JP6889703B2 - 患者の3d表面画像を手術中に観察するための方法及び装置 - Google Patents
患者の3d表面画像を手術中に観察するための方法及び装置 Download PDFInfo
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Description
本出願は、2015年9月28日に出願の米国仮特許出願第62/233,543号明細書の利益を主張し、その内容は参照により全体として本明細書に組み込まれる。
患者の3D表面画像又はシミュレーションされた3D仮想モデルを処理して、外科手術中に使用される外科手術の参照又は計画を生成するステップと、
外科医による手術中観察のために、この画像若しくはモデルを患者に投影し、且つ/又はこの画像若しくはモデルを表示するステップと
を含む方法が提供される。
患者の3D表面画像又はシミュレーションされた3D仮想モデルを処理して、外科手術中に使用される外科手術の参照又は計画を生成するためのディジタルプロセッサと、
外科医による手術中観察のために、この画像若しくはモデルを患者に投影し、且つ/又はこの画像若しくはモデルを表示するための投影ユニットと
を含むシステムが提供される。
患者の3D表面画像又はシミュレーションされた3D仮想モデルを処理して、外科手術中に使用される外科手術の参照又は計画を生成するステップと、
外科医による手術中観察のために、この画像若しくはモデルを患者に投影し、且つ/又はこの画像若しくはモデルを表示するステップと
を含む方法を提供する。
患者の3D表面画像又はシミュレーションされた3D仮想モデルを処理して、外科手術中に使用される外科手術の参照又は計画を生成するためのディジタルプロセッサと、
外科医による手術中観察のために、この画像若しくはモデルを患者に投影し、且つ/又はこの画像若しくはモデルを表示するための投影ユニットと
を含むシステムを実現する。
3D表示装置の構成要素により、3D画像の観察、操作、及び解析が可能になるとともに、外科手術の手順においてアシスタント向けに外科医の視点を提供することが可能になる。これは、たとえば、IRカメラと、外科医のたとえば保護用アイウェア又はヘッドマウント上に配置される2つ以上のIR放射源と、動きを解析して対応する画像をレンダリングするためのコンピュータと、対応する画像を表示するための1つ又は複数のモニタとを含む赤外線(IR)追跡技術を使用することによって、実現することができる。任意選択的な装置には、とりわけ、コマンド用の音声センサ、スイッチとしての足踏みペダル、及び外科医に向いているカメラを取り囲むIR光源が含まれる。
[実施例]
顔面非対称が理由で自己脂肪移植(AFG)を受けている患者は、ハンドヘルドカメラ(VECTRA(登録商標)H1、Canfield Scientific,Inc(著作権)2013)を使用して撮影された手術前の3D写真を有していた。3Dモデルを2つの別個の半面に2等分する正中矢状面を作成することによって、顔面非対称を解析した。参照の半面が欠陥側に反映されて、新規の半合成体を作成し、これが参照3Dモデルの役割を果たした。次いで、Canfield VECTRA(登録商標)解析モジュール(VAM)ソフトウェアを使用して、患者画像に参照モデルを重ね合わせた。次に、カラーマップが生成され、これが2つの表面間の差を概略的に示した。その結果得られたカラーマップは、正常な半面と異常な半面との間の相対距離に応じて色付けされた、量が不足している境界が明瞭な領域であった。投影におけるこの差が滑らかな色の変化度によって表される。
次いで、手術前患者のマーキング用のテンプレートとしてディジタル3D組織分布マップを使用して、相対的な位置及び量が不足している度合いを外科医に提示した。マップは、pdfファイルとして保存され、モバイルプラットフォーム(iPhone 5s)にアップロードされ、ハンドヘルド型スマートフォン対応のLEDポケットプロジェクタ(axaa Technologies、米国)を使用して投影された。このiPhoneプロジェクタ構造体は、安定なハンズフリー投影のために、頭上の手術室ライトに固定されていた。プロジェクタライトのプラットフォームは、投影されたマップ上の重要な目印が患者の上に位置合せされるように配置された。次いで、このオーバーレイをガイドとして使用することにより、特定の投影値に割り当てられた色付きマーキングペンを使用してマップをトレースした。
このレポートは、外科手術のマーキングをガイドするのに使用される軟部組織のコンピュータ外科手術計画を説明するものである。外科医の評価だけに依存するのではなく、3D表面走査技術を適用して、物体の対称解析を実行した。投影された画像を使用して、仮想計画を変換してORに届けた。
Claims (8)
- 3次元(3D)患者画像の手術中観察のためのシステムであって、
患者の体表解剖学的構造の1つ又は複数の3D表面画像及び/又は3Dモデルを処理して、手術中に使用される3D組織分布マップを生成するように構成されたディジタルプロセッサと、
前記3D組織分布マップを前記患者に投影する、及び/又は、手術中の観察および操作のために前記3D組織分布マップを表示する、ように構成された少なくとも1つの機器と、を含み、
前記3D組織分布マップは、前記患者の体表解剖学的構造の所望の輪郭曲線および実際の輪郭曲線を代表する合成体であり、
前記輪郭曲線が前記患者に投影されるとき、及び/又は、観察および操作のために表示されるとき、前記合成体は、前記合成体のスケールおよび位置合わせをするために、前記患者の体表解剖学的構造上の目印と位置合わせされ、前記患者の体表解剖学的構造への意図された変更を表す離散した値を含む、システム。 - 前記3D表面画像を取得するための3Dカメラをさらに備える、請求項1に記載のシステム。
- 前記少なくとも1つの機器は、前記3D組織分布マップを表示するヘッドマウント型の装置を含む、請求項1に記載のシステム。
- 前記少なくとも1つの機器は、前記3D組織分布マップを、前記患者又は対象となる別の全体像を外科医が見る向きに対応するように方向付けして表示する、請求項1に記載のシステム。
- 前記3D表面画像の処理は、前記患者の体表解剖学的構造の解析を含み、前記患者の体表解剖学的構造の解析は、表面の目印及び/又は平面の測定、前記表面の目印及び/又は平面間の距離の測定、容積測定、及び/又は対称性解析を含む、請求項1に記載のシステム。
- 前記3D表面画像の処理は、単一画像の1つ若しくは複数の領域の比較、又は1つ若しくは複数の固有画像の比較を含む、請求項1に記載のシステム。
- 前記3D組織分布マップは、符号化され得るか、前記患者に投影され得るか、又は前記患者にマーキングされ得る、ガイドを含む、請求項1に記載のシステム。
- 前記3D組織分布マップの向きは、前記患者又は対象となる別の全体像に対する外科医の視点に対応するように調整される、請求項1に記載のシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201562233543P | 2015-09-28 | 2015-09-28 | |
US62/233,543 | 2015-09-28 | ||
PCT/US2016/053698 WO2017058710A1 (en) | 2015-09-28 | 2016-09-26 | Methods and devices for intraoperative viewing of patient 3d surface images |
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