XR Surgical Navigation for Distal Screw Placement Without Fluoroscopy
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Solution Overview
Problem
Current intramedullary nailing systems face challenges in accurately placing distal interlocking screws due to deformation of the nail during insertion, requiring increased surgeon skill and radiation exposure, and existing computer-assisted systems suffer from tracking errors and electromagnetic interference.
Innovation Solution
An extended reality surgical navigation system using self-referencing sensors like head-mounted computer vision and IMU orientation, enabling real-time guidance without fluoroscopic assistance, and recalibrating for nail deformation using fluoroscopic X-ray images.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If fluoroscopic guidance is used for screw placement, then measurement precision is improved, but radiation exposure increases
Solution Approach 1:
The patent replaces fluoroscopic (radiation-based) guidance with an optical tracking system using cameras and fiducial markers. The system uses computer vision to track surgical instruments and provide navigation feedback, eliminating the need for continuous fluoroscopy while maintaining placement accuracy.
Solution Approach 2:
The system creates a virtual 3D model of the patient's anatomy and surgical plan, then overlays it onto the real surgical field using augmented reality. This virtual copy allows surgeons to visualize screw trajectories and anatomical structures without radiation exposure.
2Ease of operation
If traditional computer-assisted navigation is used, then surgical guidance is provided, but tracking errors and electromagnetic interference occur
Solution Approach 1:
The patent replaces electromagnetic tracking systems with an optical tracking system that uses cameras to detect fiducial markers and track instrument positions. This substitution eliminates electromagnetic interference and improves tracking reliability in the surgical environment.
Solution Approach 2:
The system introduces fiducial markers as intermediaries between the physical surgical instruments and the digital navigation system. These markers provide robust visual features for camera-based tracking, enabling accurate position and orientation detection without electromagnetic fields.
3Manufacturing precision
If surgeon skill is increased to compensate for nail deformation, then manufacturing precision is improved, but device complexity increases
Solution Approach 1:
The system performs preoperative planning and creates a customized surgical navigation plan before the actual surgery. Virtual screw trajectories are calculated and stored, allowing real-time guidance during surgery without requiring surgeons to mentally compensate for anatomical variations or nail deformations.
Solution Approach 2:
The navigation system provides real-time visual feedback to the surgeon during screw placement, showing the actual position relative to the planned trajectory. This closed-loop feedback enables precise screw placement even when nail deformation occurs, eliminating the need for advanced surgeon skill to compensate for such variations.
Data Source
AI summary
A surgical navigation system includes an extended reality head-mountable display (HMD). The surgical navigation system further includes a computer system comprising at least one processor, wherein the computer system is configured for performing operations. The operations include receiving camera images while a surgeon is wearing the HMD and performing a surgical procedure on a subject. The operations further include identifying at least one image feature depicted in the images. The operations further include tracking a location of at least one surgical object using the image feature. The operations further include sending one or more visual indicators to the HMD to display, to the surgeon, a target location for the surgical object for the surgical procedure. The target location includes a location external to the subject for the surgeon to use the surgical object to perform the surgical procedure on the subject.