INSTRUMENT PATH GUIDANCE USING VISUALIZATION AND FLUORESCENCE

Abstract

In a surgical method using a robotic system, a distal end of a robotically controlled surgical instrument is positioned in a patient body cavity. Operation of the instrument is controlled in response to input provided by a surgeon at an input device. An image of the interior of the body cavity is captured for display on a display. A boundary in the body cavity is identified using the image processing software by distinguishing between different colors on the image. In response to identification of the boundary, at least one of the following modes of operation is performed: providing a haptic contract at the surgeon console constraining movement of the surgical instrument to maintain the instrument along the boundary; preventing activation of an electrosurgical function of the instrument except with the instrument is within a defined distance from the boundary; allowing activation of an electrosurgical function of the instrument only when the instrument is positioned along the boundary

Claims

1. A surgical method, comprising: providing a robotic manipulator and a surgical instrument removably attached to the robotic manipulator, positioning a distal end of the surgical instrument in a patient body cavity and controlling operation of the instrument by providing input at a surgeon console; capturing an image of the body cavity for display on a display; identifying a boundary in the body cavity using the image processing software by distinguishing between different colors on the image; in response to identification of the boundary, performing at least one of the following: providing a haptic contract at the surgeon console constraining movement of the surgical instrument to maintain the instrument along the boundary; preventing activation of an electrosurgical function of the instrument except with the instrument is within a defined distance from the boundary; allowing activation of an electrosurgical function of the instrument only when the instrument is positioned along the boundary

2. The method of claim 1, where the image processing software uses the color or fluorescence of tissues within the operative view to define paths, objects or boundaries.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0008] FIG. 1 shows an exemplary surgical robot system with which the concepts described herein may be used.

[0009] FIG. 2 shows a screen capture of an image of a surgical site captured using a laparoscopic camera.

[0010] FIG. 3 shows a screen capture of an image of a surgical site as displayed on a display, and further shows an overlay generated on the display.

DETAILED DESCRIPTION

[0011] A first embodiment pairs a surgical robot system with a standard, off-the-shelf visualization system (such as Stryker or Olympus, etc.). The image processing equipment is designed to enable differentiation of objects within the field of view based on the RGB values. As an example, the FIG. 2 image is a screen capture from a laparoscopic cholecystectomy. Note the difference in the coloration of the liver tissue (bottom right) and the gallbladder tissue (top left). In accordance with one aspect of the present invention, the image processing equipment distinguishes between these two colors and defines an intersection path between the two tissues. The surgical system could use this intersection path for a multitude of features and operative modes. For example, in one mode of operation the monopolar hook could be haptically constrained with the tip at the intersection between the two tissues. This haptic constraint would help the surgeon to apply monopolar energy at exactly the right tissue plane, preventing gallbladder puncture or liver damage from electrocautery. The haptic constraint could act like a magnetonly exerting force when the instrument gets close to the defined path or object. This would allow the surgeon to freely move about the surgical field but feel the path or object when he is close.

[0012] A second mode would restrict use of an electrosurgical device, by preventing monopolar energy from being activated from the instrument unless the instrument was positioned to deliver that energy within a region bordering the identified intersection between the two tissues. This could also prevent undesired damage to adjacent tissue.

[0013] A third operative mode may enable boundaries based on tissue color identification. These boundaries may either keep surgical instruments within a given area (keep-in), or outside of a given area (keep-out). The surgical system would haptically prevent the user from moving instruments out of/into those regions, as applicable.

[0014] A second embodiment would enable the use of a surgical robotic system with an advanced visualization system (such as the one from Novadaq) equipped with fluorescence imaging technology. See the image below which illustrates a hidden structure that has been illuminated using a fluorescing dye, placed prior to the surgical intervention in the structure or blood stream. The image processing equipment would identify the presence of fluorescence and use the differentiation between the fluorescing object and surrounding tissue to identify paths or boundaries for the surgical robot. See FIG. 3. The modes of operation could be similar to those described in the primary embodiment.

[0015] The disclosed concepts are advantageous in that they define a path or region definition using visualization and tissue differentiation based on color or fluorescence. Operative modes for a surgical robot use the on paths or regions defined with the image processing equipment to, for example, prevent or allow certain types of activity, in some cases allowing the user to feel identified boundaries or paths via haptic constraints, attractions or repulsions. In some cases those modes that enable the use of instrument features the instrument is when near identified paths, objects or boundaries. Others disable the use of instrument features when the instrument is near identified paths, objects or boundaries.

[0016] It will be appreciated that the concepts described here may be used in conjunction with systems and modes of operation described in co-pending U.S. application Ser. No. 16/237,444, entitled System and Method for Controlling a Robotic Surgical System Based on Identified Structures which is incorporated herein by reference.