MONITORING METHOD AND MEDICAL SYSTEM

Abstract

A method for automatically monitoring a robot-assisted movement of a medical object through a hollow organ of a medical object of a patient performed by a robotic system is provided. The method includes tracking movement of the medical object using a medical imaging device such that the medical object and/or the hollow organ is at least partially arranged in a recording region that is mappable by the imaging device. The tracking is effected by a relative movement between the recording system of the imaging device and the patient. An image of the recording region is recorded during the tracking. In each case, a further image is recorded at regular intervals. The current image in each case and/or sensor data from a sensor assigned to the robotic system or the object is evaluated to determine whether a situation relevant to decision-making and/or safety with respect to the robotic system is present.

Claims

1. A method for automatically monitoring a movement of a medical object through a hollow organ of a patient performed by a robotic system, such that the movement is robot-assisted, the method comprising: tracking, by a medical imaging device, the movement of the medical object, such that the medical object, the hollow organ, or the medical object and the hollow organ are at least partially arranged in a recording region that is mappable by the imaging device, wherein the tracking is effected by a relative movement between a recording system of the imaging device and the patient; recording at least one image of the recording region during the tracking, wherein in each case a further image is recorded at regular intervals; evaluating a current image in each case, sensor data from a sensor assigned to the robotic system or the object, or a combination thereof, such that whether a situation relevant to decision-making, safety, or decision-making and safety with respect to the robotic system is present is determined; and outputting information when the evaluating reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety.

2. The method of claim 1, wherein the tracking is at least partially based on control signals from the robotic system.

3. The method of claim 1, wherein a control signal for interrupting the movement that is robot-assisted, the image recording, or the movement and the image recording is automatically output when the evaluating reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety, and wherein the method further comprises displaying the information.

4. The method of claim 2, wherein a control signal for interrupting the movement that is robot-assisted, the image recording, or the movement and the image recording is automatically output when the evaluating reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety, and wherein the method further comprises displaying the information.

5. The method of claim 3, further comprising displaying the current image, the evaluation of which reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety, the current image recorded at a same point in time as the sensor data that reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety, or a combination thereof until acceptance of a user input or until receipt of a control command for resuming the movement that is robot-assisted, the image recording, or the movement and the image recording.

6. The method of claim 4, further comprising displaying the current image, the evaluation of which reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety, the current image recorded at a same point in time as the sensor data that reveals the presence of the situation relevant to decision-making, safety, or decision-making and safety, or a combination thereof until acceptance of a user input or until receipt of a control command for resuming the movement that is robot-assisted, the image recording, or the movement and the image recording.

7. The method of claim 1, wherein the situation relevant to decision-making, safety, or decision-making and safety is present when a branch, a bifurcation, a peculiarity, or an anomaly of the hollow organ is detected during the evaluation or when a deviation from existing path planning exceeds a threshold value.

8. The method of claim 1, wherein path planning for an automatic or semi-automatic movement of the medical object is provided.

9. A medical system comprising: a robotic system comprising: a robot control unit; and a robot-assisted drive system comprising a drive and a drive mechanism, wherein the robot-assisted drive system is configured to move a medical object in a cavity organ of a patient based on control signals from the robot control unit; an imaging device comprising: a system control unit; and a movable recording system configured to record images of a mappable recording region, wherein the system control unit is configured to actuate the movable recording system, such that movement of the medical object is tracked; an evaluation unit configured to evaluate images of the movable recording system, such that whether a situation relevant to decision-making, safety, or decision-making and safety with respect to the robotic system is present is determined; and an output unit configured to output information.

10. The medical system of claim 9, wherein the output unit comprises a display unit.

11. The medical system of claim 9, further comprising an input unit configured to actuate the robotic system.

12. The medical system of claim 10, further comprising an input unit configured to actuate the robotic system.

13. The medical system of claim 9, wherein the robot control unit and the system control unit are configured to exchange data.

14. The medical system of claim 12, wherein the robot control unit and the system control unit are configured to exchange data.

15. The medical system of claim 9, further comprising a patient table, the patient table having a table top, wherein the patient table, the table top, or the patient table and the table top are actuatable, such that a movement relative to the movable recording system is executed.

16. The medical system of claim 14, further comprising a patient table, the patient table having a table top, wherein the patient table, the table top, or the patient table and the table top are actuatable, such that a movement relative to the movable recording system is executed.

17. The medical system of claim 9, further comprising a position-determining system, the position-determining system comprising at least one sensor, the at least one sensor being arranged on or assigned to the robotic system or the object, wherein the position-determining system is configured to determine a position of the object.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0019] FIG. 1 shows a sequence of acts of one embodiment of a method;

[0020] FIG. 2 shows a view of one embodiment of a medical system;

[0021] FIG. 3 shows a further sequence of acts of a method according to FIG. 1; and

[0022] FIG. 4 shows a view of one embodiment of a position-determining system with a sensor arranged on the object.

DETAILED DESCRIPTION

[0023] FIG. 1 shows acts of a method for automatically monitoring a robot-assisted movement of a medical object through a hollow organ of a patient performed by a robotic system. FIG. 2 shows a medical system 1 embodied to perform the method.

[0024] The medical system 1 has a robotic system and an imaging device (e.g., an X-ray device 10). The robotic system is configured to semi-automatically or automatically advance at least one object (e.g., an instrument, stent, guide wire 5, or catheter) in a hollow organ of a patient 15. Herein, semi-automatic actuation may, for example, be actuation that may be transmitted by an operator via an input unit 17 (e.g., a joystick, touchpad, rotary regulator, etc.) to a robot control unit 8. The robotic system has at least one robot control unit 8 and one robot-assisted drive system 7. The drive system 7 is configured to move the medical object (e.g., a guide wire 5) in a cavity organ of a patient 15 after the medical object has been introduced at an entry point 6 based on control signals from the robot control unit 8. Herein, the drive system 7 includes at least one drive and one drive mechanism (not shown; for example, known from EP 3406291 B1). The drive mechanism is detachably coupled to the guide wire 5, for example. The drive mechanism and the drive may be used to axially advance and withdraw the guide wire 5 and/or additionally move the guide wire 5 rotationally. The robot control unit 8 is connected to an input unit 17 (e.g., remote from the patient), which may be operated by an operator (e.g., a surgeon). The control signals are transmitted from the input unit 17 (e.g., one or more joysticks, touchpads, control buttons, etc.) to the robot control unit 8, and in this way, the movements of the object are actuated semi-automatically. Alternatively, the operator may plan a path for the object or have the path created automatically. This is transmitted to the robot control unit 8, thus enabling a fully automatic movement to take place. The path planning may also be used as a reference for a semi-automatic movement.

[0025] To obtain an overview of the intervention and the movement, the imaging device (e.g., an X-ray device 10) is provided. The X-ray device 10 has, for example, a C-arm 13 that holds an X-ray source 12 and an X-ray detector 11 and is connected to a system control 16. The C-arm 13 is arranged movably relative to the patient; in the case of a mobile X-ray device, it is also possible for the entire X-ray device to be moved. Alternatively or additionally, it is also possible for the patient table 14 or only the top 19 of the patient table 14 to be moved relative to the X-ray device or recording system. The X-ray device 10 enables images of a mappable recording region to be created and displayed on a display unit 18. The robot control unit 8 and the system control 16 of the imaging device enables data items to be exchanged bidirectionally and to communicate with each other. It is also possible for a common control including the robot control unit 8 and the system control 16 to be provided.

[0026] In the context of the method according to the present embodiments, the movements of the object are tracked NVV by the imaging. To enable the movements of the object through the hollow organ to be observed, it is important that the object and/or the hollow organ are always arranged at least partially in the recording region of the recording system of the imaging device. This may, for example, take place by way of a movement of the recording system along the path of the object and/or a movement of the patient table 14 relative to the recording system. The movements are actuatable by the system control of the X-ray device. There are various possibilities for accomplishing such tracking. For example, control signals from the robotic system may be forwarded from the robot control unit 8 to the system control 16 and used for, or at least included in, the tracking. It is also possible for path planning that has already been created to be used to control or optimize the tracking. It is also possible for additional position-determining systems to be used to determine the position of the object and used for the tracking. A position-determining system may determine the precise position of the object (e.g., using at least one sensor, such as a position sensor 21, see FIG. 4, on the object and an associated readout unit 22).

[0027] During the tracking NVV, at least one first image (e.g., a fluoroscopy image) of the recording region is recorded B1, where in each case a further image is recorded (B2 . . . BN) continuously or at regular intervals and, for example, also displayed on the display unit 18. The display unit 18 in each case displays the current image so that the operator is given an overview of the advance of the object. As soon as the first image has been recorded B1, the first image is displayed D1. When the second image has been recorded B2, the second image is displayed D2, etc. The image recorded in each case is also evaluated AW directly online to determine whether a situation relevant to decision-making and/or safety with respect to the robotic system is present. For this evaluation AW, the image is analyzed (e.g., with the aid of an image recognition system) to determine whether a branch, a bifurcation, a peculiarity, or an anomaly of the hollow organ is present. It is also possible for an analysis to be performed to determine whether a deviation of the path of the object from an existing path planning exceeds a certain (e.g., preset) threshold value and/or whether any other error tolerance is exceeded. In the case of the evaluation AW with respect to a situation relevant to decision-making and/or safety, as well as the images, it is also possible to include further data (e.g., from a position-determining system or another measuring system or sensor).

[0028] If the evaluation reveals a non-critical situation NC, the method is continued in that the tracking NVV and the recording Bk, display Dk, and evaluation AW of further images takes place (where k=1, 2, . . . , N).

[0029] If, after the recording BN of the Nth image, the evaluation reveals a situation relevant to decision-making and/or safety CRIT for this image, a control signal for aborting or interrupting UB the robot-assisted movement and the image recording is automatically output immediately. At the same time, the display DN of the Nth image is extended LIH until, for example, the acceptance of a user input IN to terminate the display or resume the method or until receipt of a control command to resume the robot-assisted movement and/or the image recording (see, e.g., FIG. 3). Therefore, a last image hold LIH takes place so that the critical Nth image remains visible to an operator until revoked. The last image hold LIH in each case takes place with the current image, the evaluation of which has revealed a critical situation or which has just been recorded or displayed (e.g., a critical situation was detected). In this way, the operator may appraise and analyze the critical situation in detail while the movements are not continued. This enables the operator to initiate measures to resolve the situation if necessary or simply to cancel the interruption UB of the robot-assisted movement and/or the method (e.g., by an input IN).

[0030] Also, it is possible for further signals to be output together with the interruption, such as, for example, optical, acoustic, or haptic warning signals. It is also possible for prompts or suggestions for certain actions to be output and displayed to the operator (e.g., a suggestion for contrast medium administration (when the situation relevant to decision-making and/or safety consisted in that the hollow organ was no longer recognizable on the image), a suggestion for path correction (when a threshold value for a path deviation from a planned path is exceeded), a suggestion for a branch (in the case of a bifurcation), or a suggestion that the movement be slowed down).

[0031] Optical, acoustic, or haptic signals may also be output during the tracking NVV without a situation relevant to decision-making and/or safety being present in order, for example, to provide information about the progress of the movement of the object or to display the precision of the control with regard to the planned path.

[0032] As an alternative to an X-ray device with a C-arm, it is also possible to use other image devices (e.g., a computed tomography unit or a magnetic resonance scanner).

[0033] The present embodiments may be briefly summarized as follows: for improved patient safety, a method is provided for automatically monitoring a robot-assisted movement of a medical object through a hollow organ of a patient performed by a robotic system. The method includes tracking the movement of the medical object by a medical imaging device such that the medical object and/or the hollow organ are at least partially arranged in the recording region that may be mapped by the imaging device. The tracking is effected by a relative movement between the recording system of the imaging device and the patient. At least one image of the recording region is recorded during the tracking. In each case, a further image is recorded at regular intervals. The current image in each case and/or sensor data from a sensor assigned to the robotic system or the object is evaluated to determine whether a situation relevant to decision-making and/or safety with respect to the robotic system is present. Information is output if the evaluation reveals a presence of a situation relevant to decision-making and/or safety.

[0034] The elements and features recited in the appended claims may be combined in different ways to produce new claims that likewise fall within the scope of the present invention. Thus, whereas the dependent claims appended below depend from only a single independent or dependent claim, it is to be understood that these dependent claims may, alternatively, be made to depend in the alternative from any preceding or following claim, whether independent or dependent. Such new combinations are to be understood as forming a part of the present specification.

[0035] While the present invention has been described above by reference to various embodiments, it should be understood that many changes and modifications can be made to the described embodiments. It is therefore intended that the foregoing description be regarded as illustrative rather than limiting, and that it be understood that all equivalents and/or combinations of embodiments are intended to be included in this description.