U.S. patent application number 13/609693 was filed with the patent office on 2013-01-03 for customized patient surgical plan.
Invention is credited to Said Haddad.
Application Number | 20130006661 13/609693 |
Document ID | / |
Family ID | 40029188 |
Filed Date | 2013-01-03 |
United States Patent
Application |
20130006661 |
Kind Code |
A1 |
Haddad; Said |
January 3, 2013 |
CUSTOMIZED PATIENT SURGICAL PLAN
Abstract
Systems, methods, and devices are disclosed which generate
surgical plans that have been customized for a particular patient.
A client generates a surgical plan request that includes data
relevant to a patient and an orthopaedic surgical procedure to be
performed upon the patient. The surgical plan system receives the
surgical plan request, generates a surgical plan that has been
customized based upon the data of the surgical plan request, and
transmits the customized surgical plan to the client.
Inventors: |
Haddad; Said; (Fort Wayne,
IN) |
Family ID: |
40029188 |
Appl. No.: |
13/609693 |
Filed: |
September 11, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11862746 |
Sep 27, 2007 |
8265949 |
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13609693 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
A61B 90/36 20160201;
G16H 70/20 20180101; A61B 2034/256 20160201; A61B 17/157 20130101;
G06F 19/00 20130101; A61B 34/10 20160201; F21V 21/22 20130101; A61B
2017/00221 20130101; A61B 2034/2068 20160201; G16H 50/50 20180101;
A61B 2090/3983 20160201; G16H 20/40 20180101; A61B 2034/252
20160201; A61B 2034/107 20160201; A61B 34/20 20160201 |
Class at
Publication: |
705/2 |
International
Class: |
G06Q 50/22 20120101
G06Q050/22 |
Claims
1. A method of a vendor to create a surgical plan for a patient of
a healthcare facility that is external to the vendor, comprising:
receiving, with a surgical plan system, a surgical plan request
transmitted from the healthcare facility, the surgical plan request
including (i) data relevant to the patient, (ii) data relevant to a
surgical procedure to be performed upon the patient, and (iii)
preference data that identifies surgical preferences related to the
surgical procedure of an orthopaedic surgeon, generating, with the
surgical plan system and based on the surgical plan request, an
order of surgical procedure instructional images that define
surgical steps of the surgical procedure, creating, in response to
receiving the surgical plan request, a surgical plan on the
surgical plan system, the surgical plan having been customized for
the patient per data of the surgical plan request, and sending,
from the surgical plan system, the surgical plan to the healthcare
facility for execution.
2. The method of claim 1, wherein sending comprises transmitting
the surgical plan to the healthcare facility via a network.
3. The method of claim 1, wherein sending comprises transmitting
the surgical plan to a handheld computer of the healthcare facility
via a network.
4. The method of claim 1, further comprising generating, on the
surgical plan system, the plurality of instructions based upon one
or more medical images that depict at least one bone of the
patient.
5. The method of claim 1, further comprising: receiving, on the
surgical plan system, from the healthcare facility a modified
surgical plan request that requests modifications to the surgical
plan, modifying, on the surgical plan system, the surgical plan to
obtain a modified surgical plan in response to receiving the
modified surgical plan request, and sending, from the surgical plan
system, the surgical plan to the healthcare facility for
execution.
6. The method of claim 1, further comprising creating, on the
surgical plan system, the surgical plan in accordance with surgical
procedures associated with a particular surgeon in response to the
surgical plan request requesting that the surgical plan be
constructed in accordance with surgical procedures associated with
the particular surgeon.
7. The method of claim 1, further comprising creating, on the
surgical plan system, the surgical plan in accordance with surgical
procedures associated with a particular institution in response to
the surgical plan request requesting that the surgical plan be
constructed in accordance with surgical procedures associated with
the particular institution.
Description
[0001] This application is a continuation application of U.S.
application Ser. No. 11/862,746, entitled "CUSTOMIZED PATIENT
SURGICAL PLAN" by Said Haddad, which was filed on Sep. 27, 2007,
the entirety of which is hereby incorporated by reference.
BACKGROUND
[0002] Surgeons are turning to minimally invasive orthopaedic
procedures. Because such procedures generally restrict the
surgeon's ability to see the operative area, surgeons generally
rely on computer systems, such as computer assisted orthopaedic
surgery (CAOS) systems, to assist in the surgical operations. CAOS
systems assist surgeons in the performance of orthopaedic surgical
procedures by, for example, displaying images illustrating surgical
steps of the surgical procedure being performed. Typical CAOS
systems are stand-alone systems that are neither integrated with,
nor configured to communicate with, other electronic systems of
networks such as, for example, hospital networks. As such, typical
CAOS systems are unable to access electronic data, such as medical
records and the like, stored in the other electronic systems and
networks. Moreover, typical CAOS systems require a surgeon to enter
considerable amount of data and other responses in order to
configure, calibrate and/or drive the system during the surgical
procedure.
SUMMARY
[0003] The present invention may comprise a system, apparatus
and/or method that may have one or more of the following features
and/or steps, which alone or in any combination may comprise
patentable subject matter.
[0004] A method of a vendor to create a surgical plan for a patient
of a healthcare facility that is external to the vendor is
disclosed. The method may include receiving, from the healthcare
facility external to the vendor, a surgical plan request that
includes data relevant to the patient and a surgical procedure to
be performed upon the patient. The method may also include
creating, in response to receiving the surgical plan request, a
surgical plan that has been customized for the patient per data of
the surgical plan request. Creating the surgical plan may include
generating instructions for the surgical plan that configure a
computer assisted orthopaedic surgery system to assist in the
surgical procedure upon the patient. The surgical plan may also be
generated based upon one or more medical images that depict at
least one bone of the patient.
[0005] The method may further include sending the surgical plan to
the healthcare facility for execution. Sending the surgical plan
may include transmitting the surgical plan to the healthcare
facility via a network. Sending the surgical plan may also include
mailing the surgical plan to the healthcare facility.
[0006] In one embodiment, the method may further include receiving
from the healthcare facility a modified surgical plan request that
requests modifications to the surgical plan. The method in such an
embodiment may further include modifying the surgical plan to
obtain a modified surgical plan in response to receiving the
modified surgical plan request, and sending the surgical plan to
the healthcare facility for execution.
[0007] Some embodiments of the method may include creating the
surgical plan in accordance with surgical procedures associated
with a particular surgeon in response to the surgical plan request
requesting that the surgical plan be constructed in accordance with
surgical procedures associated with the particular surgeon.
Similarly, other embodiments of the method may include creating the
surgical plan in accordance with surgical procedures associated
with a particular institution in response to the surgical plan
request requesting that the surgical plan be constructed in
accordance with surgical procedures associated with the particular
institution.
[0008] A machine readable medium comprising a plurality of
instructions is also provided. The instructions, in response to
being executed, may result in a computing device creating a
surgical plan for an orthopaedic surgical procedure based upon a
surgical plan request that includes an image of a bone of a
patient. The instructions may further result in the computing
device transmitting the surgical plan to a healthcare facility via
a network. The instructions of the machine readable medium may also
result in the computing device generating the surgical plan such
that the surgical plan upon being loaded by a computer assisted
orthopaedic surgery system configures the computer assisted
orthopaedic surgery system to assist in the orthopaedic surgical
procedure.
[0009] In another embodiment, the instructions may result in the
computing device generating the surgical plan such that the
surgical plan includes instructions that in response to being
executed by a computer assisted orthopaedic surgery system results
in the computer assisted orthopaedic surgery system assisting in
the orthopaedic surgical procedure. Execution of the instructions
may further result in the computing device generating the surgical
plan such that in response to being executed by a computer assisted
orthopaedic surgery system results in the computer assisted
orthopaedic surgery system displaying images of individual surgical
steps which form the orthopaedic surgical procedure.
[0010] In yet another embodiment, the instructions of the machine
readable medium result in the computing device modifying the
surgical plan to obtain a modified surgical plan in response to a
request to modify the surgical plan. Further, the instructions of
this embodiment may result in the computing device transmitting the
modified surgical plan to the healthcare facility via the
network.
[0011] The instructions may further result in the computing device
creating the surgical plan in accordance with a particular surgeon
in response to a request for the surgical plan be constructed in
accordance with the particular surgeon. The instructions may also
result in the computing device creating the surgical plan in
accordance with a particular institution in response to a request
for the surgical plan be constructed in accordance with surgical
procedures associated with the particular institution.
[0012] A system for generating surgical plans is also provided. The
system may include a client, a surgical plan system and a computer
assisted orthopaedic surgery system. The client may generate a
surgical plan request that includes data relevant to a patient and
an orthopaedic surgical procedure to be performed upon the patient.
The surgical plan system may receive the surgical plan request and
may generate a surgical plan that has been customized based upon
the data of the surgical plan request. The computer assisted
orthopaedic surgery system may assist a surgeon performing the
orthopaedic surgical procedure per the surgical plan generated by
the surgical plan system.
[0013] In one embodiment, the surgical plan system may be located
at a vendor and the computer assisted orthopaedic surgery system
may be located at a healthcare facility. Further, the surgical plan
system may select an orthopaedic implant for the orthopaedic
surgical procedure based upon at least one image of the surgical
plan request. The computer assisted orthopaedic surgery system may
also display images of individual surgical steps which form the
orthopaedic surgical procedure in response to executing the
surgical plan generated by the surgical plan system.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] The invention described herein is illustrated by way of
example and not by way of limitation in the accompanying figures.
For simplicity and clarity of illustration, elements illustrated in
the figures are not necessarily drawn to scale. For example, the
dimensions of some elements may be exaggerated relative to other
elements for clarity. Further, where considered appropriate,
reference labels have been repeated among the figures to indicate
corresponding or analogous elements.
[0015] FIG. 1 shows a system for generating surgical plans that
have been customized for a particular patient.
[0016] FIG. 2 shows a computer assisted orthopaedic surgery (CAOS)
system of FIG. 1.
[0017] FIG. 3 shows more details regarding the CAOS system of FIG.
2.
[0018] FIG. 4 shows a bone locator tool for use with the CAOS
system of FIG. 2.
[0019] FIG. 5 shows a registration tool for use with the CAOS
system of FIG. 2.
[0020] FIG. 6 shows an orthopaedic surgical tool for use with the
system of FIG. 2.
[0021] FIG. 7 shows a method for generating, modifying and
executing a custom surgical plan.
[0022] FIG. 8 shows a medical image having a digital template of an
orthopaedic implant superimposed thereon.
DETAILED DESCRIPTION OF THE DRAWINGS
[0023] While the concepts of the present disclosure are susceptible
to various modifications and alternative forms, specific exemplary
embodiments thereof have been shown by way of example in the
drawings and will herein be described in detail. It should be
understood, however, that there is no intent to limit the concepts
of the present disclosure to the particular forms disclosed, but on
the contrary, the intention is to cover all modifications,
equivalents, and alternatives falling within the spirit and scope
of the invention as defined by the appended claims.
[0024] In the following description, numerous specific details such
as logic implementations, opcodes, means to specify operands,
resource partitioning/sharing/duplication implementations, types
and interrelationships of system components, and logic
partitioning/integration choices are set forth in order to provide
a more thorough understanding of the present disclosure. It will be
appreciated, however, by one skilled in the art that embodiments of
the disclosure may be practiced without such specific details. In
other instances, control structures, gate level circuits and full
software instruction sequences have not been shown in detail in
order not to obscure the invention. Those of ordinary skill in the
art, with the included descriptions, will be able to implement
appropriate functionality without undue experimentation.
[0025] References in the specification to "one embodiment", "an
embodiment", "an example embodiment", etc., indicate that the
embodiment described may include a particular feature, structure,
or characteristic, but every embodiment may not necessarily include
the particular feature, structure, or characteristic. Moreover,
such phrases are not necessarily referring to the same embodiment.
Further, when a particular feature, structure, or characteristic is
described in connection with an embodiment, it is submitted that it
is within the knowledge of one skilled in the art to effect such
feature, structure, or characteristic in connection with other
embodiments whether or not explicitly described.
[0026] Embodiments of the invention may be implemented in hardware,
firmware, software, or any combination thereof. Embodiments of the
invention may also be implemented as instructions stored on a
machine-readable medium, which may be read and executed by one or
more processors. A machine-readable medium may include any
mechanism for storing or transmitting information in a form
readable by a machine (e.g., a computing device). For example, a
machine-readable medium may include read only memory (ROM), random
access memory (RAM), magnetic disk storage media, optical storage
media, flash memory devices, and others.
[0027] Referring to FIG. 1, a system 10 that customizes and
executes surgical plans is shown. The system 10 may include a
vendor 14 that provides the custom surgical plans 20. The system 10
may further include a healthcare facility 12 and a network 16 that
communicatively couples the vendor 14 and the healthcare facility
12. As discussed in more detail below, the healthcare facility 12
may include a computer assisted orthopedic surgery (CAOS) system 30
that executes and/or assists caregiver(s) in the execution of
custom surgical plans 20 provided by the vendor 14.
[0028] The network 16 may include one or more wide area networks
(WAN), local area networks (LAN), and/or publicly-accessible global
networks such as, for example, the Internet. In addition, the
network 16 may include one or more wired networks and/or wireless
networks. As such, the network 16 may include routers, switches,
computers, communication links, and other networking components
that cooperate to operatively couple the vendor 14 and the
healthcare facility 12.
[0029] The healthcare facility 12 may include a network 24,
computing devices or clients 26, databases 28, and CAOS systems 30.
Similar to the network 16, the healthcare facility network 24 may
include wide area networks (WAN), local area networks (LAN),
publicly-accessible global networks such as, for example, the
Internet, and/or other types of networks. In addition, the
healthcare facility network 24 may include wired networks and/or
wireless networks. As such, the healthcare facility network 24 may
include routers, switches, computers, communication links, and
other networking components that cooperate to operatively couple
computing devices 26, medical databases 28, CAOS systems 30, and
possibly other network enabled devices of the healthcare facility
12.
[0030] The computing devices 26 may display data and receive input
from caregivers of the healthcare facility 12 such as, for example,
doctors, nurses, anesthesiologists, and surgeons. The computing
devices 26 may include a variety of different computing devices
such as, for example, servers, desktop computers, laptop computers,
handheld computers, personal data assistants, mobile phones, and
possibly other computing devices. A computing device 26 is
illustrated in FIG. 1 as being physically located within the
healthcare facility 12; however, in some embodiments, one or more
of the computing devices 26 may remotely access the healthcare
facility network 24 from locations external to the healthcare
facility 12. Such embodiments may enable caregivers to order and/or
otherwise define custom surgical plans 20 while the caregiver is
away from the healthcare facility 12.
[0031] The databases 28 may store personal data, medical data,
and/or other data associated with patients of the healthcare
facility 12. In one embodiment, the databases 28 may include a
Patient Archiving Communications System (PACS) that stores medical
images for patients of the healthcare facility 12.
[0032] The vendor 14 may include a surgical plan system 40. The
surgical plan system 40 may receive a request 18 for a surgical
plan via network 16 from the healthcare facility 12, generate a
surgical plan 20 that has been customized based upon information of
the received request, and provide the healthcare facility 12 with
the custom surgical plan 20 via network 16. The surgical plan
system 40 may include one or more computing devices and associated
software, middleware, and/or firmware that cooperate to perform the
surgical plan customizations described herein. In particular, the
surgical plan system 40 may include one or more processors 46, one
or more memory devices 48, and one or more mass storage devices
49.
[0033] The processor 46 may include a microprocessor,
microcontroller, discrete processing circuitry (e.g., a collection
of logic devices), general purpose integrated circuit(s), and/or
application specific integrated circuit(s) (i.e., ASICs). The
memory device 48 may include volatile memory devices such as, for
example, dynamic random access memory (DRAM) and static random
access memory (SRAM). The memory device 48 may further include
non-volatile memory devices such as, for example, various types of
read-only memory (i.e., ROM) and FLASH memory devices. The memory
devices 48 generally store data and/or instructions that the
processors 46 are currently processing and/or expected to process
in the near future.
[0034] The mass storage devices 49 may include hard drives, DVD
drives, CD drives, database servers and/or other devices suitable
for storing large amounts of data and/or instructions. The mass
storage devices 49 in one embodiment store data and instructions in
a non-volatile manner; however, other embodiments may include mass
storage devices such as large disk caches that store data in a
volatile manner. The mass storage devices 49 generally store data
and/or instructions that the processor 46 is not expected to
process in the near future and/or is desirable to retain for
extended periods of time. In addition to the above mentioned
components, the surgical plan system 40 may include other devices
and circuitry typically found in computing devices such as, for
example, displays, input/output devices, and/or other peripheral
components.
[0035] One embodiment of a CAOS system 30 is shown in FIG. 2. As
shown, the CAOS system 30 may include a computing device 62 and a
camera unit such as, for example, mobile camera unit 66 and a fixed
camera unit 68. In some embodiments, the CAOS system 30 may include
both types of camera units 66, 68. The mobile camera unit 66
includes a stand 70 coupled with a base 72. The base 72 may include
a number of wheels 71 to allow the mobile camera unit 66 to be
repositioned within a hospital room. The mobile camera unit 66 may
include a camera head 74. The camera head 74 may include two
cameras 76. The camera head 74 may be positionable relative to the
stand 70 such that the field of view of the cameras 76 may be
adjusted.
[0036] The fixed camera unit 68 is similar to the mobile camera
unit 66 and includes a base 78, a camera head 80, and an arm 82
coupling the camera head 80 with the base 78. In some embodiments,
other peripherals, such as display screens, lights, and the like,
may also be coupled with the base 78. The camera head 80 includes
two cameras 84. The fixed camera unit 68 may be coupled to a
ceiling, as shown in FIG. 2, or a wall of the hospital room.
Similar to the camera head 74 of the camera unit 66, the camera
head 80 may be positionable relative to the arm 82 such that the
field of view of the cameras 84 may be adjusted. The camera units
66, 68 are communicatively coupled with the computing device 62.
The computing device 62 may be mounted on or otherwise coupled with
a cart 86 having a number of wheels 88 to allow the computing
device 62 to be positioned near the surgeon during the performance
of the orthopaedic surgical procedure.
[0037] Referring now to FIG. 3, additional details of one
embodiment of a CAOS system 30 are shown. In particular, the
computing device 62 may include a processor 90, a memory device 92,
and mass storage device 93. The processor 90 may include a
microprocessor, a microcontroller, discrete processing circuitry
(e.g., a collection of logic devices), general purpose integrated
circuit(s), and/or application specific integrated circuit(s)
(i.e., ASICs). The memory device 92 may include volatile memory
devices such as, for example, dynamic random access memory (DRAM)
and static random access memory (SRAM). The memory device 92 may
further include non-volatile memory devices such as, for example,
various types of read-only memory (i.e., ROM) and FLASH memory
devices. The memory devices 92 generally store data and/or
instructions that the processors 90 are currently processing and/or
expected to process in the near future.
[0038] The mass storage devices 93 may include hard drives, DVD
drives, CD drives, database servers and/or other devices suitable
for storing large amounts of data and/or instructions. The mass
storage devices 93 in one embodiment may store data and
instructions in a non-volatile manner; however, other embodiments
may include mass storage devices such as large disk caches that
store data in a volatile manner. The mass storage devices generally
store data and/or instructions that the processor 90 is not
expected to process in the near future and/or is desirable to
retain for extended periods of time.
[0039] The computing device 62 is communicatively coupled with a
display device 94. Although illustrated in FIG. 3 as separate from
the computing device 62, the display device 94 may form a portion
of the computer computing device 62 in some embodiments.
Additionally, in some embodiments, the display device 94 or an
additional display device may be positioned away from the computing
device 62. For example, the display device 94 may be positioned
upon the ceiling or wall of the operating room wherein the
orthopaedic surgical procedure is to be performed. Additionally or
alternatively, the display device 94 may include a virtual display
such as a holographic display, a body mounted display such as a
heads-up display, and/or other types of displays. The computing
device 62 may also include input devices such as a keyboard and/or
a mouse for providing data input to the computing device 62. The
display device 94 may include a touch-screen display device capable
of receiving inputs from an orthopaedic surgeon 100. That is, the
surgeon 100 may provide input data to the computing device 62, such
as making a selection from a number of on-screen choices, by simply
touching the screen of the display device 94.
[0040] The computing device 62 may be communicatively coupled to
the camera unit 66 (and/or 68). Although only the mobile camera
unit 66 is shown in FIG. 3, the fixed camera unit 68 may
alternatively be used or may be used in addition to the mobile
camera unit 66.
[0041] The CAOS system 30 may also include sensors or reference
arrays 104 which may be coupled to relevant bones of a patient 106
and/or with orthopaedic surgical tools 108. For example, as
illustrated in FIG. 4, a tibial array 110 includes a reference
array 112 and bone clamp 114. The bone clamp 114 may be coupled
with a tibia bone 116 of the patient 106 using a Schantz pin 118,
but other types of bone clamps may be used. The reference array 112
may be coupled with the bone clamp 114 via an extension arm 120.
The reference array 112 may include a frame 122 and three
reflective elements 124. The reflective elements 124 in one
embodiment are spherical, but may have other geometric shapes.
Additionally, in other embodiments sensor arrays having more than
three reflective elements may be used. The reflective elements 112
may be positioned in a predefined configuration that enables the
computing device 62 to determine the identity of the tibial array
110 based on the configuration. That is, when the tibial array 110
is positioned in a field of view 102 of the camera head 74, as
shown in FIG. 3, the computing device 62 may determine the identity
of the tibial array 110 based on the images received from the
camera head 74. Additionally, based on the relative position of the
reflective elements 114, the computing device 62 may determine the
location and orientation of the tibial array 110 and, accordingly,
the tibia 116 to which the array 110 is coupled.
[0042] Reference arrays may also be coupled to other surgical
tools. For example, a registration tool 130, as shown in FIG. 5,
may be used to register points of a bone. The registration tool 130
may include a sensor array 132 having three reflective elements 134
coupled with a handle 136 of the tool 130. The registration tool
130 may also include a pointer end 138 that is used to register
points of a bone. The reflective elements 134 may be positioned in
a configuration that enables the computing device 62 to determine
the identity of the registration tool 130 and its relative location
(i.e., the location of the pointer end 138). Additionally,
reference arrays may be used on other surgical tools such as a
tibial resection jig 140, as illustrated in FIG. 6. The jig 140 may
include a resection guide portion 142 that is coupled with a tibia
bone 144 at a location of the bone 144 that is to be resected. The
jig 140 may include a reference array 146 that is coupled with the
portion 142 via a frame 145. The reference array 146 may include
three reflective elements 148 that may be positioned in a
configuration that enables the computing device 62 to determine the
identity of the jig 140 and its relative location (e.g., with
respect to the tibia bone 144).
[0043] The CAOS system 30 may assist the orthopaedic surgeon 100 in
an orthopaedic surgical procedure including, for example, a total
knee replacement procedure. To do so, the computing device 62
and/or the display device 94 may be positioned within the view of
the surgeon 100. As discussed above, the computing device 62 may be
coupled with a movable cart 86 to facilitate such positioning. The
camera unit 66 (and/or camera unit 68) may be positioned such that
the field of view 102 of the camera head 74 covers the portion of a
patient 106 upon which the orthopaedic surgical procedure is to be
performed, as shown in FIG. 3.
[0044] During the performance of the orthopaedic surgical
procedure, a custom surgical plan 20 may include one or more
instructions that program or otherwise configure the computing
device 62 of the CAOS system 30 to display images of the individual
surgical procedure steps which form the orthopaedic surgical
procedure being performed. The images may be graphically rendered
images or graphically enhanced photographic images. For example,
the images may include three dimensional rendered images of the
relevant anatomical portions of a patient. The surgeon 100 may
interact with the computing device 62 to display the images of the
various surgical steps in sequential order. In addition, the
surgeon may interact with the computing device 62 to view
previously displayed images of surgical steps, selectively view
images, instruct the computing device 62 to render the anatomical
result of a proposed surgical step or procedure, or perform other
surgical related functions. For example, the surgeon 100 may view
rendered images of the resulting bone structure of different bone
resection procedures. In this way, the custom surgical plan 20 may
configure the CAOS system 30 to provide a surgical "walk-through"
customized to the patient 106 that the surgeon 100 may follow while
performing the surgical procedure.
[0045] In one embodiment, the custom surgical plan 20 may include
an ordered selection of instructional images that depict individual
surgical steps that make up at least a portion of the orthopaedic
surgical procedure to be performed. The instructional images may
include images of surgical tools and associated text information,
graphically rendered images of surgical tools and relevant patient
anatomy, and/or other images and/or text information that assist
the surgeon during the surgical procedure. The instructional images
may be stored in an electronic library, which may be embodied as,
for example, a database, a file folder or storage location
containing separate instructional images and an associated look-up
table, hard-coded information stored in the memory device 92, mass
storage device 93, and/or other electronic storage devices
accessible via the network 24 of the healthcare facility 12.
Accordingly, a surgical plan 20 may include among other things an
ordered selection of instructional images that are displayed to the
surgeon 100 via the display device 94 such that the instructional
images provide a surgical "walk-through" of the procedure or
portion thereof. The surgical plan 20 may also include a number of
surgical sub-step images, some of which may or may not be displayed
to and performed by the surgeon 100 based on selections chosen by
the surgeon 100 during the performance of the orthopaedic surgical
procedure.
[0046] In some embodiments, the surgeon 100 may also interact with
the computing device 62 to control various devices of the CAOS
system 30. For example, the surgeon 100 may interact with the CAOS
system 30 to control user preferences or settings of the display
device 94. Further, the computing device 62 may prompt the surgeon
100 for responses. For example, the computing device 62 may prompt
the surgeon to inquire if the surgeon has completed the current
surgical step, if the surgeon would like to view other images,
and/or other surgical procedure inquiries.
[0047] As discussed above, the computing devices 26, the database
28, and/or the CAOS system 30 may communicate with each other
and/or with the communication network 16 via the local network 24.
For example, the surgeon's computer 26 may be used to access data,
such as medical images, stored on the database 28. Additionally or
alternatively, the CAOS system 30 may be used to generate
pre-operative orthopaedic surgical plans, surgical notes created
during an orthopaedic surgery, medical images of a patient's bone
(and soft tissue) and/or orthopaedic implants coupled thereto,
and/or other data. Such data generated via the CAOS system 30 may
be stored in the database 28 by, for example, transmitting the data
from the CAOS system 30 to the database 28 via the network 24.
Additionally, other medical devices typically found in a hospital
or other healthcare facility may be used to generate medical images
of a bone (and, in some embodiments, soft tissue) of the patient.
Such medical images may also be stored in the database 28. The
medical images may be embodied as any type of medical image
providing a visual indication of a relevant bone or bones (and soft
tissue if desired) of a patient. For example, the medical images
may be embodied as any number of X-ray images, magnetic resonance
imaging (MRI) images, computerized tomography (CT) images, or the
like. Regardless, such medical images may be stored in the database
28 along with associated data relevant to the particular medical
images. Such associated data may include, but is not limited to,
the patient's name and other patient identification information,
date of the images, surgeon's or doctor's name, the name of the
hospital or healthcare facility wherein the medical images were
generated, and the like.
[0048] In operation, the vendor 14 of the custom surgical plan
system 10 may receive a request for surgical plans for a patient,
may generate a surgical plan that has been customized for the
patient, and may provide the custom surgical plan for the patient
to the healthcare facility 12. A method 200 of performing a
surgical procedure in accordance with a custom surgical plan 20 is
shown in FIG. 7. The method 200 may begin in block 202 with
defining a surgical plan request 18 for a custom surgical plan 20
that has been customized for a particular patient. To this end, one
or more caregivers of the healthcare facility 12 may define the
surgical plan request 18 by using one or more computing devices or
clients 26. In particular, the caregivers may enter or otherwise
collect surgical plan request data that is relevant to the surgical
procedure to be performed and the particular patient receiving the
surgical procedure. The surgical plan request data may include any
data relevant to the surgical plan being requested, any data
related to the orthopaedic surgical procedure to be performed, any
data related to the patient on which the orthopaedic surgical
procedure to be performed, and/or any other data useful for
customizing the orthopaedic surgical procedure to the patient. For
example, the request data may include, but is not limited to, the
type of orthopaedic surgical procedure to be performed, the type of
orthopaedic implant to be used, rendered images of the relevant
anatomical portions of the patient, digital templates of the
orthopaedic implants and/or planned resection lines, pre-operative
notes, diagrams, historic patient data, X-rays, medical images,
patient medical records, patient identification data, and/or any
other data useful for customizing the orthopaedic surgical
procedure to the patient.
[0049] Typically, medical images are generated pre-operatively in
preparation for an orthopaedic surgical procedure. The medical
images may include any number of medical images. For example, the
medical images may include a medical image of the relevant bone(s)
taken along the sagittal plane of the patient's body and a medical
image of the relevant bone(s) taken along the coronal plane of the
patient's body. The medical images may include X-ray images,
magnetic resonance imaging (MRI) images, computerized tomography
(CT) images, and/or any other type of image capable of providing
indicia of the relevant bone or bones. Such imaging devices may be
located in the healthcare facility 12 or may be located remote
therefrom. The imaging devices may or may not be communicatively
coupled to the healthcare facility 12.
[0050] At block 202, a surgeon may use a computing device 26 that
may be located in the healthcare facility 12 or external to the
healthcare facility 12 to define the surgical plan request 18. In
particular, the surgeon may define the surgical plan request 18 by
entering and/or collecting the request data via the computing
device 26. In some embodiments, the surgeon may operate the
computing device 26 to retrieve, from various information servers
of the hospital facility 12 such as databases 28, data relevant to
the surgical plan 20 such as, for example, patient medical history,
X-rays, medical images and/or other related data as described
above. In addition, the surgeon may enter constraint data that may
limit, restrict, or otherwise affect the generation of the surgical
plan 20 for the patient. For example, the constraint data may
include the surgeon's preference for an orthopaedic implant type,
the surgeon's preference for particular parts of the implant, the
degree of acceptable orthopedic implant sizes (e.g., a restriction
on the range of implant sizes that may be recommended), the amount
of bone that will be resected, the planned location and/or
orientation of the orthopaedic implant, fixation type (e.g., cement
or cementless), material type, finish, and other features such as
head size and other preferences such as metal-on-metal,
metal-on-ceramic, ceramic-on-ceramic, metal-on-poly, or the
like.
[0051] The constraint data may further identify a branded surgical
procedure that has been branded or otherwise associated with a
particular surgeon, healthcare facility, university and/or another
person or institution. For example, a surgeon may request a
surgical plan 20 for a knee replacement in the style of Dr. Brown.
Similarly, a surgeon may request an Oxford Clinic arthroplasty of
the knee. In this manner, a surgeon may obtain the latest surgical
plans 20 that will enable the surgeon to use techniques perfected
by other surgeons or developed by other institutions, thus
increasing the rate at which such new procedures may be propagated
through the medical community.
[0052] At block 204, the surgical plan request 18 may be
transferred from the healthcare facility 12 to the vendor 14. In
one embodiment, a computing device 26 or CAOS system 30 of the
healthcare facility 12 may transmit the surgical plan request 18 to
the surgical plan system 40 of the vendor 14 via network 16.
However, other manners of providing the surgical plan request 18 to
the surgical plan system 40 are also contemplated. For example,
instead of a computing device 26 or CAOS system 30 transmitting the
surgical plan request 18 to the surgical plan system 40, the
surgical plan system 40 may retrieve the request from a computing
device 26, CAOS system 30, and/or another device via network 16.
Further, the surgical plan system 40 may also support receiving
surgical plan requests 18 from storage devices such as CD-ROMs,
DVD-ROMs, thumb drives, floppy disks, portable hard drives. In such
an embodiment, a caregiver of the healthcare facility 12 may store
the surgical plan request 18 to the storage device and mail or
otherwise deliver the storage device to the vendor 14. The vendor
14 may then upload the request from the storage device to the
surgical plan system 40.
[0053] The surgical plan system 40 at block 206 may create a
surgical plan 20 based upon the constraints and other data provided
by the surgical plan request 18. In creating the surgical plan 20,
the surgical plan system 40 may perform a digital templating
procedure on medical images of the surgical plan request 18 to
determine an orthopaedic implant to recommend to the surgeon or
healthcare facility for use with relevant bone(s) of the patient.
To do so, the surgical plan system 40 may be configured to
determine relevant aspects of the patient's bone or bony anatomy
from the medical images. For example, the surgical plan system 40
may determine one or more mechanical axis of the relevant bones,
determine one or more resection planes of the relevant bones,
locate particular features of the relevant bones, and/or the like.
Based on such determinations, the surgical plan system 40 may
select an appropriate orthopaedic implant type and size that also
satisfies the implant constraint data of the surgical plan request
18. The surgical plan system 40 may also be configured to determine
recommended range of sizes of the orthopaedic implant. For example,
in some embodiments, the surgical plan system 40 may be configured
to determine an orthopaedic implant within a range of plus or minus
two sizes. For example, the surgical plan system 40 may recommend
an orthopaedic implant of a size 5+/-2 sizes (i.e., a range of size
3 to size 7).
[0054] In creating the surgical plan 20, the surgical plan system
40 may also retrieve a digital template(s) of the orthopaedic
implant. The digital template may be retrieved from, for example,
the memory device 48, mass storage device 49 or from any other
storage location capable of storing a number of digital templates.
The digital template may include one or more two-dimensional and/or
three-dimensional electronic renderings of the orthopaedic implant
selected for the surgical procedure, or components thereof, that is
capable of being superimposed on a medical image of the patient.
For example, a digital template may be embodied as a
two-dimensional or three-dimensional electronic rendering of an
orthopaedic knee implant component that is capable of being
superimposed or otherwise incorporated into a medical image of a
tibia or femur bone of the patient. As discussed in more detail
below, the digital template may be used in conjunction with indicia
of the determined aspects or features of the relevant bones such as
lines or other indicia of the mechanical axis or resection
points/planes of the relevant bones.
[0055] The surgical plan system 40 may superimpose or otherwise
incorporate the digital template into the medical images of the
surgical plan request 20. For example, in one illustrative
embodiment, as illustrated in FIG. 8, a digital template 300 of an
orthopaedic implant is superimposed on a medical image 302 of a
bone of the patient. As discussed above, although the illustrative
digital template 300 is illustrated as a two-dimensional template,
in other embodiments, the digital template may include any number
of two-dimensional and/or three-dimensional electronic renderings
of the orthopaedic implant.
[0056] The surgical plan system 40 may be configured to use any
suitable algorithm and data of the surgical plan request 18 to
determine a recommended location and orientation of the orthopaedic
implant, as represented by the digital template, with respect to
the patient's bone. For example, if implant constraint data
provides an estimated amount of resection of the patients' bone,
the surgical plan system 40 may be configured to position the
digital template in the medical images based on such estimated
resection. In addition, any one or more of the aspects of the bone
as determined above may be used to determine the proper positioning
of the digital template. For example, the determined mechanical
axis, resection planes, and/or other determined aspects of the
relevant bones may be used to determined the proper positioning of
the digital template. In this way, the surgical plan system
generates a number of digital templated medical images having
indicia of the relevant bone's of the patient and indicia of the
recommended orthopaedic implant positioned in a location and
orientation.
[0057] Although described above as an automated process, in some
embodiments, the creation of the surgical plan 20 may be a
semi-automated or a manual process. For example, a technician such
as a CAD operator or medical technician of the vendor 14 may
determine the aspects of the relevant bones such as the mechanical
axis, the resection lines, and/or other particular features of the
relevant bones. The technician may edit the medical images such
that indicia of such aspects are superimposed or otherwise
incorporated into the medical images. For example, the technician
may electronically draw the mechanical axes and/or resection lines.
Once such aspects of the relevant bones are determined, the
surgical plan system 40 may be configured to determine a
recommended orthopaedic implant and create a custom surgical plan
20 based on the aspects of the relevant bones determined by the
technician, retrieve a digital template of the recommended
orthopaedic implant, and superimpose or otherwise incorporate the
digital template into the medical image based on, for example, the
determined aspects of the relevant bones.
[0058] In other embodiments, the custom surgical plan 40 may be
manually created by the vendor 14. In such embodiments, a
technician may determine the aspects of the relevant bones,
incorporate indicia of such aspects into the medical images (e.g.,
draw the mechanical axis, resection lines, etc. of the relevant
bones), and determine a recommended orthopaedic implant and
surgical plan 20 based on such aspects. The technician may then
manually superimpose or otherwise incorporate a digital template of
the recommended orthopaedic implant into the medical images. The
technician may locate and orientate the digital template based on
the determined aspects of the relevant bones. For example, the
technician may position the digital template of the recommended
orthopaedic implant in the medical image using a suitable CAD
software program or the like.
[0059] Regardless, the surgical plan system 40 at block 212 may
transfer the surgical plan 20 to the healthcare facility 16. In one
embodiment, surgical plan system 40 may transmit the custom
surgical plan 20 to the healthcare facility 12 via the network 16.
The custom surgical plan 20 may be stored in a database 28 of the
healthcare facility 12 that is accessible to the CAOS systems 30.
However, the custom surgical plan 20 may alternatively or
additionally be stored in computing devices 26 or CAOS systems 30
of the healthcare facility 12.
[0060] At block 214, the surgeon may review the surgical plan via a
computer device 26 and/or CAOS system 30. For example, the surgeon
may review the digital templated medical images to determine if the
digital template of the orthopaedic implant is properly located
with respect to the patient's bone, if the type of recommended
orthopaedic implant is correct, if a larger or smaller orthopaedic
implant size is more desirable, and/or the like. Furthermore, the
surgeon may review the series of operations defined by the surgical
plan 20.
[0061] At block 216, the surgeon may decide based upon his review
of the surgical plan 20 to have the vendor 14 modify the surgical
plan 20. If the surgeon decides to have the vendor 14 change the
surgical plan 20, the surgeon at block 218 may modify aspects of
the surgical plan request 18 such as, for example, providing
further constraints or directives regarding the custom surgical
plan 20 and transfer the modified surgical plan request 18 to the
vendor 14. For example, the surgeon may modify a digital templated
medical images and/or other data of the received surgical plan 20
and transmit the modified digital templated medical images and/or
other data to the surgical plan system 40.
[0062] The surgical plan system 40 at block 220 may modify the
surgical plan 20 per the modified surgical plan request 18. The
surgical plan system 40 may perform any number of corrective
procedures on the surgical plan 20 based upon the modified digital
templated medical images and/or recommendation data (e.g., the
range of recommended orthopaedic implant sizes) received from the
surgeon in process step 218.
[0063] The surgical plan system 40 may then return to block 212 in
order to transmit the modified surgical plan 20 to the healthcare
facility 12. In this manner, the vendor 14 and the surgeon may
modify the surgical plan 20 for the patient until the surgeon is
satisfied with the surgical plan 20.
[0064] If the surgeon is satisfied with the custom surgical plan 20
for the patient, the CAOS system 30 may be configured based upon
the custom surgical plan 20 at block 222. The custom surgical plan
20 may configure the CAOS system 30 using various different
techniques. The computing device 62 of the CAOS system 30 may
receive the surgical plan 20 directly from the vendor 14. The
computing device 62 of the CAOS system 30 may load the surgical
plan 20 from a computing device 26 and/or database 28 of the
healthcare facility 12. The computing device 62 of the CAOS system
30 may load the surgical plan 20 from a machine readable medium
such as CD-ROM, DVD-ROM, thumb drive, floppy or other portable
storage device created by the vendor 14 or a computing device 26 of
the healthcare facility. In another embodiment, a surgical plan 20
may comprise a document of instructions for a caregiver such as a
technician to manually input into the computing device 62 of the
CAOS system 30 prior to the orthopaedic surgical procedure.
[0065] At block 224, the CAOS system 30 directs a surgeon through
the orthopaedic surgical procedure per the custom surgical pan 20
for the patient. In particular, the computing device 62 of the CAOS
system 30 per the surgical plan 20 may control the display device
94 to display images of the individual surgical steps which form
the orthopaedic surgical procedure.
[0066] While the disclosure has been illustrated and described in
detail in the drawings and foregoing description, such an
illustration and description is to be considered as exemplary and
not restrictive in character, it being understood that only
illustrative embodiments have been shown and described and that all
changes and modifications that come within the spirit of the
disclosure are desired to be protected.
* * * * *