real-time mental integration increases
Solution Approach 1:
The system merges multiple views of patient anatomy and surgical tool positions into a single integrated three-dimensional display. This combines comprehensive navigation information from multiple angles while eliminating the need for surgeons to mentally integrate separate two-dimensional views in real-time, thereby reducing cognitive load and improving situational awareness.
3Ease of operation
If a robotic arm is used to perform the surgery, then surgeon fatigue is reduced, but the tactile feel during tool advancement is reduced
Solution Approach 1:
The system implements real-time impedance sensing that provides continuous feedback to the robotic arm during tool advancement. This feedback mechanism allows the robotic system to detect tissue transitions and provide haptic or visual feedback to the surgeon, compensating for the loss of natural tactile feel while maintaining the ergonomic benefits of robotic assistance.
4Device complexity
If the working end of the surgical tool is difficult to visualize in three dimensions, then the surgical procedure complexity increases, but the need for image-based navigation increases
Solution Approach 1:
The system creates a virtual copy or representation of the surgical tool and patient anatomy in three-dimensional space using pre-acquired images and real-time tracking. This virtual model allows the surgeon to visualize and confirm the precise three-dimensional location of the working end without directly observing it, thereby reducing surgical complexity while improving spatial awareness and precision.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances precision and safety by ensuring the surgical tool follows the pre-operative plan, reducing the risk of damage to sensitive tissues like the spinal cord and vascular structures during procedures.
Implementation Method 1
a trajectory of a working end of a penetrating tool is guided by an impedance sensing system
Implementation Method 2
Surgical navigation and robotic systems are known that use x-ray or fluoroscopic images to assist a physician in visualizing the location of a working end of a surgical tool within patient anatomy
Data Source
AI summary
Systems, instruments, and methods are provided verifying the surgery is being performed in accordance with a surgical plan, wherein a surgical tool having a sensor outputs a data signal that enables the trajectory of the surgical tool to be displayed as an overlay on an image of an anatomical portion of a patient and a visual or audible signal that confirms the surgical tool is penetrating the anatomical portion in accordance with the surgical plan and/or that issues an alert indicating that the surgical tool is not being inserted into the anatomical portion according to the surgical plan.