Granted Patent B2

US 10,806,518 · App. 16/238,504 · Granted Oct 20, 2020

Inventor: Derek Amanatullah (Palo Alto, CA)

Assignee: Arthrology Consulting, LLC

A61B34/10A61B5/0037A61B5/0064A61B5/4528A61B5/7425A61B17/1703A61B17/175A61B17/1764A61B90/37G09B23/28A61B17/155A61B17/157A61B2034/102A61B2034/104A61B2034/105

Abstract

Claims (148)

1. A method for tracking and adapting to deviations from surgical plans comprising:

accessing a virtual patient model defining a target resected contour of a hard tissue of interest;

during a first period of time succeeding resection of the hard tissue of interest within a surgical operation:

accessing a first sequence of optical scans recorded by an optical sensor facing a surgical field occupied by a patient;

detecting a set of features representing the patient in the first sequence of optical scans;

registering the virtual patient model to the hard tissue of interest in the surgical field based on the set of features; and

detecting an actual resected contour of the hard tissue of interest in the first sequence of optical scans;

calculating a spatial difference between the actual resected contour of the hard tissue of interest detected in the first sequence of optical scans and the target resected contour of the hard tissue of interest represented in the virtual patient model registered to the hard tissue of interest in the surgical field;

presenting the spatial difference to a surgeon during the surgical operation;

labeling the spatial difference with a post-operative outcome of the patient;

storing the spatial difference in a database with a corpus of spatial differences labeled with patient outcomes for a set of instances of the surgical operation within a population of patients; and

deriving a correlation between outcomes and spatial differences between actual resected contours of the hard tissue of interest and target resected contours of the hard tissue of interest within the population of patients.

2. The method of claim 1 :

further comprising, during an initial period of time preceding the first period of time and succeeding incision of the patient proximal the hard tissue of interest:

accessing an initial sequence of optical scans recorded by the optical sensor;

detecting an unresected contour of the hard tissue of interest in the initial sequence of optical scans; and

registering virtual hard tissue features defined in the virtual patient model to the unresected contour of the hard tissue of interest; and

detecting the set of features, on the patient and proximal the hard tissue of interest, in the initial sequence of optical scans;

further comprising deriving a spatial relationship between the set of features and the virtual patient model based on registration of the virtual patient model to the hard tissue of interest; and

wherein registering the virtual patient model to the hard tissue of interest in the surgical field based on the set of features during the first period of time comprises registering the virtual patient model to the hard tissue of interest based on the spatial relationship and the set of features detected in the first sequence of optical scans.

3. The method of claim 2 , further comprising:

calculating an absolute spatial difference between the actual resected contour of the hard tissue of interest detected in the first sequence of optical scans and the unresected contour of the hard tissue of interest;

labeling the absolute spatial difference with a post-operative outcome of the patient;

storing the absolute spatial difference with a second corpus of absolute spatial differences labeled with patient outcomes for the set of instances of the surgical operation within the population of patients; and

deriving a second correlation between outcomes and absolute spatial differences between actual resected contours of the hard tissue of interest and unresected contours of the hard tissue of interest within the population of patients.

4. The method of claim 3 :

wherein deriving the second correlation between outcomes and spatial differences comprises deriving the second correlation between:

successful recoveries within the population of patients; and

absolute spatial differences between actual resected contours of the hard tissue of interest and unresected contours of the hard tissue of interest within the population of patients; and

further comprising, for a second instance of the surgical operation planned for a second patient, generating a recommended absolute spatial difference between actual resected contours of the hard tissue of interest and unresected contours of the hard tissue of interest in the second patient, during the second instance of the surgical operation, based on the correlation.

5. The method of claim 2 :

wherein accessing the virtual patient model comprises accessing the virtual patient model defining a virtual representation of a generic unresected contour of the hard tissue of interest and a virtual representation of a generic target resected contour of the hard tissue of interest;

wherein registering virtual hard tissue features defined in the virtual patient model to the unresected contour of the hard tissue of interest comprises:

calculating a best-fit location that minimizes error between the virtual representation of the generic unresected contour of the hard tissue of interest and the unresected contour of the hard tissue of interest detected in the initial sequence of optical scans;

morphing the virtual representation of the generic unresected contour of the hard tissue of interest in the virtual patient model into conformity with the unresected contour of the hard tissue of interest detected in the initial sequence of optical scans; and

morphing the virtual representation of the generic resected contour of the hard tissue of interest in the virtual patient model into conformity with the virtual representation of the generic unresected contour of the hard tissue of interest in the virtual patient model.

6. The method of claim 2 , wherein accessing the virtual patient model comprises:

accessing the virtual patient model comprising a virtual representation of the unresected contour of the hard tissue of interest;

during the initial period of time, receiving a command from the surgeon specifying a set of target resection parameters for the hard tissue of interest; and

projecting the set of target resection parameters onto the virtual representation of the unresected contour of the hard tissue of interest to define the target resected contour of the hard tissue of interest; and

storing the target resected contour of the hard tissue of interest in the virtual patient model.

7. The method of claim 1 :

further comprising, prior to the surgical operation:

accessing a pre-operative scan of the hard tissue of interest of the patient;

extracting a virtual representation of the unresected contour of the hard tissue of interest from the pre-operative scan;

generating a virtual representation of the target resected contour of the hard tissue of interest based on the virtual unresected contour of the hard tissue of interest and a pre-operative surgical plan defined by the surgeon;

compiling the virtual representation of the unresected contour of the hard tissue of interest and the virtual representation of the target resected contour of the hard tissue of interest into the virtual patient model; and

storing the virtual patient model, in association with the patient, in a database; and

wherein accessing the virtual patient model comprises, during the surgical operation, accessing the virtual patient model from the database.

8. The method of claim 1 , further comprising:

during the first period of time:

prompting the surgeon to confirm intent of the spatial difference; and

in response to confirmation of intent of the spatial difference from the surgeon, prompting the surgeon to provide a reason for the spatial difference; and

in response to receipt of the reason from the surgeon, recording the spatial difference, confirmation of intent of the spatial difference, and the reason in the database and in association with the surgical operation.

9. The method of claim 1 , further comprising:

detecting insufficient material removal from the hard tissue of interest based on the spatial difference;

in response to detecting insufficient material removal from the hard tissue of interest, serving a prompt to the surgeon to remove additional material from the hard tissue of interest;

during a second period of time succeeding a second resection of the hard tissue of interest within the surgical operation:

accessing a second sequence of optical scans recorded by the optical sensor;

detecting the set of features representing the patient in the second sequence of optical scans;

registering the virtual patient model to the hard tissue of interest in the surgical field based on the set of features; and

detecting a second actual resected contour of the hard tissue of interest in the second sequence of optical scans;

calculating a second spatial difference between the second actual resected contour of the hard tissue of interest detected in the second sequence of optical scans and the target resected contour of the hard tissue of interest represented in the virtual patient model registered to the hard tissue of interest in the surgical field; and

presenting the second spatial difference to the surgeon.

10. The method of claim 1 :

wherein accessing the virtual patient model comprises accessing the virtual patient model defining the target resected contour of the hard tissue of interest and defining a second target resected contour of a second hard tissue of interest adjacent the hard tissue of interest;

further comprising:

detecting excessive material removal from the hard tissue of interest based on the spatial difference;

in response to detecting excessive material removal from the hard tissue of interest, modifying the second target resected contour of a second hard tissue of interest to compensate for excessive material removal from the hard tissue of interest.

11. The method of claim 10 :

wherein accessing the virtual patient model comprises accessing the virtual patient model defining the target resected contour of the hard tissue of interest comprising a femur and defining a second target resected contour of a second hard tissue of interest comprising a tibia;

wherein calculating the spatial difference comprises detecting a spatial difference between actual resection of a femoral condyle of the patient and target resection of the femoral condyle of the patient;

wherein detecting excessive material removal from the hard tissue of interest comprises detecting resection of excessive material from the femoral condyle of the patient; and

wherein modifying the second target resected contour of the second hard tissue of interest to compensate for excessive material removal from the hard tissue of interest comprises reducing magnitude of resection of a tibial plateau of the patient to compensate for excessive material removal from the femoral condyle of the patient.

12. The method of claim 1 :

wherein storing the spatial difference in the database with the corpus of spatial differences labeled with patient outcomes for the set of instances of the surgical operation within the population of patients comprises aggregating the corpus of spatial differences labeled with patient outcomes for the set of instances of the surgical operation performed by the surgeon;

wherein deriving the correlation between outcomes and spatial differences comprises deriving the correlation between:

successful recoveries within the population of patients operated on by the surgeon; and

spatial differences between actual resected contours of the hard tissue of interest and target resected contours of the hard tissue of interest specified in surgical plans defined by the surgeon; and

further comprising, for a second surgical plan defined by the surgeon for a second instance of the surgical operation planned for a second patient, serving a recommendation for adjustment of the second surgical plan, based on the correlation, to the surgeon prior to the second instance of the surgical operation.

13. The method of claim 1 , further comprising, during the first period of time:

selecting a frame in the first sequence of optical scans;

projecting a virtual representation of an unresected contour of the hard tissue of interest, defined in the virtual patient model, onto the frame;

writing the spatial difference to the frame; and

serving the frame to a physician portal affiliated with a second surgeon located remotely from the surgical field.

14. The method of claim 1 :

wherein accessing the virtual patient model comprises accessing the virtual patient model defining the target resected contour of a femoral condyle of a femur of the patient;

wherein detecting the actual resected contour of the hard tissue of interest in the first sequence of optical scans comprises detecting the actual resected contour the femoral condyle of the patient in the first sequence of optical scans; and

wherein detecting the spatial difference comprises detecting the spatial difference between the actual resected contour of the femoral condyle detected in the first sequence of optical scans and the target resected contour of the femoral condyle defined in the virtual patient model.

15. The method of claim 14 :

wherein calculating the spatial difference comprises:

calculating a distance magnitude difference between the actual resected contour of the femoral condyle and the target resected contour of the femoral condyle;

calculating an orientation difference between the actual resected contour of the femoral condyle and the target resected contour of the femoral condyle; and

characterizing a surface profile difference between the actual resected contour of the femoral condyle and the target resected contour of the femoral condyle; and

wherein presenting the spatial difference to the surgeon during the surgical operation comprises rendering the distance magnitude difference, the orientation difference, and the surface profile difference on a display present near the surgical field.

16. The method of claim 15 , wherein rendering the distance magnitude difference, the orientation difference, and the surface profile difference on the display comprises, during the second period of time:

detecting a position of an augmented reality headset, worn by a surgeon and comprising the display, proximal the surgical field;

estimating a perspective of the surgeon viewing the surgical field based on the position of the augmented reality headset;

generating an augmented reality frame comprising a projection of the target resected contour of the hard tissue of interest of the patient, defined in the virtual patient model, from the perspective of the surgeon;

inserting the distance magnitude difference, the orientation difference, and the surface profile difference into the augmented reality frame; and

at the augmented reality headset, rendering the augmented reality frame.

17. The method of claim 1 , further comprising:

calculating an absolute spatial difference between the actual resected contour of the hard tissue of interest detected in the first sequence of optical scans and an unresected contour of the hard tissue of interest defined in the virtual patient model;

accessing a second correlation between outcomes and absolute spatial differences between actual resected contours of the hard tissue of interest and unresected contours of the hard tissue of interest within the population of patients subject to instances of the surgical operation;

predicting a probability of successful outcome of the patient based on the absolute spatial difference and the second correlation;

in response to the probability of successful outcome exceeding a threshold probability, prompting the surgeon to move to a next step of the surgical operation; and

in response to the probability of successful outcome falling below the threshold probability, prompting the surgeon to correct the actual resected contour of the hard tissue of interest of the patient to reduce the spatial difference.

18. A method for tracking and adapting to deviations from surgical plans comprising:

accessing a virtual patient model defining a target position of an artificial implant on a tissue of interest;

during a first period of time succeeding placement of the artificial implant on the tissue of interest within a surgical operation:

accessing a first sequence of optical scans recorded by an optical sensor facing a surgical field occupied by a patient;

detecting a set of features representing the patient in the first sequence of optical scans;

registering the virtual patient model to the tissue of interest in the surgical field based on the set of features; and

detecting an actual position of the artificial implant on the tissue of interest in the first sequence of optical scans;

calculating a spatial difference between the actual position of the artificial implant on the tissue of interest detected in the first sequence of optical scans and the target position of the artificial implant on the tissue of interest represented in the virtual patient model registered to the tissue of interest in the surgical field;

presenting the spatial difference to a surgeon during the surgical operation;

calculating an absolute position of the artificial implant on the tissue of interest detected in the first sequence of optical scans;

accessing a correlation between outcomes and absolute positions of instances of the artificial implant on the tissue of interest within a population of patients subject to instances of the surgical operation;

predicting a probability of successful outcome of the patient based on the absolute position of the artificial implant on the tissue of interest and the correlation;

in response to the probability of successful outcome exceeding a threshold probability, prompting the surgeon to move to a next step of the surgical operation; and

in response to the probability of successful outcome falling below the threshold probability, prompting the surgeon to adjust the absolute position of the artificial implant on the tissue of interest.

19. A method for tracking and adapting to deviations from surgical plans comprising:

accessing a virtual patient model defining a target resected contour of a hard tissue of interest;

during a first period of time succeeding resection of the hard tissue of interest within a surgical operation:

accessing a first sequence of optical scans recorded by an optical sensor facing a surgical field occupied by a patient;

detecting a set of features representing the patient in the first sequence of optical scans;

registering the virtual patient model to the hard tissue of interest in the surgical field based on the set of features; and

detecting an actual resected contour of the hard tissue of interest in the first sequence of optical scans;

calculating a spatial difference between the actual resected contour of the hard tissue of interest detected in the first sequence of optical scans and the target resected contour of the hard tissue of interest represented in the virtual patient model registered to the hard tissue of interest in the surgical field;

presenting the spatial difference to a surgeon during the surgical operation;

calculating an absolute spatial difference between the actual resected contour of the hard tissue of interest detected in the first sequence of optical scans and an unresected contour of the hard tissue of interest defined in the virtual patient model;

accessing a correlation between outcomes and absolute spatial differences between actual resected contours of the hard tissue of interest and unresected contours of the hard tissue of interest within a population of patients subject to instances of the surgical operation;

predicting a probability of successful outcome of the patient based on the absolute spatial difference and the correlation;

in response to the probability of successful outcome exceeding a threshold probability, prompting the surgeon to move to a next step of the surgical operation; and

in response to the probability of successful outcome falling below the threshold probability, prompting the surgeon to correct the actual resected contour of the hard tissue of interest of the patient to reduce the spatial difference.

20. A method for tracking and adapting to deviations from surgical plans comprising:

accessing a virtual patient model defining a target resected contour of a hard tissue of interest;

further comprising, during an initial period of time preceding the first period of time and succeeding incision of the patient proximal the hard tissue of interest:

accessing an initial sequence of optical scans recorded by the optical sensor; and

detecting an unresected contour of the hard tissue of interest in the initial sequence of optical scans;

during a first period of time succeeding resection of the hard tissue of interest within a surgical operation:

accessing a first sequence of optical scans recorded by an optical sensor facing a surgical field occupied by a patient; and

detecting an actual resected contour of the hard tissue of interest in the first sequence of optical scans;

calculating an absolute spatial difference between the actual resected contour of the hard tissue of interest detected in the first sequence of optical scans and the unresected contour of the hard tissue of interest;

presenting the absolute spatial difference to a surgeon during the surgical operation;

labeling the absolute spatial difference with a post-operative outcome of the patient;

storing the absolute spatial difference in a database with a corpus of absolute spatial differences labeled with patient outcomes for a set of instances of the surgical operation within a population of patients; and

deriving a correlation between outcomes and absolute spatial differences between actual resected contours of the hard tissue of interest and unresected contours of the hard tissue of interest within the population of patients.

Assignments (1)

Continuity (7)

Cited By (12)

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