REGISTERED INSTRUMENT MOVEMENT INTEGRATION
Systems and method are disclosed whereby elongate medical instruments may be registered to adjacent tissue structures and other structures, and may be navigated and operated in a coordinated fashion to maximize ranges of motion, ease of use, and other factors. A method for registering an instrument relative to nearby structures may comprise moving a portion of the instrument between two in situ positions, tracking movement during this movement with both a kinematic model and also a localization sensor based configuration, determining the orientation of the tracked portion relative to both the instrument coordinate system used in the kinematic modeling and also a localization coordinate reference frame, and adjusting the orientation of the instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors. Methods and configurations for navigating coupled and registered instrument sets are also disclosed.
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The present application claims the benefit under 35 U.S.C. §119 to U.S. Provisional Patent application Ser. No. 61/116,454, filed Nov. 20, 2008. The foregoing application is hereby incorporated by reference into the present application in its entirety.
FIELD OF THE INVENTIONThe invention relates generally to remotely steerable medical instrument systems, such as telerobotic surgical systems, and more particularly to registration and navigation of such systems in a three-dimensional environment adjacent tissue and other structures, in furtherance of minimally invasive diagnostic and therapeutic procedures.
BACKGROUNDMinimally invasive medical techniques often rely on steerable elongate instruments, such as steerable catheters, to conduct procedures. One of the challenges in conducting diagnostic and/or interventional cases with minimally invasive instruments is understanding wherein pertinent medical instrumentation is located and/or oriented related to nearby tissue structures and other instrumentation. Imaging modalities such as radiography, fluoroscopy, and ultrasound may not be ideally suited for understanding the detailed positioning and orientation of instruments in real or near-real time. For example, it is possible to use multiple planes and/or imaging field of view perspectives with modalities such as fluoroscopy to determine the location and orientation of instrumentation that shows up in the images relative to anatomy which also is featured in the images—but multiplanar imaging may not be convenient or accurate enough to facilitate realtime navigation of minimally invasive instruments through various anatomical spaces. Further, it is possible to utilize kinematic models of instruments to understand the positions and orientations of portions of such instruments, but compliance, control mechanism slack, repositioning, and other factors may lead to the desire to recalibrate kinematic-based position and/or orientation models relative to the actual anatomy from time to time. Embodiments are presented herein to address these and other challenges.
SUMMARYOne embodiment is directed to a method for navigating a coupled instrument set, comprising registering an instrument set, comprising a first instrument having a first instrument workspace, movably coupled to a second instrument having a second instrument workspace, relative to a three-dimensional map of nearby anatomical structures; presenting an operator with a user interface configured to allow for selection of various anatomical destinations wherein operation of the instrument set is desired; and upon selection of an anatomical destination by an operator, assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination. Registering an instrument set may comprise registering the instrument set relative to a master input device an operator display; and registering the instrument set relative to a three-dimensional map of nearby anatomical structures. Registering the instrument set relative to a three-dimensional map of nearby anatomical structures may comprise navigating the registered instrument set to one or more known anatomical landmarks also featured on the three-dimensional map of nearby anatomical structures, and aligning the map with the instrument workspace of one or more of the instruments comprising the instrument set. Registering the instrument set may comprise registering the first instrument relative to a master input device and operator display, then registering the second instrument relative to the first instrument. Registering an instrument set may comprise moving a portion of the first instrument between a first position in situ and a second position in situ relative to a first instrument coordinate reference frame; tracking movement of the portion relative to the first instrument coordinate reference frame using a kinematic model, and also tracking movement of the portion relative to a localization coordinate reference frame using one or more localization sensors coupled to the portion; determining the orientation of the portion relative to both the first instrument coordinate reference frame and the localization coordinate reference frame; and adjusting the orientation of the first instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors. Presenting an operator with a user interface configured to allow for selection of various anatomical destinations may comprise presenting the operator with a set of menu driven software selections, presenting the operator with a set of hardware interfaces associated with various anatomical destinations, or presenting the operator with a map of anatomical destinations which may be selected using a master input device. Assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination may comprise limiting commanded movement to movement along a single path. In one embodiment the single path is a line. In another embodiment the single path is a curved path. Limiting commanded movement may comprise imparting haptic feedback to the operator through a haptic master input device. Limiting commanded movement may comprise providing a haptic groove feedback configuration to the operator. Limiting commanded movement may comprise providing a gravity well feedback configuration to the operator. Assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination may comprise limiting commanded movement to movement along a single plane. Limiting commanded movement may comprise imparting haptic feedback to the operator through a haptic master input device. Assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination may comprise avoiding contact between the first or second instruments and certain predetermined anatomical zones of preferred contact avoidance. Avoiding contact may comprise imparting haptic feedback to the operator through a haptic master input device. Assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination may comprise automatically navigating the first and second instrument to the selected anatomical destination. Automatically navigating may comprise taking into account predetermined movement limitations of the first and second instrument. Automatically navigating may comprise taking into account predetermined anatomical contact limitations. Assisting the operator in repositioning the instrument set may comprise sequentially assisting the operator in repositioning one of the first or second instruments toward the selected anatomical destination, then assisting the operator in repositioning the remaining one of the first or second instruments toward the selected anatomical destination. The first and second instruments may be coaxially and movably coupled to one another, and subsequent to positioning of the first, the second may be advanced along the path of the first. The first and second instruments may comprise robotically navigable catheters, and assisting the operator in repositioning the instrument set may comprise electromechanically navigating the first instrument toward the selected anatomical destination, and subsequently following the path established by the first instrument with electromechanical advancement of the second instrument. The first instrument may be repositioned to the selected anatomical destination before movement of the second. The first and second instruments may be alternately and incrementally positioned toward the selected anatomical destination in a plurality of sequences.
Another embodiment is directed to a method for navigating a coupled instrument set, comprising registering an instrument set, comprising a first instrument having a first instrument workspace, movably coupled to a second instrument having a second instrument workspace, relative to a three-dimensional map of nearby anatomical structures; presenting an operator with a user interface configured to allow the operator to input navigation commands of the first instrument relative to nearby anatomical structures; and upon input of a navigation command by an operator for the first instrument, moving the first instrument as commanded, while also moving the second instrument so as to keep the first instrument close to a preferred portion of the workspace of the first instrument by repositioning the second instrument. Registering an instrument set may comprise registering the instrument set relative to a master input device an operator display; and registering the instrument set relative to a three-dimensional map of nearby anatomical structures. Registering the instrument set relative to a three-dimensional map of nearby anatomical structures may comprise navigating the registered instrument set to one or more known anatomical landmarks also featured on the three-dimensional map of nearby anatomical structures, and aligning the map with the instrument workspace of one or more of the instruments comprising the instrument set. Registering the instrument set may comprise registering the first instrument relative to a master input device and operator display, then registering the second instrument relative to the first instrument. Registering an instrument set may comprise moving a portion of the first instrument between a first position in situ and a second position in situ relative to a first instrument coordinate reference frame; tracking movement of the portion relative to the first instrument coordinate reference frame using a kinematic model, and also tracking movement of the portion relative to a localization coordinate reference frame using one or more localization sensors coupled to the portion; determining the orientation of the portion relative to both the first instrument coordinate reference frame and the localization coordinate reference frame; and adjusting the orientation of the first instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors. The method may further comprise secondarily moving the second instrument so as to keep the second instrument as close to a preferred portion of the workspace of the second instrument by repositioning the second instrument. Current positions of the instrument workspaces for the first and second instruments may be illustrated in a user interface relative to the instrument set and nearby anatomical structures. In one embodiment the preferred portion of the workspace of the first instrument may be the center of said workspace. In another embodiment the preferred portion of the workspace of the first instrument may be a forward-oriented conical volume of said workspace. In one embodiment the preferred portion of the workspace of the second instrument may be the center of said workspace. In another embodiment the preferred portion of the workspace of the second instrument may be a forward-oriented conical volume of said workspace. The first and second instruments are coaxially coupled. In one embodiment the second instrument may be moved so as to keep the first instrument close to the preferred portion of the workspace of the first instrument only after the first instrument crosses a threshold of misalignment with the preferred portion of the workspace.
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In another embodiment, the exact opposite pattern may be conducted, with the inner instrument (81) starting in a curved position, then retracted, or “autoretracted” back toward the outer instrument (79) distal tip (62). This order of events may be advantageous because retraction is generally a safe, noninterfering maneuver relative to other surrounding structures, such as tissue structures, and also because particularly with “autoretract” functionality, the trajectory generally is a straight line when projected in the XZ plane, as illustrated in
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In one very simplified embodiment, alignment could be conducted based on a much smaller set of data—such as two data points: one data point from a fully retracted inner instrument position, and one data point from an extended and curved inner instrument configuration. This embodiment would, of course, be more prone to inaccuracy due to noise in such a small dataset.
Subsequent to having a reliable line fitted through each of the kinematic-based data and the localization-based data, an orientation difference between the kinematic-based data coordinate system (the instrument coordinate reference frame—48) and the localization-based data coordinate system (the localization coordinate reference frame—46) may be determined, and this difference may be treated as an error in the orientation of the instrument coordinate reference frame (48) which may be minimized by reorienting the instrument coordinate reference frame (48). Subsequent to such minimization, the two coordinate systems should be registered, “aligned”, or “calibrated” relative to each other, and navigation of the instrument assembly (42) relative to the updated/reoriented instrument coordinate reference frame (48) should produce more predictable movements relative to other related coordinate systems and structures registered thereto.
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Such registration embodiments may be broadly applied. For example, in one embodiment, they may be applied to an instrument configuration comprising a localized intravascular ultrasound (“IVUS”) catheter coupled to another steerable catheter, such as through the working lumen of such steerable catheter. A localization sensor coupled to the IVUS catheter, and a kinematic model, may be used as described above to conduct movements and register the IVUS catheter and steerable catheter to various coordinate reference frames, to allow for coordinated, “instinctive” navigation relative to the coordinate systems of, for example, a master input device and/or display upon which IVUS and other images may be presented to the operator.
Having registered an instrument set to other pertinent coordinate systems and structures which are registered or aligned thereto, many intraoperative instrument coordination paradigms may be facilitated. Some of these are illustrated in
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In another embodiment, a shape representing the desired region of the second instrument's workspace may be modeled as an implicit surface, and rendered haptically using haptic implicit surface algorithms—and the direction of the resultant force may be used as the direction in which to move the first instrument. Such force direction may be altered if the motion of the first instrument is desired to be constrained in some way; for example, in one embodiment, it may be projected onto an instrument roll plane to prevent adding torque.
While multiple embodiments and variations of the many aspects of the invention have been disclosed and described herein, such disclosure is provided for purposes of illustration only. For example, wherein methods and steps described above indicate certain events occurring in certain order, those of ordinary skill in the art having the benefit of this disclosure would recognize that the ordering of certain steps may be modified and that such modifications are in accordance with the variations of this invention. Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially. Accordingly, embodiments are intended to exemplify alternatives, modifications, and equivalents that may fall within the scope of the claims.
Claims
1. A method for navigating a coupled instrument set, comprising:
- a. registering an instrument set, comprising a first instrument having a first instrument workspace, movably coupled to a second instrument having a second instrument workspace, relative to a three-dimensional map of nearby anatomical structures;
- b. presenting an operator with a user interface configured to allow for selection of various anatomical destinations wherein operation of the instrument set is desired; and
- c. upon selection of an anatomical destination by an operator, assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination.
2. The method of claim 1, wherein registering an instrument set comprises:
- a. registering the instrument set relative to a master input device an operator display; and
- b. registering the instrument set relative to a three-dimensional map of nearby anatomical structures.
3. The method of claim 2, wherein registering the instrument set relative to a three-dimensional map of nearby anatomical structures comprises navigating the registered instrument set to one or more known anatomical landmarks also featured on the three-dimensional map of nearby anatomical structures, and aligning the map with the instrument workspace of one or more of the instruments comprising the instrument set.
4. The method of claim 2, wherein registering the instrument set comprises registering the first instrument relative to a master input device and operator display, then registering the second instrument relative to the first instrument.
5. The method of claim 1, wherein registering an instrument set comprises:
- a. moving a portion of the first instrument between a first position in situ and a second position in situ relative to a first instrument coordinate reference frame;
- b. tracking movement of the portion relative to the first instrument coordinate reference frame using a kinematic model, and also tracking movement of the portion relative to a localization coordinate reference frame using one or more localization sensors coupled to the portion;
- c. determining the orientation of the portion relative to both the first instrument coordinate reference frame and the localization coordinate reference frame; and
- d. adjusting the orientation of the first instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors.
6. The method of claim 1, wherein presenting an operator with a user interface configured to allow for selection of various anatomical destinations comprises presenting the operator with a set of menu driven software selections, presenting the operator with a set of hardware interfaces associated with various anatomical destinations, or presenting the operator with a map of anatomical destinations which may be selected using a master input device.
7. The method of claim 1, wherein assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination comprises limiting commanded movement to movement along a single path.
8. The method of claim 7, wherein the single path is a line.
9. The method of claim 7, wherein the single path is a curved path.
10. The method of claim 7, wherein limiting commanded movement comprises imparting haptic feedback to the operator through a haptic master input device.
11. The method of claim 10, wherein limiting commanded movement comprises providing a haptic groove feedback configuration to the operator.
12. The method of claim 10, wherein limiting commanded movement comprises providing a gravity well feedback configuration to the operator.
13. The method of claim 1, wherein assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination comprises limiting commanded movement to movement along a single plane.
14. The method of claim 13, wherein limiting commanded movement comprises imparting haptic feedback to the operator through a haptic master input device.
15. The method of claim 1, wherein assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination comprises avoiding contact between the first or second instruments and certain predetermined anatomical zones of preferred contact avoidance.
16. The method of claim 15, wherein avoiding contact comprises imparting haptic feedback to the operator through a haptic master input device.
17. The method of claim 1, wherein assisting the operator in repositioning the instrument set such that the first instrument workspace and second instrument workspace are optimized relative to the selected anatomical destination comprises automatically navigating the first and second instrument to the selected anatomical destination.
18. The method of claim 17, wherein automatically navigating comprises taking into account predetermined movement limitations of the first and second instrument.
19. The method of claim 17, wherein automatically navigating comprises taking into account predetermined anatomical contact limitations.
20. The method of claim 1, wherein assisting the operator in repositioning the instrument set comprises sequentially assisting the operator in repositioning one of the first or second instruments toward the selected anatomical destination, then assisting the operator in repositioning the remaining one of the first or second instruments toward the selected anatomical destination.
21. The method of claim 20, wherein the first and second instruments are coaxially and movably coupled to one another, and wherein subsequent to positioning of the first, the second may be advanced along the path of the first.
22. The method of claim 21, wherein the first and second instruments comprise robotically navigable catheters, and wherein assisting the operator in repositioning the instrument set comprises electromechanically navigating the first instrument toward the selected anatomical destination, and subsequently following the path established by the first instrument with electromechanical advancement of the second instrument.
23. The method of claim 22, wherein the first instrument is repositioned to the selected anatomical destination before movement of the second.
24. The method of claim 22, wherein the first and second instruments are alternately and incrementally positioned toward the selected anatomical destination in a plurality of sequences.
25. A method for navigating a coupled instrument set, comprising:
- a. registering an instrument set, comprising a first instrument having a first instrument workspace, movably coupled to a second instrument having a second instrument workspace, relative to a three-dimensional map of nearby anatomical structures;
- b. presenting an operator with a user interface configured to allow the operator to input navigation commands of the first instrument relative to nearby anatomical structures; and
- c. subsequent to input of a navigation command by an operator for the first instrument, moving the first instrument as commanded, while also moving the second instrument so as to keep the first instrument close to a preferred portion of the workspace of the first instrument by repositioning the second instrument.
26. The method of claim 25, wherein registering an instrument set comprises:
- a. registering the instrument set relative to a master input device and operator display; and
- b. registering the instrument set relative to a three-dimensional map of nearby anatomical structures.
27. The method of claim 26, wherein registering the instrument set relative to a three-dimensional map of nearby anatomical structures comprises navigating the registered instrument set to one or more known anatomical landmarks also featured on the three-dimensional map of nearby anatomical structures, and aligning the map with the instrument workspace of one or more of the instruments comprising the instrument set.
28. The method of claim 26, wherein registering the instrument set comprises registering the first instrument relative to a master input device and operator display, then registering the second instrument relative to the first instrument.
29. The method of claim 25, wherein registering an instrument set comprises:
- a. moving a portion of the first instrument between a first position in situ and a second position in situ relative to a first instrument coordinate reference frame;
- b. tracking movement of the portion relative to the first instrument coordinate reference frame using a kinematic model, and also tracking movement of the portion relative to a localization coordinate reference frame using one or more localization sensors coupled to the portion;
- c. determining the orientation of the portion relative to both the first instrument coordinate reference frame and the localization coordinate reference frame; and
- d. adjusting the orientation of the first instrument coordinate reference frame to minimize the difference between determined orientations using the kinematic model and localization sensors.
30. The method of claim 25, further comprising secondarily moving the second instrument so as to keep the second instrument as close to a preferred portion of the workspace of the second instrument by repositioning the second instrument.
31. The method of claim 25, wherein the current positions of the instrument workspaces for the first and second instruments are illustrated in a user interface relative to the instrument set and nearby anatomical structures.
32. The method of claim 25, wherein the preferred portion of the workspace of the first instrument is the center of said workspace.
33. The method of claim 25, wherein the preferred portion of the workspace of the first instrument is a forward-oriented conical volume of said workspace.
34. The method of claim 30, wherein the preferred portion of the workspace of the second instrument is the center of said workspace.
35. The method of claim 30, wherein the preferred portion of the workspace of the second instrument is a forward-oriented conical volume of said workspace.
36. The method of claim 25, wherein the first and second instruments are coaxially coupled.
36. The method of claim 25, wherein the second instrument is moved so as to keep the first instrument close to the preferred portion of the workspace of the first instrument only after the first instrument crosses a threshold of misalignment with the preferred portion of the workspace.
Type: Application
Filed: Jul 22, 2009
Publication Date: May 20, 2010
Applicant: Hansen Medical, Inc. (Mountain View, CA)
Inventors: Neal A. Tanner (Mountain View, CA), Christopher M. Sewell (Sunnyvale, CA)
Application Number: 12/507,766
International Classification: A61B 19/00 (20060101);