Image Guided Surgery using Rapid Prototyping Models

描述（由申请人提供）： 神经外科计划的基本原则之一是能够产生手术方法，最大限度地减少对正常组织的破坏，同时允许所需的靶组织暴露。为了帮助外科医生了解目标组织的位置以及它们与正常组织的关系，已经开发了图形工作站。创建患者特异性三维诊断数据集的过程，提供评估替代手术计划的能力，以及在手术时将优化的虚拟手术计划应用于真实的世界患者的能力，被称为图像引导手术。最先进的图像引导手术可分为两大类，基于框架的引导和无框架引导。在制定和执行手术计划时，每种方法都有显著的优点和缺点。缺点包括框架应用、从初始成像到手术的最后部分需要框架存在、在手术室中使用框架工作的必要性以及手术时间的增加。对于无框架图像引导，缺点包括患者与模型配准的潜在不准确性以及由所需的3维仪器跟踪设备施加的问题和约束。我们提出了一种新的引导系统，该系统利用定制的患者特定框架。这个新框架在手术时在虚拟患者模型世界和实际患者之间创建所需的对齐。与常规的有框或无框图像引导一样，开发了虚拟手术计划。然后从三维诊断数据集导出患者的表面。该表面描述允许计算精确地适合患者皮肤的帧。这种独特的配合在手术时提供了患者的虚拟三维模型和真实的患者之间的几何配准。该配准允许在手术时将虚拟手术计划应用于患者。虚拟手术计划的传输通过将所需的对线组件包括到定制患者特定框架的设计中来完成。活检夹持器、皮肤和骨切口相关说明、皮肤夹、定制牵开器设计和牵开器夹持器均包含在患者专用定制框架的设计中。

DESCRIPTION (provided by applicant): One of the basic tenets of Neurosurgical planning is the ability to generate an operative approach that minimizes the disruption of normal tissues while allowing the required exposure of target tissues. To aid the surgeon in his or her ability to appreciate the location of target tissues, as well as their relationship to normal tissues, graphical workstation have been developed. The process of creating a patient specific 3- dimensional diagnostic dataset, provide the ability evaluate alternate surgical plans and the ability to apply the optimized virtual surgical plan to the real world patient at the time of surgery is termed image guided surgery. State of the art image guided surgery can be broken down into two broad categories, frame based guidance and frameless guidance. Each provides significant advantages and disadvantages when developing and carrying out a surgical plan. Disadvantages include frame application, the need for the frame to be present from initial imaging to the final portion of the procedure, the necessity of working with the frame in the operating room and the increase in operative time. For frameless image guidance the disadvantages include the potential inaccuracies in the patient to model registration as well problems and constraints imposed by the required 3-dimensional instrument tracking equipment. We are proposing a new guidance system that utilizes custom fabricated patient specific frame. This new frame creates the required alignment between the virtual patient model world and the actual patient at the time of surgery. As with routine framed or frameless image guidance a virtual surgical plan is developed. The surface of the patient is then derived from a 3-dimensional diagnostic dataset. This surface description allows the computation of a frame that precisely fits to he patient skin. This unique fit provides the geometric registration between the virtual 3-dimensional model of the patient and the real patient at the time of surgery. This registration permits the application of a virtual surgical plan to the patient at the time of surgery. The transfer of the virtual surgical plan is accomplished by including into the design of the custom patient specific frame the required alignment components. Biopsy holders, instructions regarding skin and bone incisions, skin clips, custom retractor design and retractor holders are all included into the design of the patient specific custom frame.