Soft body automatic registration and surgical monitoring system

Abstract

A surgical hardware and software monitoring system and method allows for surgical planning while the patient is available for surgery, for example while the patient is being prepared for surgery so that the system may model the surgical site. In one embodiment, the model may be used to track contemplated surgical procedures and warn the physician regarding possible boundary violations that would indicate an inappropriate location in a surgical procedure. In another embodiment, the monitoring system may track the movement of instruments during the procedure and in reference to the model to enhance observation of the procedure. In a further embodiment the monitoring system can be used to model and track the changes in the surgical site itself.

What is claimed is: 
     
         1 . A method for real time monitoring the position of an object in relation to a surgical site of a patient, the method comprising the steps of:
 removably attaching a fiducial reference to a fiducial location on the patient proximate the surgical site;   performing a scan with the fiducial reference attached to a fiducial location to obtain scan data;   determining the three-dimensional location and orientation of the fiducial reference from the scan data;   obtaining real time image information of the surgical site;   determining in real time the three-dimensional location and orientation of the fiducial reference from the image information;   deriving a spatial transformation matrix for expressing in real time the three-dimensional location and orientation of the fiducial reference as determined from image information in terms of the three-dimensional location and orientation of the fiducial reference as determined from scan data;   determining in real time the three-dimensional location and orientation of the object from the image information; and   relating the three-dimensional location and orientation of the object to the three-dimensional location and orientation of the fiducial reference as determined from the image information.   
     
     
         2 . The surgical monitoring method of  claim 1  wherein the fiducial reference is configured in at least one of marked and shaped for having at least one of its location and its orientation determined from the scan data. 
     
     
         3 . The surgical monitoring method of  claim 1  wherein the fiducial reference is configured in at least one of marked and shaped to allow the fiducial reference to be uniquely identified from the scan data. 
     
     
         4 . The surgical monitoring method of  claim 1  further comprising a tracking marker in fixed three-dimensional spatial relationship with the fiducial reference, wherein the tracking marker is configured for having at least one of its location and its orientation determinable based on the image information and the scan data. 
     
     
         5 . The surgical monitoring method of  claim 4  further comprising a first tracking pole, wherein the tracking marker is configured to be removably and rigidly connected to the fiducial reference by the first tracking pole. 
     
     
         6 . The surgical monitoring method of  claim 5  wherein that the first tracking pole has a three-dimensional structure uniquely identifiable by the controller from the image information. 
     
     
         7 . The surgical monitoring method of  claim 5  wherein the first tracking pole has a three-dimensional structure allowing for three-dimensional orientation to be determinable from image information. 
     
     
         8 . The surgical monitoring method of  claim 5  wherein the first tracking pole and fiducial reference are configured to allow the first tracking pole to connect to a single unique location on the fiducial reference in a first single unique three-dimensional orientation. 
     
     
         9 . The surgical monitoring method of  claim 5  wherein the fiducial reference is configured for the attachment in a single second unique three-dimensional orientation of at least a second tracking pole attached to a second tracking marker. 
     
     
         10 . The surgical monitoring method of  claim 5  wherein the first tracking marker has a three-dimensional shape uniquely identifiable by the controller from image information. 
     
     
         11 . A method for tracking in real time changes in a surgical site, the method comprising the steps of:
 removably attaching a multi-element fiducial reference to a fiducial location on the patient body proximate the surgical site, the multi-element fiducial reference comprising a plurality of pattern segments individually locatable based on scan data;   performing a scan with the fiducial reference attached to the fiducial location to obtain the scan data;   determining the three-dimensional locations and orientations of at least a selection of the pattern segments based on the scan data; obtaining real time image information of the surgical site;   determining in real time the three-dimensional locations and orientations of the at least a selection of the pattern segments from the image information; and   deriving in real time the spatial distortion of the surgical site by comparing in real time the three-dimensional locations and orientations of the at least a selection of the pattern segments as determined from the image information with the three-dimensional locations and orientations of the at least a selection of the pattern segments as determined from the scan data.   
     
     
         12 . The surgical tracking method of  claim 11  wherein the marker pattern includes a multi-element fiducial pattern comprising a plurality of pattern segments and every one of said plurality of segments is individually configured for having a segmental three-dimensional location and orientation determinable based on scan data of the surgical site, and for having the segmental three-dimensional location and orientation determinable based on image information about the surgical site. 
     
     
         13 . The surgical tracking method of  claim 12  wherein the plurality of pattern segments have unique differentiable shapes that allow the determining step to identify them uniquely from at least one of scan data and image information. 
     
     
         14 . The surgical tracking method of  claim 12  further comprising tracking markers attached to at least a selection of the pattern segments, the tracking markers having at least one of identifying marks and orientation marks that allow their three-dimensional orientations to be determined by the controller from the image information. 
     
     
         15 . The surgical monitoring system of  claim 12  wherein the determining step further calculates the locations of anatomical features in the proximity of the multi-element fiducial pattern. 
     
     
         16 . The surgical tracking method of  claim 12  further comprising tracking markers attached to at least a selection of the pattern segments, the tracking markers having at least one of identifying marks and orientation marks that allow their three-dimensional orientations to be determinable from the image information. 
     
     
         17 . The surgical monitoring system of  claim 14  wherein the determining step finds the locations and orientations of at least a selection of the pattern segments based on image information and scan data. 
     
     
         18 . The surgical monitoring system of  claim 14  wherein the determining step further calculates the locations of anatomical features in the proximity of the multi-element fiducial pattern.