DE10350011A1 - Medical training and patient treatment system for use in hospital, has coordinate measuring systems aimed at landmark indicators on patient and has base station and computer with display - Google Patents

Abstract

The patient (16) may be replaced by a small lightweight model (17) for training purposes. Landmark indicators (2,3,12,13) may be used for training purposes or during the examination of a real patient. A first coordinate measuring system (1) may be used with a reference coordinate system (4) and is connected to a base station (6) via an interface (5). A second coordinate measuring system (11) may be mounted on a tripod. An interface (10) is connected to a computer (8) with an input/output system (9).

Description

The The invention relates to a training and treatment system for navigation in medicine according to the generic term of claim 1.

The System is in particular for the training as well as the preparation and implementation of a patient-individual navigated interventions in medicine suitable.

Medical navigation systems are in many areas of surgery and dentistry so-called "gold standard". Are known navigation systems for clinical use (eg US 6021343 ) in the surgical subjects MKG surgery, otolaryngology, neurosurgery, traumatology, orthopedics and others. They work according to the principle of position measurement (position and orientation) of the instruments relative to patient image data (projection data, volume tomographic data, kinematic data).

Outside of clinical use dentistry training places are known in dentistry, which work on a similar principle, however, designed and implemented to form surgical techniques without navigation systems. The company DenX ( US 56881118 ) has deposited such a system as a patent.

Known are over it addition endoscopic training systems without navigation function, which also not for are suitable for clinical use.

The navigation systems known from the prior art for clinical use on the patient are equipped with a high-quality and very expensive measuring technique. This has several consequences:
The systems are very large and not or only very limited mobile. For this reason, the devices are typically located in clinics in the operating room (behind the hygiene lock) and are not always freely accessible to students or even to the attending physician.

Out For this reason, the attending physician can not optimally on the navigation supported Patient data collection or patient-specific treatment to prepare.

In proof hospitals is entering the OP area by the doctor with a rental of space and costs, typically only through the OP can not be settled by preparing the surgery.

It is necessary, the clothes for to change the entry of the germ-free surgical area.

at image-based navigation systems (CT, MRT, etc.) are at the booth Although technically possible in principle, the patient data in the office or at another spatially separate workplace (e.g., at the desk at home). However, this happens with a different software or user interface as the treatment system. The image data is displayed differently than in the OP situation.

It is not possible the actual Intervention with the navigation system and the application of the navigation principle play through in advance, since the large device only with considerable effort (Weight, cost, size, insurance, Hygiene, risk) from the operating room to the office or can be brought home. The latter is up to date the technology practically excluded.

Furthermore that must be high quality device with maximum availability in the OP, so that by a frequent operational use the equipment costs can be justified. The latter plays especially in diagnosis-based billing systems a big Role.

at non-image navigation systems (e.g., OrthoPilot, Aesculap) is the Patient data acquisition, however, directly to the measuring technology of the navigation system coupled. The doctor does not even have the opportunity here, on the patient image acquisition without the expensive navigation system to prepare. He can therefore neither the process of Image capture nor the image analysis and the use of the navigation system outside play through the operating theater. A procurement multiple systems for planning, Training and treatment is not for cost and space reasons possible.

This is another significant disadvantage of current navigation systems.

In The future will be more and more sensor systems with navigation systems be coupled to the image capture. Here arises the same problem: Imaging can only be done using a navigation system be rehearsed patient-specific.

The state of the art, which is known from dentistry as a simulator system, does not have the task of providing patient-specific surgical preparations but serves exclusively for the training of dentists in order to enable them to treat patients without navigational aids. For the applications of the simulator system for the preparation of cavities for dental fillings described there, there are no clinical navigation systems. Also the objective and the concept of the system can not be transferred.

task The invention is the known disadvantages of the prior art avoid and develop a system that is considered non-clinical Navigation system is inexpensive and easy to transport and simple coupling to an additional module to a clinical Navigation system can be transformed. It will possible, navigated patient-specific interventions spatially separated from and in time before the clinical procedure with largely the same workflow and comparable system operation play through.

These The object is achieved by a system according to the features of claim 1 solved.

The training and treatment system for the navigation in medicine a system for the training, individual preparation and execution of navigated interventions consisting of two coordinate measuring systems ( 1 . 11 ), a base station ( 6 ) with data processing unit ( 8th ) for the location (position and orientation) of landmarks ( 2 . 3 . 12 . 13 ), Input-output system ( 9 ), characterized in that the coordinate measuring system for position detection (position and orientation) of landmarks is duplicated, wherein a coordinate measuring system ( 1 ) is a high-quality clinical requirements sufficient coordinate measuring and the second coordinate measuring system ( 11 ) is a simpler coordinate measuring system that does not meet clinical requirements and can be operated by the same navigation software.

The System is in particular for the training as well as the preparation and implementation of a patient-individual navigated interventions in medicine advantageously applicable.

By the system will make it possible To familiarize students with navigation technology in a hands-on way and the "gold standard" of clinical treatment early to convey practically. The training can be played out on the basis of real patient cases become and thus become much more realistic than in pure principle studies. In training can address all problems in the workflow with navigation systems To be received. A comparable training to the current standard can be shortened significantly and thus cheaper be designed. Particularly advantageous is the transferability of the training and surgical preparation for the real clinical procedure.

One Quasi-identical surgical setup during surgical preparation of the operation like the later This reduces the error rate due to errors or mistakes Confusion considerably.

The Training system is lightweight, inexpensive and portable and therefore can be transported easily and at significantly lower cost risk. So can also transports the devices for communication and consultation between colleagues become. The devices can be transported to an apartment as well as in lecture rooms.

While currently only few devices available for training can stand now by the cheap version Training systems in much higher Number available be put.

By the better training opportunity can be existing clinical systems are better utilized.

By the relief of the clinical systems from education is the Availability of the clinical systems and the utilization higher and therefore the costs of Systems less per use.

The Clinical use of the navigation system is no longer by one Non-clinical occupancy to prepare for intervention in the clinical system prevented.

Thereby It will also be easier to customize the application software for individual users.

The costs for Landmarks and instruments can be reduced significantly in the training area, there as well There are no requirements for clinical requirements. It is then possible, that Instrument set without medical approvals and much cheaper use.

One greater Another advantage is that a Doctor for a treatment a patient individually with the patient record or possibly even play directly with the participation of a patient outside the operating theater and explain can.

The Software development can also be done on the training systems and thereby allows a significantly low-cost software development

It demonstrate:

1 Navigation system for patient-specific surgical preparation and clinical use,

2 Training workplace with independent gem calculator and school measuring system,

3 Mobile computer unit with integrated coordinate measuring device.

1 shows a clinical navigation system consisting of an operating room coordinate measuring system ( 1 ), Landmarks ( 2 . 3 ), whose position (position and orientation) relative to a reference coordinate system ( 4 ) with the OR coordinate measuring system ( 1 ) can be measured, an interface ( 5 ) for coupling the OR coordinate measuring system ( 1 ) to a medical base station ( 6 ) as well as interfaces ( 7 ) for coupling the application or patient-specific data processing unit ( 8th ) of the navigation system.

The base station ( 6 ) has an output system ( 9 ) of information to the attending physician (monitor, speakers, projectors, glasses, etc.) or to control a downstream peripheral device. This output system ( 9 ) can also be part of the data processing unit ( 8th ) be. The output unit can also be realized as an off-input unit (touch display).

The assembled clinical navigation system consisting of the measuring system ( 1 ), the landmarks ( 2 . 3 ), the base station ( 6 ) and the data processing unit ( 8th ), must meet the requirements for clinical navigation systems.

The data processing unit ( 8th ), from the base station ( 6 ) and via an interface ( 10 ) for coupling a low-cost, small school coordinate measuring system ( 11 ) feature. The school coordinate measuring system ( 11 ) can either have the same landmarks ( 2 . 3 ) like the OR coordinate measuring system ( 1 ) or alternatively it uses cheaper landmarks ( 12 . 13 ).

The resulting non-clinical school navigation system consisting of measuring system ( 2 ), the landmarks ( 2 . 3 ) or the landmarks ( 12 . 13 ) and the data processing unit ( 8th ) does not meet the requirements for a clinical navigation system and can therefore be designed significantly cheaper. All components of the non-clinical school navigation system are lightweight and portable.

The measuring interface ( 5 ), only the coupling of a clinically approved OR coordinate measuring system ( 1 ) allow. The school interface ( 10 ), the coupling of a school coordinate measuring system ( 11 ) but can also provide the coupling of the clinically approved OR coordinate measuring system ( 1 ) allow.

Either the school navigation system as well as the clinical navigation system use largely the same software interface to the impression of the clinical Navigation system also to produce the school navigation system.

Both navigation systems can work with the original instrument set. For the school navigation system, it is advantageous to have a transportable and inexpensive version of suitable patient models ( 14 ) and instrument models ( 15 ) vorzuhalten. The school coordinate measuring system ( 11 ) is transportable and does not necessarily meet the requirements (certificates, accuracy, hygiene) of a medical product. This makes it much cheaper to realize.

A embodiment for the School navigation system would be a simple stereo video-based system with a FireWire interface connected to a laptop or palmtop with simple printed patterns as Landmarks.

2 shows another form of realization. It consists of the school interface ( 10 ) between data processing unit ( 8th ) and school coordinate measuring system ( 11 ) is a simple standard interface of data processing (eg USB, FireWire, Serial) and is provided with a standard connector.

In this case, an independent existing computer (eg PC, laptop, palmtop) can be used for training or preparation of the patient-specific navigation intervention. This then forms an independent data processing output unit ( 14 . 9 ) of the training system. In this case, the interface ( 7 ) of the base station ( 6 ) alternatively to a removal of the data processing unit ( 8th ) for recording the data carrier (CD, USB, etc.).

A portable version is then only for the school coordinate measuring system ( 11 ) as well as a data carrier ( 15 ) containing the data processing software and, if necessary, the patient image data. Both read-only media (eg CD-ROM) and rewritable data media (eg USB stick) can be used as data media. It may be useful to store the entire treatment software together with the image data on the data carrier and optionally even boot from it, so as not to jeopardize the safety of the clinical treatment system. An embodiment in which the navigation software is stored on a read-only data carrier and the patient data is stored on a rewritable data carrier makes sense.

For purely training purposes, only readable media is preferable. For the preparation a patient-specific intervention, in which even the planning data are created or changed, a writable disk is used.

For the training then instead of the patient ( 16 ), Models ( 17 ) and either the original instruments ( 18 ) or instrument models ( 19 ).

The School-coordinate measurement does not have to necessarily according to the same measuring principles work like the OR coordinate measuring system. It is for example conceivable the basis of a coordinate measuring arm with the phantom kinematically to couple and the Meßspitze of the measuring arm connect to the instrument without play.

3 shows a further embodiment. Here is the inexpensive miniaturized school coordinate measuring system ( 11 ) directly into the transportable data processing unit ( 8th ) to reduce the number of components to be transported.

Also the realization of an inexpensive coordinate measuring system by two simple Video camera systems (e.g., webcams) make sense.

The system consisting of the data processing unit ( 8th ), the OR coordinate measuring system ( 1 ), the surgical landmarks ( 2 . 3 ), the medical base station ( 6 ), the output unit ( 9 ) and the software that has been used at least once via a data medium ( 15 ) can be operated as a normal clinical navigation system.

A embodiment The basic unit consists of a laptop docking station, a medical Isolating transformer as well as electrical interfaces and a housing that meets the legal requirements for medical devices. Of the Laptop is going over the Interface of the docking station to the base station and to the coordinate measurement connected and forms the computer unit of the navigation system.

Of the The term laptop generally describes a mobile data processing unit with integrated input / output unit and interfaces for coupling from docking station and or peripherals.

However, for training purposes or to prepare a navigational intervention, the data processing unit may ( 8th ) at the interface ( 7 ) are disconnected from the base station. The practitioner can then use the data processing unit ( 8th ) from the base station ( 6 ) and together with a school coordinate measuring system ( 11 ) to his office or workplace outside the surgical area.

Meanwhile, the clinical navigation system can only be used by another colleague if he also has a comparable data processing unit ( 8th ) with appropriate software to the base station ( 6 ).

Together with the data processing unit ( 8th ) and the school coordinate measuring system ( 11 ), the practitioner can also use a school instrument set ( 18 . 19 ) with real or school landmarks ( 2 . 3 . 12 . 13 ) and optionally a patient model ( 17 ) in the non-sterile environment or operate there. At the office workstation, the school coordinate measuring system ( 11 ) via the school interface ( 10 ) to the data processing unit ( 8th ) are connected.

The Landmarks become at the office workplace simply attached to the instrument and the phantom or the patient or are already integrated into instrument, school instrument or phantom. In dependence from the application become patient, patient model, and the instruments with the school coordinate measuring system calibrated and registered. Then the practitioner can have his navigate through the intervention of the phantom. A simple one embodiment The navigation system consists of a laptop and a cheap one Stereo camera system that over FireWire is connected. Neither laptop nor video camera need to be built, electrical or hygiene requirements comparable to a medical device fulfill.

The practitioner can analyze intervention plans and play through them. He can use the findings for rescheduling, and play through critical situation. He can integrate the result of the surgical preparation into a modified intervention planning which he can save on the data carrier in the data processing unit ( 8th . 14 . 15 ) or externally on a mobile data carrier ( 15 ) can save

For training purposes does not have to necessarily a disk used to store the result.

It is even useful and possible in some applications to perform the navigated procedure together with the patient ( 16 ) instead of a patient model ( 17 ) to prepare.

It is possible that multiple clinicians with multiple mobile computing devices ( 8th ) or independent data processing units ( 14 ) and possibly also several school measurement systems to prepare their specifically performed navigated operation individually at different locations and then before each surgery, their Data processing unit ( 14 ) for each OP to configure the clinical navigation system for the OP.

In the case of an independent computer system ( 14 ) would be on the disk ( 15 ) Not only patient image data but also the navigation software are stored. In this case, the school coordinate measuring system ( 11 ) as well as the data medium ( 15 ) from the practitioner to the workplace ( 14 ) to be brought.

It may be useful one or more copies of the treatment software for one or provide multiple data processing units. It may be useful be to couple the license rights to a disk rather than to a computer unit. It may be useful to boot from the disk.

With Special calibration routines can also be simple video cameras as a coordinate measuring system be used.

1

OP coordinate measurement

2

Surgical landmark

3

Surgical landmark

4

Reference coordinate system

5

Measuring interface

6

medical base station

7

DV Interface

8th

Data processing unit

9

Input / output system

10

School interface

11

School-coordinate measurement

12

School landmark

13

School landmark

14

Independent DV system

15

disk

16

patient

17

patient model

18

instrument

19

instrument model

Claims (14)

A system for training, individual preparation and execution of navigated interventions consisting of two coordinate measuring systems ( 1 . 11 ), a base station ( 6 ) with data processing unit ( 8th ) for the location (position and orientation) of landmarks ( 2 . 3 . 12 . 13 ), Input-output system ( 9 ), characterized in that the coordinate measuring system for position detection (position and orientation) of landmarks is duplicated, wherein a coordinate measuring system ( 1 ) is a high-quality clinical requirements sufficient coordinate measuring and the second coordinate measuring system ( 11 ) is a simpler coordinate measuring system that does not meet clinical requirements and can be operated by the same navigation software. A system according to claim 1, characterized in that the navigation software of the system is not limited to the data processing unit ( 8th ) but on the disk ( 15 ) with the school coordinate measuring system ( 11 ) together with an independent computer system ( 14 ) can be operated. A system according to claim 1, characterized in that the data processing unit ( 8th ) from the base station ( 6 ) can be solved and the school coordinate measuring system ( 11 ) together with the data processing unit ( 8th ) without base station ( 6 ) can be operated. A system according to claims 1-3, characterized in that both coordinate measuring systems ( 1 . 11 ) can process the same and or other landmarks. A system according to claims 1-3, characterized in that the coordinate measuring systems ( 1 . 11 ) use different or the same measuring principles. A system according to claims 1-5, characterized in that the school coordinate measuring system ( 11 ) not at the base station ( 6 ) can be operated. A system according to claims 1-5, characterized in that the school coordinate measuring system ( 11 ) not parallel to the OR coordinate measuring system ( 1 ) at the base station ( 6 ) can be operated. A system according to claims 1-7, characterized in that the school coordinate measuring system ( 11 ) consists of simple independent camera modules and can be easily calibrated by a measuring body. A system according to claims 1-8, characterized in that the school coordinate measuring system ( 11 ) in the data processing unit ( 8th ) is integrated or fastened to it. A system according to claims 1-9, characterized that the Software quality criteria calculated and recorded. A system according to claims 1-10, characterized that the recorded treatment criteria, only after completion of the treatment for disposal be put. A system according to claims 1-9, characterized that the recorded treatment criteria, the practitioner continuously be signaled (visual, acoustic, etc.). A system according to claims 1-12, characterized in that the base unit ( 6 ) is designed as a mini-computer docking station together with a medical isolating transformer and a protective housing as well as medically approved electronics, the clinical operating room coordinate measuring system is designed via connectors with medical approval and is connected in the protective housing to the docking station, the data processing unit ( 8th ) is designed as a small computer and has an interface for the connection of one or more video cameras and optionally has an interface for the recording of mobile data carriers. A system according to claim 1-13, characterized in that both planning and / or treatment software are stored together with the patient data on a mobile data carrier and with any stationary and mobile data processing units ( 8th . 14 ) can be operated.