PATIENT BEARING SYSTEM, A ROBOTIC SYSTEM

Abstract

A patient bearing system and a robotic system are disclosed. The patient bearing system includes a patient bearing and at least one ultrasound transducer with an ultrasound head at least partly located in the patient bearing and being spatially located to transmit ultrasound signals to a target space. The ultrasound head is at least partly located in the patient bearing. The robotic system includes a patient bearing system and a robot configured for at least partly operate the system and the computer system is programmed for performing image acquisitions and analysis of a body part at least partly located in target space.

Claims

1-90. (canceled)

91. A patient bearing system comprising: a patient bearing configured to support at least a body part of a patient and including a bearing surface configured to be in physical contact with a body surface of the body part; at least one ultrasound transducer at least partly located in the patient bearing and configured to transmit ultrasound signals to a target space comprising a region adjacent to the bearing surface; and a computer system in data communication with the at least one ultrasound transducer, the computer system configured to generate location data characterizing a location of the at least one ultrasound transducer.

92. The patient bearing system of claim 91, wherein the at least one ultrasound transducer includes a transducer head, and wherein the generated location data characterizes a location of the transducer head.

93. The patient bearing system of claim 92, wherein the location data characterizes the location of at least one of the at least one ultrasound transducer or the transducer head relative to a reference node.

94. The patient bearing system of claim 93, wherein the reference node comprises at least one of a predefined site of the bearing system, a site defined by a reference element located in the target space, and a site defined by an operator input.

95. The patient bearing system of claim 93, further comprising a localization sensor in data communication with the computer system and configured to determine the location of at least one of the at least one ultrasound transducer and the transducer head relative to the reference node.

96. The patient bearing system of claim 92, wherein the computer system is configured to generate a virtual scene associated to a virtual coordinate system and representing at least a portion of the target space at least partly located within a distance of up to about 0.5 m from the transducer head.

97. The patient bearing system of claim 96, wherein the ultrasound transducer is configured to acquire ultrasound echo signals from the target space and to transmit the acquired ultrasound echo signals to the computer system, and wherein the generation of the virtual scene comprises generating image data representing the virtual scene from the acquired ultrasound echo signals.

98. The patient bearing system of claim 96, wherein the virtual scene is correlated to an actual scene comprising at least the portion of the target space, and wherein the virtual scene is correlated to a camera-acquired scene of the actual scene.

99. The patient bearing system of claim 98, wherein the computer system is configured to generate the virtual coordinate system and to correlate the virtual coordinate system to an actual coordinate system associated with the actual scene.

100. The patient bearing system of claim 96, wherein the computer system is configured for generating ultrasound images from the image data representing the virtual scene and for projecting the ultrasound images to generate a visual virtual scene.

101. The patient bearing system of claim 91, wherein the patient bearing comprises a main bearing portion adapted to support at least a torso of a patient, and wherein the at least one ultrasound transducer is disposed in the main bearing portion.

102. The patient bearing system of claim 101, wherein the patient bearing comprises at least one articulated arm coupled to the main bearing portion, and wherein at least one further ultrasound transducer is at least partly located in the articulated arm.

103. The patient bearing system of claim 102, wherein the further ultrasound transducer includes a further ultrasound transducer head, wherein the further ultrasound transducer head is at least partly located in or at an extremity of the articulated arm.

104. The patient bearing system of claim 103, wherein the further ultrasound transducer head faces outward from the articulated arm.

105. The patient bearing system of claim 96, wherein the at least one ultrasound transducer is physically connected to a spatial adjustment arrangement that is configured to adjust the spatial location of the transducer head.

106. The patient bearing system of claim 105, wherein the spatial adjustment arrangement comprises at least one of a telescopic leg, an articulated leg, and a pneumatically adjustable leg and wherein at least one of the telescopic leg, the articulated leg, and the pneumatically adjustable leg is engaged with or fixed to the at least one ultrasound transducer.

107. The patient bearing system of claim 105, wherein the spatial adjustment arrangement is configured to adjust at least one of the location of the transducer head relative to the patient bearing surface, an orientation of the transducer head relative to the patient bearing surface, and/or an orientation of the transducer head relative to a surface of a body part supported by the patient bearing surface.

108. The patient bearing system of claim 92, wherein the bearing system comprises an applicator arrangement configured to apply a coupling medium onto a front portion of the transducer head, the applicator arrangement comprising a coupling medium reservoir and at least one supply channel extending from the coupling medium reservoir to the front portion of the transducer head and configured to supply the coupling medium to the front portion of the transducer head.

109. The patient bearing system of claim 91, wherein the bearing system comprises a solid coupling medium cover, wherein the solid coupling medium cover comprises a cover layer of an elastomeric polymer, the elastomeric polymer comprising one or more of natural rubber, silicone rubber, cross-linked hydrophilic polymer, a hydrogel, and an alcogel.

110. The patient bearing system of claim 105, wherein the spatial adjustment arrangement is in data communication with and is controllable by the computer system.

111. The patient bearing system of claim 98, wherein the computer system is configured for displaying at least one view of the virtual scene onto a display together with or in a side by side with or in shifted vision with displaying the camera acquired scene of the actual scene correlated to the virtual scene.

112. A patient bearing, comprising: a bearing surface configured to be in physical contact with a body surface of a body part of a patient; and at least one ultrasound transducer disposed at the bearing surface and configured to transmit an ultrasound signal to a target space adjacent to the bearing surface.

113. The patient bearing of claim 112, wherein the at least one ultrasound transducer comprises a transducer head, the transducer head configured to transmit the ultrasound signal in a cone-shaped beam pattern.

114. The patient bearing of claim 113, wherein a shape of a periphery of the transducer head is one of rectangular, round, and oval.

115. The patient bearing of claim 113, wherein the transducer head and the bearing surface are located in a common plane.

116. The patient bearing of claim 113, wherein the transducer head protrudes relative to the bearing surface and is configured to be in physical contact with the body surface of the body part of the patient.

117. The patient bearing of claim 113, wherein the at least one ultrasound transducer is mounted on a spatial adjustment arrangement configured to adjust a spatial location of the transducer head.

118. The patient bearing of claim 117, wherein the spatial adjustment arrangement comprises a telescopic leg configured to adjust the spatial location of the transducer head such that a desired level of contact of the transducer head with the body surface of the body part of the patient is achieved.

119. The patient bearing of claim 112, wherein at least a portion of the bearing surface is tiltable.

120. The patient bearing of claim 112, wherein a first portion of the bearing surface protrudes relative to a second portion of the bearing surface.

121. The patient bearing of claim 117, wherein the bearing surface is malleable and has a shape that is configured to be altered by the spatial adjustment arrangement.

122. The patient bearing of claim 113, wherein the transducer head comprises a frame including one or more contact sensors, the one or more contact sensors configured to determine whether the transducer head is in contact with the body surface of the body part of the patient.

Description

BRIEF DESCRIPTION

[0191] The above and/or additional objects, features and advantages of the present invention will be further elucidated by the following illustrative and non-limiting description of embodiments of the present invention, with reference to the appended drawings.

[0192] The figures are schematic and are not drawn to scale and may be simplified for clarity. Throughout, the same reference numerals are used for identical or corresponding parts.

[0193] FIG. 1 shows an embodiment of a bearing system.

[0194] FIG. 2 is a perspective view of a patient bearing of a patient bearing system of an embodiment.

[0195] FIG. 3 is a cross sectional view of a patient bearing and a computer system forming part of a patient bearing system of an embodiment.

[0196] FIG. 4 is a cross sectional view of a patient bearing of a patient bearing system of an embodiment.

[0197] FIGS. 5a and 5b illustrate an ultrasound transducer of an embodiment.

[0198] FIG. 6 is a perspective view of a patient bearing of a patient bearing system of an embodiment.

[0199] FIGS. 7a and 7b illustrate a patient bearing of an embodiment supporting a body part.

[0200] FIG. 8 illustrates a robotic system of an embodiment.

[0201] FIGS. 9a and 9b illustrate a patient bearing system of an embodiment in use.

[0202] FIGS. 10a and 10b illustrate a further patient bearing system of an embodiment in use.

[0203] FIGS. 11a and 11b illustrate a patient bearing system comprising reference markers of an embodiment in use.

[0204] FIG. 12 illustrates a bearing system of an embodiment in use.

[0205] FIG. 13 illustrates a robotic system of an embodiment in use.

[0206] FIG. 14 is a process diagram of an operation step of a patient bearing system of an embodiment.

[0207] FIG. 15 is a schematic view of a patient bearing of an embodiment supporting a body part and comprising an articulated arm.

[0208] FIG. 16 is a schematic view of another patient bearing of an embodiment supporting a body part and comprising an articulated arm.

[0209] FIG. 17 is a schematic view of a patient bearing of an embodiment comprising a main section and an articulating section.

[0210] The patient bearing system shown in FIG. 1 comprises a patient bearing 1 for supporting at least a body-part of a patient. Advantageously, the patient bearing is adapted to support the entire body of a patient. The patient bearing 1 comprises a bearing surface 2 adapted to be in physical contact with a body surface of a body-part supported by the patient bearing. The patient may advantageously be positioned with his or her body in contact with the bearing surface 2.

[0211] The patient bearing system comprises at least one ultrasound transducer 3 and a computer system 6 in data communication with the ultrasound transducer 3. The ultrasound transducer 3 is at least partly located in the patient bearing 1 and is spatially located to transmit ultrasound signals 4 to a target space, here illustrated with the arrows 5. The target space comprises an area of space adjacent to the bearing surface 1.

[0212] In this embodiment the computer system 6 is illustrated as a single computer with a screen 6a, however as explained above the computer system 6 may comprise a single computer or a plurality of computers in data communication, wireless, by wire and/or via the internet. Advantageously, the computer system comprises a central computer and optionally one or more satellite processors and/or memories for storing data.

[0213] The computer system is in data communication with the ultrasound transducer, for receiving data from the ultrasound transducer and for controlling one or more spatial parameters and/or one or more beam parameters.

[0214] The patient bearing may be stationary or it may have wheels (not shown) or a wheel arrangement, such as a hospital bed or an ambulance stretcher.

[0215] The patient bearing 11 of FIG. 2 comprises a bearing surface 12 adapted to be in physical contact with a body surface of a body-part supported by the patient bearing, and a plurality of ultrasound transducers 13 are at least partly located in the patient bearing 11 and spatially located to transmit ultrasound signals to a target space.

[0216] The ultrasound transducers are illustrated to have a rectangular periphery at their transducer head front. However, the ultrasound transducer head front may have any other peripheral shape, such as round or oval. The ultrasound transducer head front is shown to be located in plan with the bearing surface 12. In variations, the head front may be protruding relative to the bearing surface 12 to provide a good contact to a surface area of the body part located onto the bearing surface 12.

[0217] The plurality of ultrasound transducers 13 may be located in the patient bearing 11 to form any desired pattern of ultrasound transducer head fronts at and/or protruding from the bearing surface 12, such as in rows and lines or located in groups.

[0218] FIG. 3 illustrates a patient bearing 21, with a bearing surface 22 seen in a cross sectional cut through a portion of the patient bearing 21 comprising a number of ultrasound transducers 23 with respective head fronts 23a. The ultrasound transducers 23 are mounted on the patient bearing 21 onto a spatially adjustment arrangement 24 for adjusting the spatial location of said transducer head front 23a. The spatial adjustment arrangement 24 comprises respective telescopic legs 24a connected to each of the respective ultrasound transducers 23, for individual adjustment of the spatial location of the respective transducer head fronts 23a. The telescopic legs 24a may be articulated and/or slightly resilient for ensuring a desired contact of the respective transducer head fronts 23a to a surface area of a body part located onto the bearing surface 22. In this embodiment, the adjustment arrangement 24 also houses a wire 26b for data communication between the ultrasound transducers 23 and the computer system 26.

[0219] FIG. 4 illustrates an example of a patient bearing 31 of a patient bearing system of an embodiment in cross sectional view. The patient bearing comprises a number of sections along its length, designated a first end section 31a, a mid-section 31b and a second end section 31c. The patient bearing 31 comprises a number of ultrasound transducers 33 at least partly located in the patient bearing 31. The ultrasound transducers 33 are connected to a spatial adjustment arrangement 34, for spatially adjusting the ultrasound transducers 33 within and relative to the patient bearing 31.

[0220] In the first and second end sections 31a, 31c the bearing surface 32 is substantially flat. In the mid-section 31b, the bearing surface 32 protrudes above the bearing surface 32 at the first and second end sections 31a, 31c. This protrusion may be provided as a pre-shaped protruding surface of the patient bearing 31 or it may be malleable to ensure that the head front of the ultrasound transducers 33 are in physical contact with or is capable of coming into physical contact with the relevant body part of the patient. A malleable bearing surface 32 may, for example, be shaped as desired by the spatial adjustment arrangement 34 pushing up the bearing surface 32 by the ultrasound transducer 33 at the mid section 31b.

[0221] Advantageously the bearing surface 32 is dynamically pliant and formable by the spatially adjustment arrangement 34.

[0222] FIG. 5a illustrates the ultrasound transducer 43 in a cross-sectional side view. Only the head 43b of the ultrasound transducer 43 is shown in details.

[0223] The ultrasound transducer head 43b comprises a piezoelectric ceramic element 43c, not shown, electrodes, and one or more lenses (not shown). The transducer head may comprise other elements, such as damping element(s) and matching layer.

[0224] FIG. 5b illustrates the ultrasound transducer 43 in a top view. The transducer head fronts 43a comprise a surrounding frame comprising a number of contact sensors 43d, e.g., as described above, such as operating by impedance measurement. The frame also comprises a coupling medium applicator arrangement comprising two oppositely arranged coupling medium secretors 43e. Supply channels (not shown) are positioned so as to supply coupling medium from a coupling medium reservoir to the transducer head front 43a.

[0225] The patient bearing 51 of FIG. 6 comprises four bearing portions 51a, 51b, 51c, 51d. Bearing portions 51a, 51b, 51c, 51d may be tilted and/or separated from each other. Three of the bearing portions, e.g., 51a, 51b, 51c, comprise ultrasound transducers 53 at least partly located in the respective bearing portions 51a, 51b, 51c, whereas the fourth of the bearing portion, e.g., 51d, does not comprise any ultrasound transducers but merely serves to support the patient.

[0226] The total patient bearing 51 may in an embodiment be formed from a plurality of individual patient bearing portions that are modular. This modularity provides flexibility to obtain a final patient bearing having the ultrasound transducers located at desired locations relative to the body portion to be supported and monitored and/or subjected to surgery and/or the surgical procedure to be performed.

[0227] FIGS. 7a and 7b illustrate a patient bearing 61 having a bearing surface 62 that includes a tilting arrangement 66 that is configured to tilt the patient bearing 61.

[0228] As illustrated, a patient 65, with head 65a is supported by the bearing surface 61.

[0229] In FIG. 7a, the patient bearing 61 is in a horizontal and non-tilted orientation, with the patient 65 lying on the bearing surface 62 with his or her back in contact with the bearing surface 62.

[0230] The tilting arrangement 66 comprises a central hinge 66a and a rigid swing element 66b connected to the patient bearing, so that the swing element can swing around the hinge 66a to thereby tilt the patient bearing as shown in FIG. 7b.

[0231] The robotic system shown in FIG. 8 comprises a patient bearing 71 having bearing surface 72 adapted to be in physical contact with a body surface of a body-part supported by the patient bearing 71 and a plurality of ultrasound transducers 73 are at least partly located in the patient bearing 71 and spatially located to transmit ultrasound signals to a target space. The robotic system comprise four articulated robot arms 74, each comprising a not shown end effector. The respective end effectors are located at the end of the robot arms 74a and are here illustrated to hold respective instruments 75. Each instrument 75 comprises a proximal end 75a and a distal end 75b. The respective instruments 75 may comprise respective tools at their distal ends 75b, e.g., for performing a surgical procedure. The skilled person will understand that the robotic system may comprise any number of articulated robot arms.

[0232] The robot arms 74 are physically coupled to the patient bearing 71 and in addition, the ultrasound transducers 73 as well as the robot arms 74 are in data communication and are advantageously controllable by the computer system. Thereby the relative spatial location between the respective robot arms 74, including the instruments 75 mounted to the respective robot arms 74 and the respective ultrasound transducers, are known to the computer system and the computer system may thereby provide a very accurate correlation between actual and virtual scene and thereby a highly accurate operation of the robot arms 74 and their respective instruments 75 based on the image data of the virtual scene.

[0233] FIG. 9a shows a side view of a patient lying on and supported by a patient bearing 81 comprising a number of ultrasound transducers 83 arranged in three transverse rows, where a first row comprises a single ultrasound transducer and where each row of transducers may be operated individually from each other.

[0234] FIG. 9b shows a transverse sectional view “B”. The ultrasound transducer 83 is configured to emit ultrasound signals to a target space T. The higher concentration of the ultrasound signals are in a cone shaped space C and the body part of the patient to be examined is advantageously located in this cone shaped space. The VS portion of the target space is advantageously selected to be a portion or all of the cone shaped space. The ultrasound transducer 83 is configured to acquire ultrasound echo signals from the VS portion of the target space and the acquired signals are transmitted the computer system. The computer system is configured to generate a virtual scene associated to a virtual coordinate system and representing the VS portion of the target space. The virtual coordinate system may be as described above. The virtual scene comprises data representing images or image segments for the corresponding actual scene. In this example, the computer system is programmed to perform a virtual sectioning in the virtual scene to generate data representing images of consolidated lung tissue of the patient. The image data is transmitted to the screen 86a to be displayed.

[0235] FIG. 10a shows a side view of a patient lying on and supported by a patient bearing 91 comprising a number of ultrasound transducers 93 arranged in three transverse rows, where a middle row comprises a three ultrasound transducers and where each row of transducers may be operated individually from each other.

[0236] FIG. 10b shows a transverse sectional view “B”. The ultrasound transducers 93 are configured to emit ultrasound signals to a target space T. The higher concentration of the ultrasound signals are in cone shaped spaces C in front of the respective ultrasound transducer 93. These cone shaped spaces are overlapping and provide together a large area of space with a high beam concentration suitable of providing the VS space from where the echo signals for the virtual scene is collected. The computer system 96 moves the VS space and thereby shifts the virtual scene that represents echo data from the VS space, within this cone shaped spaces C, e.g., upon instructions from an operator to thereby examine locations of the body part within these cone shaped spaces or even within the entire target space. However, the VS space typically is a space of a desired high concentration of ultra sound waves. Thus, the computer system may sectioning through the cone shaped spaces C or even through the entire target space by moving the VS scene, and thereby the operator may perform an excellent scanning of the body part.

[0237] The computer system is configured to generate a virtual scene associated to a virtual coordinate system and representing the VS portion of the target space. In the present example, the computer system has moved the VS space and thereby shifted the virtual scene until a tumor was observed, and thereafter the computer system has performed a 3D segmenting of the tumor to determine shape and size of the tumor. These data obtained in the virtual scene comprises location attributes representing the relatively pose to the virtual coordinate system. The virtual coordinate system is correlated to an actual coordinate system and thereby the computer system may also identify the pose (location and orientation) of the tumor based on the image data of the virtual scene.

[0238] The image data is transmitted to the screen 96a for being displayed. In the screen 96b, the patient tumor is visualized by zoom in the left image and in a 3D visualization in the right image.

[0239] The patient bearing system of FIGS. 11a and 11b corresponds to the patient bearing system of FIGS. 10a and 10b, with the difference that the patient bearing system of FIGS. 11a and 11b comprises a plurality of reference markers 97a, 97b, such a reference nodes e.g., as described above. The reference markers comprises a plurality of reference markers 97a located on the patient bearing and a plurality of reference markers 97b located on the patient. The computer system 96 may be in data communication with said respective reference markers for determining their relative location. In addition, the patient bearing system comprises a pair of camera detectors 97c located for visually determine the relative location of one or more of the reference markers 97a, 97b and for acquire actual image of the patient and for providing a patient reference overview of the virtual scene anatomy location.

[0240] The image data is transmitted to the screen 96a for display. On the screen 96b, the patient tumor is visualized by zoom in the left image and in a 3D visualization in the right image. In the left side view, the virtual images of the tumor may be projected onto a camera acquires actual scene or onto a computer modeled actual scene comprising a human anatomical model constructed by the computer system from the plurality of sensors 97a, 97b and optionally pre-operative data.

[0241] The patient bearing system illustrated in FIG. 12 is in use for providing a visual perception during a minimally invasive surgery procedure. The patient bearing system comprises a patient bearing 101, with a bearing surface 102 and a plurality of ultrasound transducers 103 at least partly located in the patient bearing 101. The patient bearing comprises at least a pair of reference markers 107.

[0242] A patient 108 is lying with his or her back in contact with the bearing surface 102. The patient bearing 101 and the patient 108 are shown in a transverse cross sectional view through the abdominal region of the patient. The surgical cavity 108a is filled with gas to make space for performing the minimally invasive surgery procedure. The ultrasound transducers 103 are individually controlled by the not shown computer system of the patient bearing system e.g., with respect to at least one of a spatially parameter, such as location and/or orientation and/or at least one beam parameter, such as diameter (footprint), wavelength, frequency, focus location, depth penetration, pulse rate and/or diverging angle, to provide that the higher concentration of ultrasound signals, with a desired penetration depth are provided to result in echo signals from the target space comprising the surgical site 108b of the patient and provided by the combined cone shaped spaces C. As illustrated, the individual cone shaped spaces C may differ, due to the individual regulation of the ultrasound transducers 103.

[0243] Two minimally invasive surgical instruments 105, each having a proximal end 105a and a distal end, are partially inserted into the surgical cavity 108b via cannula ports (not shown), with their respective proximal ends 105a outside the surgical cavity 108a and their respective distal ends 105b inside the surgical cavity 108a. A surgical tool (not shown) is located at the respective distal ends 105b of each if the surgical instruments. Exemplary surgical tools include a grasper, a suture grasper, a stapler, forceps, a dissector, scissors, suction instrument, clamp instrument, electrode, curette, ablators, scalpels, a biopsy instrument, retractor instrument, and combinations thereof.

[0244] In addition, a camera instrument 109 with a proximal end 109a and a distal end 109b is inserted into the surgical cavity 108a with its proximal end 109a outside the surgical cavity 108a and its distal end 109b carrying camera elements (not shown) located in the surgical cavity 108a to acquire images of the actual surgical site 108b of the patient 108. The camera element is in data communication with and, ideally, controllable by the computer system.

[0245] The minimally invasive surgical instruments 105 may be manually or robotic maneuvered by an operator via their respective proximal ends 105a. The camera instrument 109 may be stationary or it may be automatically maneuvered by the computer system or maneuvered by the operator via its proximal end 109a.

[0246] Each of the surgical instruments 105 and the camera instrument 109 comprises a pose element P at each of their respective proximal and distal ends 105a, 105b, 109a, 109b. The pose elements P have the function of determining, in real time, the pose of the instruments 105, 109. The respective pose elements P may, individually, be a sensor (e.g., a motion sensor and/or a position sensor determining position relative to a node), or a marker (such as a fiducial marker), a tag or a node. Each of the pose elements located outside the surgical cavity 108a are advantageously a sensor or a tag. The pose elements located inside the surgical cavity 108a, especially the pose elements of the surgery instruments 105, may be markers, such as fiducial markers or nodes observable via the camera. The pose elements P may advantageously be in data communication directly or via another element, such as the camera element, with the computer system.

[0247] In operation, the computer system generates a virtual scene associated to a virtual coordinate system and representing a VS portion of the combined cone shaped spaces C of the target space. The computer system is gradually shifting the virtual scene (and thus moving the VS space) along a desired path in the combined cone shaped spaces C. In this example, this imaging procedure revealed tumor. Thereafter the computer system performed a virtual image 3D segmentation of the tumor and registration of organ subsurface structures and determined shape and size of the tumor as well as location and orientation of the tumor.

[0248] The image data, and optionally data representing subsurface structures, shape, size, location and orientation of the tumor are transmitted to the screen 106a for display. On the screen 106a the camera acquired images of the actual scene are shown in real time and the virtual scene is augmented inside the camera acquired actual scene.

[0249] The robotic system illustrated in FIG. 13 comprises the patient bearing system of FIG. 12 and a number of robot arms 104 configured to maneuver the minimally invasive surgery instruments 105. The robot arms 104 are controlled by the computer system at least partly based on the image data acquired in the virtual scene.

[0250] FIG. 14 illustrates a procedure for detecting and imaging a critical structure in a body part of a patient using a robotic system.

[0251] In step A the computer system determines the ultrasound transducers (and their head fronts) relative pose to a node located in a known location at or relative to the patient bearing. This determination may be performed before and/or after the body part is positioned onto the bearing surface of the patient bearing and may be performed each time any of the ultrasound transducers has bees spatially adjusted. The computer system may additionally preset the beam parameters for the respective ultrasound transducer, e.g., in dependence of an operator input for the imaging procedure to be performed e.g., via a database comprising preferred beam parameter settings for respective imaging procedures.

[0252] In step B, The computer system begins to generate the virtual scene.

[0253] In step C, pose of robotic arms is moved under control of the computer system and the pose of the robotic arms is constantly known and controlled by the computer system based on the robotic arms being coupled, such as physically coupled to the bearing.

[0254] In step D, the computer system is constantly registering and controlling pose between robotic arms and pose of surgical tool and camera location.

[0255] In step E, the computer system is constantly registering surgical instrument pose and surgical surface relative to patient bearing e.g., a node located in a known location at or relative to the patient bearing.

[0256] In step F, the computer system is shifting the virtual scene to comprise desired spatial fractions of the target space as a function of time, such as to shift the virtual scene gradually or continuously along a selected path of the target space. Thereby a surgeon or the computer system may shift the virtual scene to desired locations and/or locations having selected properties, e.g., densities, hue, structure etc. Thereby the computer system may identify a critical structure, such as a tumor, a vessel or an ureter.

[0257] In step G, the computer system the computer system is processing the image data of the virtual scene for determining pose of the respective digital represented image segments and thereby segmenting a selected location comprising critical structure, determining pose, structure, shape and size of critical structure and registering the critical structure relative to actual space.

[0258] In step G, image data and optionally data representing subsurface structures, shape, size, location and orientation of the critical structure are transmitted to a screen for being displayed as an augmented virtual scent onto an actual image acquired by a camera.

[0259] In an embodiment, the step G is replaced with or comprises additionally that the computer system is making the surgeon aware—e.g., by sound or visually (such as by a depiction)—of a nearby critical structure when getting closing to the critical structure and/or the computer system provides a visual and/or acoustic navigation path to operate near or at the critical structure (e.g., tumor resection margin).

[0260] It should be noted, that the steps A-H may be provided in another sequence or order and/or two or more steps may be provided simultaneously and/or may be repeated.

[0261] The patient bearing 111 shown in FIG. 15 comprises an articulated arm 114, which may be as the robotic arms described above with the difference that an ultrasound transducer 115 is mounted to the articulated arm 114 at a far end of the articulated arm 114 relative to the patient bearing 111. In the shown embodiment a patient 116 is supported by the patient bearing 111 to provide that a body part is at least partly in the target space and the computer system is configured for moving the the articulated arm 114 to obtain a desired ultrasound scan from the body part from an angle that is different from the image angle of the ultrasound transducer(s) at least partly located in the patient bearing 111. The image data and/or ultrasound echo signal data obtained from the ultrasound transducer 115 outside the patient bearing 111, may be applied in the data processing together with the ultrasound echo signal data of the ultrasound transducer at least partly located in the patient bearing 111, e.g., for generating the virtual scene. Alternatively, the image data and/or ultrasound echo signal data obtained from the ultrasound transducer 115 outside the patient bearing 111 may be processed separately from the ultrasound echo signal data of the ultrasound transducer at least partly located in the patient bearing 111.

[0262] The patient bearing 111 shown in FIG. 16 comprises an articulated arm 124, which may be as the robotic arms described above with the difference that an ultrasound transducer 125 is mounted to the articulated arm 124 at a distance to the patient bearing 121. In the shown embodiment a patient 126 is supported by the patient bearing 121 to provide that a body part is at least partly in the target space and the computer system is configured for moving the the articulated arm 124 to tilt it relative to the patient bearing 121 to provide a desired contact between the ultrasound transducer 125 and a body part of the patient to provide that ultrasound images may be obtained from the body part from an angle that is different from the image angle of the ultrasound transducer(s) at least partly located in the patient bearing 121. The image data and/or ultrasound echo signal data obtained from the ultrasound transducer 125 outside the patient bearing 121, may be applied as the image data and/or ultrasound echo signal data obtained from the ultrasound transducer 115 described in FIG. 15

[0263] The patient bearing 131a, 131b shown in FIG. 17 comprises first section 131a and a second section 131b (also referred to as main section and limb section), which are tiltable relative to each other. In the shown embodiment the first section 131a of the patient bearing comprises an ultrasound transducer 135a at least partly located therein and the second section 131b comprises an ultrasound transducer 135b at least partly located therein.

[0264] Preferably, the bearing system comprises a plurality of ultrasound transducer at least partly incorporated in each of the first and second sections 131a, 131b. This plurality of ultrasound transducer have not been drawn into the illustration but may be as described and/or illustrated elsewhere herein.

[0265] In use, the first section 131a was initially not tilted with respect to the second section 131b to provide that the bearing surface was substantially plane. The patient has laid down onto both the first and second sections 131a, 131b and thereafter the computer system—e.g., upon instruction from a user, such as a surgeon—has tilted the first section 131a relative to the second section to provide that the body portion in the target space may be imaged using the ultrasound transducers 135a, 135b embedded in the respective first and second sections 131a, 131b of the patient bearing. Thereby, image data and/or ultrasound echo signal data may be obtained from different angles using the ultrasound transducers 135a, 135b. This skilled person will realize that this may result in a high resolution, accurate and high quality imaging.