Surgical guidance system with low interference metal support structure

Abstract

In accordance with the invention, a reliable apparatus for guiding an ablation probe to a target location inside a human body is thus provided. The apparatus allows incorporation of a conventional metal operating room table, but further comprises a substantially non-conductive separation structure positioned over the metal operating room table and underneath a horizontally oriented electromagnetic field generator. The resultant structure is adapted to support a human body in the prone or supine position over the operating table. Further support padding may also be provided. The electromagnetic field generator creates an electromagnetic field that extends through the torso of said human body positioned over the electromagnetic field generator. An ultrasound probe and ablation probe interacts with the electromagnetic field to generate positional information that is processed by a computing device to generate a graphic representation of location information on a display device.

Claims

1. A system for guiding a medical instrument to a target location inside a human body, the system comprising: a non-conductive separation structure positionable on an operating room table, wherein the non-conductive separation structure comprises a base, a side wall that extends upwardly from the base, the base and side wall together defining a recess, and a cover member pivotably coupled to the side wall and configured to cover the recess when positioned in a closed configuration; an electromagnetic field generator configured to be accommodated within the recess of the non-conductive separation structure, wherein the non-conductive separation structure and electromagnetic field generator are configured to support a human body when disposed between the human body and the operating room table, the electromagnetic field generator configured to generate an electromagnetic field at least in the space above the electromagnetic field generator, whereby the electromagnetic field extends through a torso of the human body positioned over the electromagnetic field generator; a medical instrument configured to be positioned in a region of the torso; a position information component carried by the medical instrument, the position information component configured to interact with the electromagnetic field to generate medical instrument positional information; and a computing device configured to generate a graphic representation indicating a position of the medical instrument based on the medical instrument position information, wherein the graphic representation comprises an avatar of the medical instrument to be displayed on one or more display devices.

2. The system as in claim 1, wherein the non-conductive separation structure is made out of foam rubber.

3. The system as in claim 1, wherein the non-conductive separation structure is formed integrally with the electromagnetic field generator.

4. The system as in claim 1, wherein the non-conductive separation structure has a thickness in a range between 0.25 inches and 7.0 inches.

5. The system as in claim 1, wherein the non-conductive separation structure has a thickness in a range between 0.50 inches and 7.0 inches.

6. The system as in claim 1, further comprising cushioning disposed over the non-conductive separation structure.

7. The system as in claim 1, further comprising one or more removable features selected from the group consisting of a section configured to support a head of the human body; a section configured to support feet of the human body; and a section configured to support legs of the human body.

8. The system as in claim 1, wherein the electromagnetic field generator is orientated above and parallel to a plane defined by a surface of the operating room table.

9. The system as in claim 1, wherein the graphic representation comprises real-time correctional information for display on a display device.

10. The system as in claim 1, wherein the computing device is further configured to generate a guidance animation to be displayed on the one or more display devices.

Description

BRIEF DESCRIPTION THE DRAWINGS

(1) The operation of the invention will become apparent from the following description taken in conjunction with the drawings, in which:

(2) FIG. 1 is an isometric view of the inventive operating room tabletop field generator housing assembly as a part of an operating room table;

(3) FIG. 2 is an isometric view similar to the view of FIG. 1, but with the top face member removed for clarity of illustration, exposing internal components of the inventive system;

(4) FIG. 3 is an isometric view similar to that of FIG. 1 showing the top face member hinged open to allow placement of an electromagnetic field generator;

(5) FIG. 4 is an isometric view including the top cushions of the inventive table system and forming a completed assembly;

(6) FIGS. 5-7 illustrate components of the inventive system; and

(7) FIG. 8 is an isometric view illustrating the system of the invention In use.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

(8) Referring to FIGS. 1-4, with particular attention to FIG. 1, the inventive operating room table, which is particularly adapted for housing an electromagnetic field generator in a unitary assembly, may be understood. The operating room table assembly 10, which functions to house a tabletop electromagnetic field generator 12, has the overall shape, when assembled, of a rectangular solid as seen in FIG. 2. It may be supported on any suitable support, such as the platform formed by rectangular solid 14, as illustrated, or four table legs adapted to roll, for example, into and out of an operating room. Electromagnetic field generator 12 may be any commercial device in this class, including the Aurora system manufactured by Northern Digital Inc.

(9) Table assembly 10 comprises an operating table of, for example, conventional design. This may be a steel carriage with wheels or rectangular base support 14, supporting a platform member 16. Platform member 16 comprises a leg supporting portion 18 and a head supporting portion 20.

(10) In accordance with the preferred embodiment, platform member 16 is made of a rigid strong construction capable of supporting the human body and with a rigidity which enables leg supporting portion 18 to support the outstretched legs of an individual. In accordance with the construction of operating tables of the type which are commonly on the market, platform member 16 may be made of steel, for example steel supporting members having, for example, the configuration of cylindrical tubes, rectangular tubes, elongated orthogonal members joined along their length forming an L-beam, I-beam construction and so forth. If desired, leg supporting portion 18 and head supporting portion 20 may be made to rotate on a hinge, allowing them to rest hanging down in the vertical position. This allows the operating room table to take up minimal space when not in use. At the same time, means may be provided for such hinging leg and head supporting portions 18 and 20 to be locked in the horizontal position (as illustrated) to support the head and legs.

(11) In accordance with the invention, it is contemplated that support 14 and platform member 16 may together comprise a conventional operating room table. More particularly, it is one of the objects of the present invention to provide support structure to be used with a conventional operating table to enable use of an electromagnetic field generator while still preventing inaccuracies or other unreliability in the readings from the system associated with the electromagnetic field generator.

(12) The torso of the patient is supported by central portion 22. Referring to FIGS. 1 and 3, central portion 22 is designed to support electromagnetic field generator 12. Referring to FIGS. 5-7, central portion 22 supports a central support member 23. Central support member 23 includes a well 24 which is configured to receive electromagnetic field generator 12. The portion of central support member 23 which supports electromagnetic field generator 12 has a thickness 25 greater than ¼ inch, preferably greater than ½ inch and most preferably greater than three-quarters of an inch, although this thickness will vary depending on the characteristic of the electromagnetic field generator and other associated system components. A pair of steps 26 and 28 (FIG. 2) define the lengthwise limits of well 24, and have a height which substantially matches the thickness of electromagnetic field generator 12.

(13) A head support member 32 is positioned on one side of central support member 23 to provide support for the head of the patient. This allows central support member 23 to lie flat across steps 26 and 28, and electromagnetic field generator 12. As shown in FIG. 3, such placement may be facilitated by an optional hinge 33, which joins the main body portion of central support member 23 and top face member 36. Hinge 33 may be made of vinyl-coated fabric or any suitable material. A leg support member 30 is positioned on the opposite side of central support member 23 to provide comfortable support for the legs of the patient.

(14) In accordance with the invention, it is contemplated that support members 23, 30 and 32 will be made of relatively rigid material, such as a rigid foam plastic. Alternatively, foam plastic with relatively little flexibility, for example high density foam rubber may be used. However, lighter materials are preferred because they are easier to handle. In accordance with the invention, support members 23,30 and 32 are covered with a suitable outer covering, such as vinyl or other plastic material. While a textile may be used, a plastic covering is preferred because of the ease with which the same may be cleaned and because it serves as a barrier which prevents contamination of the internal support core members forming support members 23, 30 and 32.

(15) In accordance with a preferred embodiment of the invention, it is contemplated that a set of cushions will be put over support members 23, 30 and 32. Such cushions are secured to their respective support members by mating strips of Velcro® hook and loop adhesion fabric which are adhered to the facing sides of the support members and their respective cushions. More particularly, adhesion fabric strips 34 are secured to the top face 36 of central support member 23. Similarly, adhesion fabric strips 40 and 38 are secured to head and leg support members 32 and 30, respectively.

(16) In similar fashion, head support member 32 is secured to central support member 23 by adhesion fabric 42 on head support member 32 and adhesion fabric 44 on central support member 23. Leg support member 30 is secured to central support member 23 by adhesion fabric 46 on leg support member 30 and adhesion fabric 48 on central support member 23. Likewise, the rigidity and stability of the structure may be insured by including mating adhesion fabric strips at all interfaces between support members and other support members, cushions and other cushions and interfaces between cushions and support members.

(17) More particularly, the inventive table assembly 10 may include a head cushion 50, a central cushion 52 and a leg cushion 54, thus completing the structure of the inventive operating table 56. Head cushion 50, central cushion 52 and leg cushion 54 may be made of any suitable cushioning material, such as flexible foam rubber, flexible foam plastic or any other material suitable for cushioning, bedding or other flexible support. In accordance with the invention, it is contemplated that head cushion 50, central cushion 52 and leg cushion 54 will be made of a more flexible, softer material then central, head and leg support members 23, 32 and 30. The requirement for cushions 50-54 is of a soft feeling cushioning member. On the other hand the requirements for central, leg and head support members 23, 30 and 32 are for no or low flexibility as their primary function is to support electromagnetic field generator 12 in a desired position.

(18) As alluded to above, when it is desired to use the inventive system, support members 23,30 and 32 are placed on a conventional operating table, with the various elements optionally but preferably held together by Velcro® type joining members. Next, top face member 36 is hinged upwardly to the position shown in FIG. 3, by putting the fingers through cutout 56 and pulling upwardly against indentation 58 (FIG. 6). Electromagnetic field generator 12 is then placed in position as illustrated. Top face member 36 is hinged downwardly over electromagnetic field generator 12 to the position illustrated in FIG. 1. The assembly is then ready to receive the head cushion 50, central cushion 52 and leg cushion 54 which are secured in place by Velcro® type joining members, as detailed above. The system then takes the configuration shown in FIG. 4, and is ready to receive patient 60 as illustrated in FIG. 8.

(19) Referring to FIG. 8, the operation of the inventive operating room patient supporting table housing an electromagnetic field generator housing assembly 10 may be understood. A patient 60 may be positioned in the supine position lying on the operating room table above the electromagnetic field generator 12 such that the torso 62 of patient 60 is positioned directly above the horizontal field generator 12. When turned on, the horizontal field generator 12 produces an electromagnetic field 64 which is used in the generation of position and orientation information in three dimensions. A probe 66, for example an ablation probe 66, is inserted into, for example, the insufflated abdominal cavity of patient 60. Probe 66 carries a number of position information components, for example position detectors 68, which may be coupled to a computer 70. Computer 70 produces an image of a target location, an image of the physiology (for example, a physiological image generated by an ultrasound probe 74, where ultrasound probe position and orientation is detected by detectors 76) an image of probe 66 on monitor 72 together with an image of the physiology. A transducer 68, which may be mounted on or contained within probe 66 interacts with horizontal field generator 12, through electromagnetic field 64, generates signals corresponding to a set of positional information coupled to computer 70. The positional information is interpreted by a computer 70 which then displays images of probe 66 (or optionally an avatar representing the state of a critical functionality) and positional information on the physiological structure of interest on monitor 72.

(20) Thus, computer 70 combines the ultrasound probe positional information with the ablation probe positional information to generate an image which can be combined with a target avatar, to create a guidance animation which may be displayed in addition to and/or instead of image information on computer monitor 72. In accordance with the invention, guidance system animation and/or images are viewed by the surgeon during a procedure, for the purpose of assisting with the manipulation of ablation probe 66 and ultrasound probe 74.

(21) After an operation has been completed, the various components of the operating table may be removed and stored separately, and the operating table used in a conventional fashion until the inventive system is again required or desired.

(22) Modifications of the particular structures disclosed are within the intended scope of the invention. The compartment forming support members 23,30 and 32 may be made from foam material as disclosed above in accordance with a preferred embodiment, or alternatively, plastic, wood, or a non-conductive composite material.

(23) While illustrative embodiments of the invention have been described, it is noted that various modifications will be apparent to those of ordinary skill in the art in view of the above description and drawings. Such modifications are within the scope of the invention which is limited and defined only by the following claims.