U.S. patent application number 15/139682 was filed with the patent office on 2016-08-18 for auxiliary image display and manipulation on a computer display in a medical robotic system.
This patent application is currently assigned to Intuitive Surgical Operations, Inc.. The applicant listed for this patent is Intuitive Surgical Operations, Inc.. Invention is credited to Brian David Hoffman, Rajesh Kumar, David Q. Larkin, Giuseppe Prisco, Nitish Swarup, Guanghua G. Zhang.
Application Number | 20160235496 15/139682 |
Document ID | / |
Family ID | 37744551 |
Filed Date | 2016-08-18 |
United States Patent
Application |
20160235496 |
Kind Code |
A1 |
Hoffman; Brian David ; et
al. |
August 18, 2016 |
AUXILIARY IMAGE DISPLAY AND MANIPULATION ON A COMPUTER DISPLAY IN A
MEDICAL ROBOTIC SYSTEM
Abstract
To assist a surgeon performing a medical procedure, auxiliary
images generally indicating internal details of an anatomic
structure being treated are displayed and manipulated by the
surgeon on a computer display screen to supplement primary images
generally of an external view of the anatomic structure. A master
input device controlling a robotic arm in a first mode may be
switched by the surgeon to a second mode in order to function
instead as a mouse-like pointing device to facilitate the surgeon
performing such auxiliary information display and manipulation.
Inventors: |
Hoffman; Brian David;
(Mountain View, CA) ; Kumar; Rajesh; (Sunnyvale,
CA) ; Larkin; David Q.; (Menlo Park, CA) ;
Prisco; Giuseppe; (Calci, IT) ; Swarup; Nitish;
(Sunnyvale, CA) ; Zhang; Guanghua G.; (San Jose,
CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Intuitive Surgical Operations, Inc. |
Sunnyvale |
CA |
US |
|
|
Assignee: |
Intuitive Surgical Operations,
Inc.
Sunnyvale
CA
|
Family ID: |
37744551 |
Appl. No.: |
15/139682 |
Filed: |
April 27, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
11583963 |
Oct 19, 2006 |
|
|
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15139682 |
|
|
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60728450 |
Oct 20, 2005 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/742 20130101;
A61B 2018/00982 20130101; G06F 3/011 20130101; A61B 1/00193
20130101; A61B 90/361 20160201; G06F 3/04817 20130101; G06F 3/016
20130101; G06F 3/0486 20130101; A61B 90/37 20160201; A61B 18/12
20130101; A61B 2090/3782 20160201; A61B 34/10 20160201; A61B 5/055
20130101; A61B 2018/00595 20130101; G06F 2203/014 20130101; G06F
2203/04804 20130101; A61B 34/76 20160201; A61B 90/36 20160201; A61B
34/71 20160201; G06F 3/04845 20130101; A61B 34/70 20160201; A61B
2018/00994 20130101; A61B 2090/101 20160201; A61N 7/022 20130101;
A61B 2018/00577 20130101; A61B 2090/378 20160201; A61B 1/313
20130101; G06F 3/04847 20130101; A61B 18/1482 20130101; G06F 3/0481
20130101; A61B 2090/374 20160201; G06F 3/0346 20130101; A61B 34/30
20160201; G06F 3/04842 20130101; G06F 2203/04806 20130101; A61B
1/04 20130101; A61B 34/37 20160201; A61B 2090/364 20160201 |
International
Class: |
A61B 34/37 20060101
A61B034/37; A61B 1/04 20060101 A61B001/04; A61B 18/12 20060101
A61B018/12; A61B 34/10 20060101 A61B034/10; A61B 5/00 20060101
A61B005/00; A61B 1/00 20060101 A61B001/00; A61B 5/055 20060101
A61B005/055; A61B 1/313 20060101 A61B001/313 |
Claims
1. A method for displaying on a computer display screen an effect
of a therapeutic procedure being applied by a therapy instrument to
an anatomic structure, comprising: generating an auxiliary image
indicating the effect of the therapeutic procedure being applied by
the therapy instrument to the anatomic structure; and displaying a
primary image of the anatomic structure overlaid with the auxiliary
image on the computer display screen during the therapeutic
procedure.
2. The method according to claim 1, wherein the therapeutic
procedure is performed using a medical robotic system, and the
therapy instrument is robotically manipulatable by a surgeon using
the medical robotic system to perform the therapeutic
procedure.
3. The method according to claim 1, wherein the primary image is
captured prior to the therapeutic procedure.
4. The method according to claim 3, wherein the primary image is a
pre-operative image generated by ultrasound.
5. The method according to claim 3, wherein the primary image is a
pre-operative image generated by magnetic resonance imaging.
6. The method according to claim 3, wherein the primary image is a
pre-operative image generated by computed axial tomography.
7. The method according to claim 3, wherein the auxiliary image is
a computer model of the therapeutic effect being applied by the
therapy instrument during the therapeutic procedure.
8. The method according to claim 7, wherein the computer model is a
volumetric shape determined at least partially by the geometry of a
therapeutic end of the therapy instrument.
9. The method according to claim 7, wherein the computer model is a
volumetric shape determined at least partially by a heat level
being applied to the anatomic structure by a therapeutic end of the
therapy instrument.
10. The method according to claim 7, wherein the computer model is
a volumetric shape determined at least partially by features of
surrounding tissue of the anatomic structure being subjected to the
therapeutic procedure.
11. The method according to claim 1, wherein the primary image is
captured during the therapeutic procedure.
12. The method according to claim 11, wherein the primary image is
an intra-operative image captured by a camera unit.
13. The method according to claim 12, wherein the camera unit
includes a stereoscopic pair of cameras.
14. The method according to claim 12, wherein the camera unit is
included in an endoscope.
15. The method according to claim 14, wherein the endoscope is a
laparoscope.
16. The method according to claim 11, wherein the auxiliary image
is a computer model of the therapeutic effect being applied by the
therapy instrument during the therapeutic procedure.
17. The method according to claim 16, wherein the computer model is
a volumetric shape determined at least partially by a shape of a
therapeutic end of the therapy instrument.
18. The method according to claim 16, wherein the computer model is
a volumetric shape determined at least partially by a heat level
being applied to the anatomic structure by a therapeutic end of the
therapy instrument.
19. The method according to claim 16, wherein the computer model is
a volumetric shape determined at least partially by features of
surrounding tissue of the anatomic structure being subjected to the
therapeutic procedure.
20. The method according to claim 11, wherein the auxiliary image
is an intra-operative image generated by ultrasound.
21. The method according to claim 22, wherein the therapeutic
procedure destroys abnormal tissue of the anatomic structure using
radio frequency ablation.
22. The method according to claim 21, wherein the abnormal tissue
includes diseased tissue.
23. The method according to claim 22, wherein the diseased tissue
includes at least one tumor.
24. The method according to claim 21, wherein the abnormal tissue
includes damaged tissue.
25. The method according to claim 21, wherein the therapeutic
procedure is one of a group consisting of radio frequency ablation,
high intensity focused ultrasound, and cauterization.
26. A method for displaying a selected portion of an auxiliary
image of an anatomic structure as an overlay to a primary image of
the anatomic structure on a computer display screen, comprising:
associating a movable window with a pointing device such that the
movable window is positionable on the computer display screen using
the pointing device; registering an auxiliary image of an anatomic
structure with a primary image of the anatomic structure so as to
be at a same position and orientation in a common reference frame;
and displaying the primary image on the computer display screen,
and a portion of the registered auxiliary image corresponding to
the same screen coordinates as the movable window as an overlay to
the primary image in the movable window.
27. The method according to claim 26, wherein the primary image is
captured by an image capturing device during a minimally invasive
surgical procedure being performed using a medical robotic system,
and the image capturing device is robotically manipulatable using
the medical robotic system while performing the medical
procedure.
28. The method according to claim 26, wherein the movable window
appears as a circular lens on the display screen.
29. The method according to claim 26, wherein the movable window
appears as a rectangular lens on the display screen.
30. The method according to claim 26, wherein the primary image is
a three-dimensional image of the anatomic structure, and the
computer display screen is a three-dimensional computer display
screen.
31. The method according to claim 26, wherein an entire part of the
registered auxiliary image corresponding to the same screen
coordinates as the movable window is displayed as an overlay to the
primary image in the movable window.
32. The method according to claim 26, wherein the portion of the
registered auxiliary image corresponding to the same screen
coordinates as the movable window is expanded so as to fit and be
displayed as an overlay to the primary image in the movable window
so as to appear as a magnified view of the auxiliary image.
33. The method according to claim 32, further comprising: receiving
a magnification factor selected by a user viewing the computer
display screen; and applying the magnification factor to determine
the portion of the registered auxiliary image to be fitted and
displayed as an overlay to the primary image in the movable
window.
34. The method according to claim 26, wherein the primary and
auxiliary images are three-dimensional images of the anatomic
structure, and the computer display screen is a three-dimensional
computer display screen.
35. The method according to claim 26, wherein the movable window is
associated with a user selectable depth of the auxiliary image so
that a two-dimensional slice of the auxiliary image corresponding
to a depth selected by a user is displayed as an overlay to the
primary image in the movable window.
36. The method according to claim 26, wherein the primary image is
a pre-operative image generated by magnetic resonance imaging.
37. The method according to claim 26, wherein the primary image is
a pre-operative image generated by computed axial tomography.
38. The method according to claim 26, wherein the primary image is
an inter-operative image captured by a camera unit.
39. The method according to claim 38, wherein the camera unit is
included in an endoscope.
40. The method according to claim 38, wherein the auxiliary image
is a pre-operative captured image.
41. The method according to claim 40, wherein the pre-operative
captured image is generated by magnetic resonance imaging.
42. The method according to claim 40, wherein the pre-operative
captured image is generated by computed axial tomography.
43. The method according to claim 40, wherein the pre-operative
captured image is generated by ultrasound.
44. The method according to claim 38, wherein the auxiliary image
is an intra-operative captured image.
45. The method according to claim 44, wherein the intra-operative
captured image is generated by ultrasound.
46. The method according to claim 44, wherein the intra-operative
captured image is generated by a second camera unit.
47. A medical robotic system comprising: an image capturing device
for capturing images; a robotic arm holding the image capturing
device; a computer display screen; a master input device adapted to
be manipulatable by an user in multiple degrees-of-freedom
movement; and a processor configured to control movement of the
image capturing device according to user manipulation of the master
input device when the master input device is in an image capturing
mode, and controlling the displaying of images derived from the
captured images on the computer display screen according to user
manipulation of the master input device when the master input
device is in an image manipulating mode.
48. The medical robotic system according to claim 47, wherein the
master input device is configured so as to be manipulatable in six
degrees of freedom so that the master input device operates as a
three-dimensional mouse when in the image manipulating mode.
49. The medical robotic system according to claim 47, wherein the
processor is configured so as to perform a grabbing function on one
of the derived images being displayed on the computer display
screen when a user activates a control input while a cursor
associated with the master input device is being displayed on the
derived image, and perform a moving function on the derived image
when the user moves the master input device while keeping the
control input activated when in the image manipulating mode.
50. The medical robotic system according to claim 49, wherein the
processor is further configured to provide haptic feedback to the
master input device while performing the moving function on the
derived image.
51. The medical robotic system according to claim 50, wherein the
haptic feedback is provided by associating a virtual mass and
inertial properties to the derived image so that the user would
feel a reflected force when the processor is performing the
grabbing and moving functions on the derived image in response to
user manipulation of the master input device while in the image
manipulating mode.
52. The medical robotic system according to claim 49, wherein the
image capturing device captures auxiliary images and the processor
is configured to cause a primary image captured by a primary image
capturing device to be displayed on the computer display screen
with at least a portion of one of the derived images overlayed over
the primary image.
53. The medical robotic system according to claim 52, wherein the
processor is configured to facilitate manually registering the one
of the derived images with the primary image by a user performing
the grabbing and moving functions on the derived image so as to
register the derived image with the primary image as they are both
being displayed on the computer display screen when in the image
manipulating mode.
54. The medical robotic system according to claim 47, wherein the
master input device has a gripper adapted to be squeezed by a hand
of a user to function as a control input when the master input
device is in the image manipulating mode.
55. The medical robotic system according to claim 54, wherein the
processor is configured to adjust a parameter associated with the
derived images when the gripper is squeezed and rotated around an
axis of the gripper when the master input device is in the image
manipulating mode.
56. The medical robotic system according to claim 55, wherein the
adjustable parameter is a brightness of the derived image.
57. The medical robotic system according to claim 55, wherein the
adjustable parameter is a color of the derived image.
58. The medical robotic system according to claim 55, wherein the
adjustable parameter is a level of detail of the derived image.
59. The medical robotic system according to claim 58, wherein the
level of detail of the derived image is determined by a level of
coarseness of a mesh structure defining the derived image.
60. The medical robotic system according to claim 47, wherein the
derived images are three-dimensional volumes generated from the
captured images; and the processor is further configured to display
one of the three-dimensional volumes and a two-dimensional window
on the computer display screen, manipulate a position and
orientation of the window on the computer display screen in
response to user manipulation of the master input device, and
define a cut-plane by an intersection of the window with the
three-dimensional volume so as to indicate a two-dimensional slice
of the three-dimensional volume.
61. The medical robotic system according to claim 60, wherein the
two-dimensional slice is displayed in the window.
62. The medical robotic system according to claim 60, wherein the
two-dimensional slice is displayed in a picture-in-picture window
of the computer display screen.
63. The medical robotic system according to claim 60, wherein the
processor is further configured to display a user selectable number
of two-dimensional windows on the computer display screen,
individually manipulate positions and orientations of the windows
on the computer display screen in response to user manipulation of
the master input device, and define cut-planes by intersections of
the manipulated windows with the three-dimensional volume so as to
indicate corresponding two-dimensional slices of the
three-dimensional volume.
64. The medical robotic system according to claim 63, wherein the
two-dimensional slices are displayed in corresponding
picture-in-picture windows of the computer display screen.
65. The medical robotic system according to claim 60, wherein the
processor is configured to display the two-dimensional window on
the computer display screen in response to user selection of an
item included in a displayed menu on the computer display
screen.
66. The medical robotic system according to claim 60, wherein the
processor is configured to display the two-dimensional window on
the computer display screen in response to user selection of an
icon being displayed on the display screen.
67. The medical robotic system according to claim 66, wherein the
icon is displayed in a periphery area of the computer display
screen, and the processor is further configured to interpret user
mouse-type actions of clicking on the icon and dragging the icon
away from the periphery area as a user selection of the icon.
68. The medical robotic system according to claim 67, wherein the
image capturing device is an ultrasound probe and the derived
images are three-dimensional ultrasound images of an anatomic
structure that are computer generated from two-dimensional
ultrasound slices captured by the ultrasound probe.
69. The medical robotic system according to claim 47, wherein the
processor is further configured to display one of the derived
images and an eraser image on the computer display screen,
manipulate at least a position of the eraser image on the computer
display screen in response to user manipulation of the master input
device, and erase any portion of one of the derived image being
displayed on the computer display screen that is traversed by the
eraser image as the eraser image is being manipulated on the
computer display screen.
70. The medical robotic system according to claim 69, wherein the
processor is configured to erase all detail of the portion of the
derived image that is traversed by the eraser image.
71. The medical robotic system according to claim 69, wherein the
processor is configured to reduce the detail of the portion of the
derived image that is traversed by the eraser image.
72. The medical robotic system according to claim 71, wherein the
reduction of detail of the portion of the derived image that is
traversed by the eraser image entails reducing the fineness of a
mesh structure defining the derived image.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority to U.S. provisional
application Ser. No. 60/728,450 filed Oct. 20, 2005, which is
incorporated herein by reference.
FIELD OF THE INVENTION
[0002] The present invention generally relates to medical robotic
systems and in particular, to the displaying and manipulating of
auxiliary images on a computer display in a medical robotic
system.
BACKGROUND OF THE INVENTION
[0003] Medical robotic systems such as those used in performing
minimally invasive surgical procedures offer many benefits over
traditional open surgery techniques, including less pain, shorter
hospital stays, quicker return to normal activities, minimal
scarring, reduced recovery time, and less injury to tissue.
Consequently, demand for minimally invasive surgery using medical
robotic systems is strong and growing.
[0004] One example of a medical robotic system is the daVinci.RTM.
Surgical System from Intuitive Surgical, Inc., of Sunnyvale, Calif.
The daVinci.RTM. system includes a surgeon's console, a
patient-side cart, a high performance 3-D vision system, and
Intuitive Surgical's proprietary EndoWrist.TM. articulating
instruments, which are modeled after the human wrist so that when
added to the motions of the robotic arm assembly holding the
surgical instrument, they allow at least a full six degrees of
freedom of motion, which is comparable to the natural motions of
open surgery.
[0005] The daVinci.RTM. surgeon's console has a high-resolution
stereoscopic video display with two progressive scan cathode ray
tubes ("CRTs"). The system offers higher fidelity than
polarization, shutter eyeglass, or other techniques. Each eye views
a separate CRT presenting the left or right eye perspective,
through an objective lens and a series of mirrors. The surgeon sits
comfortably and looks into this display throughout surgery, making
it an ideal place for the surgeon to display and manipulate 3-D
intra-operative imagery.
[0006] In addition to primary imagery being displayed on the
display screen, it is also desirable at times to be able to
concurrently view auxiliary information to gain better insight or
to otherwise assist in the medical procedure being performed. The
auxiliary information may be provided in various modes such as text
information, bar graphs, two-dimensional picture-in-picture images,
and two-dimensional or three-dimensional images that are registered
and properly overlaid with respect to their primary image
counterparts.
[0007] For auxiliary images, the images may be captured
pre-operatively or intra-operatively using techniques such as
ultrasonography, magnetic resonance imaging, computed axial
tomography, and fluoroscopy to provide internal details of an
anatomic structure being treated. This information may then be used
to supplement external views of the anatomic structure such as
captured by a locally placed camera.
[0008] Although there are a plethora of auxiliary information
sources as well as manners of displaying that information,
improvements in the display and manipulation of auxiliary images is
still useful to better assist surgeons in performing medical
procedures with medical robotic systems.
OBJECTS AND SUMMARY OF THE INVENTION
[0009] Accordingly, one object of various aspects of the present
invention is a method for displaying auxiliary information
including the effect of a therapeutic procedure as an overlay to or
otherwise associated with an image of an anatomic structure being
treated at the time by the procedure.
[0010] Another object of various aspects of the present invention
is a method for displaying a user selected portion at a user
specified magnification factor of a volume rendering of an
auxiliary image of an anatomic structure as a registered overlay to
a primary image of the anatomic structure on a computer display
screen.
[0011] Another object of various aspects of the present invention
is a medical robotic system having a master input device that may
be used to manually register images in a three-dimensional space of
a computer display.
[0012] Another object of various aspects of the present invention
is a medical robotic system having a master input device that may
be used to define cut-planes of a volume rendering of an anatomic
structure in a three-dimensional space of a computer display.
[0013] Another object of various aspects of the present invention
is a medical robotic system having a master input device that may
be used to selectively modify portions or details of a volume
rendering of an anatomic structure in a three-dimensional space of
a computer display.
[0014] Another object of various aspects of the present invention
is a medical robotic system having a master input device that may
be used to vary display parameters for a rendering of an anatomic
structure being displayed on a computer display screen.
[0015] Still another object of various aspects of the present
invention is a medical robotic system having a master input device
that may be switched between an image capturing mode wherein the
master input device controls movement of an image capturing device,
and an image manipulating mode wherein the master input device
controls display and manipulation of images captured by the image
capturing device on a computer display screen.
[0016] These and additional objects are accomplished by the various
aspects of the present invention, wherein briefly stated, one
aspect is method for displaying on a computer display screen an
effect of a therapeutic procedure being applied by a therapy
instrument to an anatomic structure, comprising: generating an
auxiliary image that indicates the effect of the therapeutic
procedure being applied by the therapy instrument to the anatomic
structure; and displaying a primary image of the anatomic structure
overlaid with the auxiliary image on the computer display screen
during the therapeutic procedure.
[0017] Another aspect is a method for displaying a selected portion
of an auxiliary image of an anatomic structure as an overlay to a
primary image of the anatomic structure on a computer display
screen, comprising: associating a movable window with a pointing
device such that the movable window is positionable on the computer
display screen using the pointing device; registering an auxiliary
image of an anatomic structure with a primary image of the anatomic
structure so as to be at a same position and orientation in a
common reference frame; and displaying the primary image on the
computer display screen, and a portion of the registered auxiliary
image corresponding to the same screen coordinates as the movable
window as an overlay to the primary image in the movable
window.
[0018] Still another aspect is a medical robotic system comprising:
an image capturing device for capturing images; a robotic arm
holding the image capturing device; a computer display screen; a
master input device adapted to be manipulatable by an user in
multiple degrees-of-freedom movement; and a processor configured to
control movement of the image capturing device according to user
manipulation of the master input device when the master input
device is in an image capturing mode, and controlling the
displaying of images derived from the captured images on the
computer display screen according to user manipulation of the
master input device when the master input device is in an image
manipulating mode.
[0019] Additional objects, features and advantages of the various
aspects of the present invention will become apparent from the
following description of its preferred embodiment, which
description should be taken in conjunction with the accompanying
drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0020] FIG. 1 illustrates a top view of an operating room employing
a medical robotic system utilizing aspects of the present
invention.
[0021] FIG. 2 illustrates a block diagram of a medical robotic
system utilizing aspects of the present invention.
[0022] FIG. 3 illustrates a laparoscopic ultrasound probe useful
for a medical robotic system utilizing aspects of the present
invention.
[0023] FIG. 4 illustrates a flow diagram of a method for displaying
on a computer display screen an effect of a therapeutic procedure
being applied by a therapeutic instrument to an anatomic structure,
utilizing aspects of the present invention.
[0024] FIG. 5 illustrates an external view of an anatomic structure
with a therapeutic instrument inserted in the anatomic structure
for performing a therapeutic procedure.
[0025] FIG. 6 illustrates an internal view of an anatomic structure
with a discernable therapeutic effect shown as captured by a
therapy sensing device.
[0026] FIG. 7 illustrates a computer display screen displaying an
effect of a therapeutic procedure registered to an anatomic
structure being treated by the procedure, as generated by a method
utilizing aspects of the present invention.
[0027] FIG. 8 illustrates a flow diagram of a method for displaying
a selected portion of an auxiliary image of an anatomic structure
in a user movable magnifying glass on a computer display screen,
utilizing aspects of the present invention.
[0028] FIG. 9 illustrates a flow diagram of a method for displaying
a manipulatable window of an internal view of an anatomic structure
at a specified magnification factor, utilizing aspects of the
present invention.
[0029] FIG. 10 illustrates an auxiliary image of an anatomic
structure and concentric areas of the auxiliary image representing
different magnification factors for display on a computer display
screen in a magnifying glass by a method utilizing aspects of the
present invention.
[0030] FIG. 11 illustrates a computer display screen with a primary
image of an anatomic structure and an overlaid portion of an
auxiliary image of the anatomic structure viewed in a magnifying
glass lens as displayed by a method utilizing aspects of the
present invention.
[0031] FIG. 12 illustrates a flow diagram of a method performed by
a processor in a medical robotic system for manipulating objects
displayed on a computer display screen utilizing aspects of the
present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0032] FIG. 1 illustrates, as an example, a top view of an
operating room employing a medial robotic system. The medical
robotic system in this case is a Minimally Invasive Robotic
Surgical ("MIRS") System 100 including a Console ("C") utilized by
a Surgeon ("S") while performing a minimally invasive diagnostic or
surgical procedure with assistance from one or more Assistants
("A") on a Patient ("P") who is reclining on an Operating table
("O").
[0033] The Console includes a Master Display 104 (also referred to
herein as a "Display Screen" or "computer display screen") for
displaying one or more images of a surgical site within the Patient
as well as perhaps other information to the Surgeon. Also included
are Master Input Devices 107, 108 (also referred to herein as
"Master Manipulators"), one or more Foot Pedals 105, 106, a
Microphone 103 for receiving voice commands from the Surgeon, and a
Processor 102. The Master Input Devices 107, 108 may include any
one or more of a variety of input devices such as joysticks,
gloves, trigger-guns, hand-operated controllers, grippers, or the
like. The Processor 102 is preferably a personal computer that may
be integrated into the Console or otherwise connected to it in a
conventional manner.
[0034] The Surgeon performs a medical procedure using the MIRS
System 100 by manipulating the Master Input Devices 107, 108 so
that the Processor 102 causes their respectively associated Slave
Arms 121, 122 to manipulate their respective removably coupled and
held Surgical Instruments 138, 139 (also referred to herein as
"Tools") accordingly, while the Surgeon views three-dimensional
("3D") images of the surgical site on the Master Display 104.
[0035] The Tools 138, 139 are preferably Intuitive Surgical's
proprietary EndoWrist.TM. articulating instruments, which are
modeled after the human wrist so that when added to the motions of
the robot arm holding the tool, they allow at least a full six
degrees of freedom of motion, which is comparable to the natural
motions of open surgery. Additional details on such tools may be
found in commonly owned U.S. Pat. No. 5,797,900 entitled "Wrist
Mechanism for Surgical Instrument for Performing Minimally Invasive
Surgery with Enhanced Dexterity and Sensitivity," which is
incorporated herein by this reference. At the operating end of each
of the Tools 138, 139 is a manipulatable end effector such as a
clamp, grasper, scissor, stapler, blade, needle, needle holder, or
energizable probe.
[0036] The Master Display 104 has a high-resolution stereoscopic
video display with two progressive scan cathode ray tubes ("CRTs").
The system offers higher fidelity than polarization, shutter
eyeglass, or other techniques. Each eye views a separate CRT
presenting the left or right eye perspective, through an objective
lens and a series of mirrors. The Surgeon sits comfortably and
looks into this display throughout surgery, making it an ideal
place for the Surgeon to display and manipulate 3-D intra-operative
imagery.
[0037] A Stereoscopic Endoscope 140 provides right and left camera
views to the Processor 102 so that it may process the information
according to programmed instructions and cause it to be displayed
on the Master Display 104. A Laparoscopic Ultrasound ("LUS") Probe
150 provides two-dimensional ("2D") ultrasound image slices of an
anatomic structure to the Processor 102 so that the Processor 102
may generate a 3D ultrasound computer model or volume rendering of
the anatomic structure.
[0038] Each of the Tools 138, 139, as well as the Endoscope 140 and
LUS Probe 150, is preferably inserted through a cannula or trocar
(not shown) or other tool guide into the Patient so as to extend
down to the surgical site through a corresponding minimally
invasive incision such as Incision 161. Each of the Slave Arms
121-124 includes a slave manipulator and setup arms. The slave
manipulators are robotically moved using motor controlled joints
(also referred to as "active joints") in order to manipulate and/or
move their respectively held Tools. The setup arms are manually
manipulated by releasing normally braked joints (also referred to
as "setup joints") to horizontally and vertically position the
Slave Arms 121-124 so that their respective Tools may be inserted
into the cannulae.
[0039] The number of surgical tools used at one time and
consequently, the number of slave arms being used in the System 100
will generally depend on the medical procedure to be performed and
the space constraints within the operating room, among other
factors. If it is necessary to change one or more of the tools
being used during a procedure, the Assistant may remove the tool no
longer being used from its slave arm, and replace it with another
tool, such as Tool 131, from a Tray ("T") in the Operating
Room.
[0040] Preferably, the Master Display 104 is positioned near the
Surgeon's hands so that it will display a projected image that is
oriented so that the Surgeon feels that he or she is actually
looking directly down onto the surgical site. To that end, an image
of the Tools 138, 139 preferably appear to be located substantially
where the Surgeon's hands are located even though the observation
points (i.e., that of the Endoscope 140 and LUS Probe 150) may not
be from the point of view of the image.
[0041] In addition, the real-time image is preferably projected
into a perspective image such that the Surgeon can manipulate the
end effector of a Tool, 138 or 139, through its associated Master
Input Device, 107 or 108, as if viewing the workspace in
substantially true presence. By true presence, it is meant that the
presentation of an image is a true perspective image simulating the
viewpoint of an operator that is physically manipulating the Tools.
Thus, the Processor 102 transforms the coordinates of the Tools to
a perceived position so that the perspective image is the image
that one would see if the Endoscope 140 was looking directly at the
Tools from a Surgeon's eye-level during an open cavity
procedure.
[0042] The Processor 102 performs various functions in the System
100. One important function that it performs is to translate and
transfer the mechanical motion of Master Input Devices 107, 108 to
their associated Slave Arms 121, 122 through control signals over
Bus 110 so that the Surgeon can effectively manipulate their
respective Tools 138, 139. Another important function is to
implement the various methods described herein in reference to
FIGS. 4-12.
[0043] Although described as a processor, it is to be appreciated
that the Processor 102 may be implemented in practice by any
combination of hardware, software and firmware. Also, its functions
as described herein may be performed by one unit, or divided up
among different components, each of which may be implemented in
turn by any combination of hardware, software and firmware. When
divided up among different components, the components may be
centralized in one location or distributed across the System 100
for distributed processing purposes.
[0044] Prior to performing a medical procedure, ultrasound images
captured by the LUS Probe 150, right and left 2D camera images
captured by the stereoscopic Endoscope 140, and end effector
positions and orientations as determined using kinematics of the
Slave Arms 121-124 and their sensed joint positions, are calibrated
and registered with each other.
[0045] Slave Arms 123, 124 may manipulate the Endoscope 140 and LUS
Probe 150 in similar manners as Slave Arms 121, 122 manipulate
Tools 138, 139. When there are only two master input devices in the
system, however, such as Master Input Devices 107, 108 in the
System 100, in order for the Surgeon to manually control movement
of either the Endoscope 140 or LUS Probe 150, it may be required to
temporarily associate one of the Master Input Devices 107, 108 with
the Endoscope 140 or the LUS Probe 150 that the Surgeon desires
manual control over, while its previously associated Tool and Slave
Manipulator are locked in position.
[0046] Although not shown in this example, other sources of primary
and auxiliary images of anatomic structures may be included in the
System 100, such as those commonly used for capturing ultrasound,
magnetic resonance, computed axial tomography, and fluoroscopic
images. Each of these sources of imagery may be used
pre-operatively, and where appropriate and practical,
intra-operatively.
[0047] FIG. 2 illustrates, as an example, a block diagram of the
System 100. In this system, there are two Master Input Devices 107,
108. Master Input Device 107 controls movement of either a Tool 138
or a stereoscopic Endoscope 140, depending upon which mode its
Control Switch Mechanism 211 is in, and Master Input Device 108
controls movement of either a Tool 139 or a LUS Probe 150,
depending upon which mode its Control Switch Mechanism 231 is
in.
[0048] The Control Switch Mechanisms 211 and 231 may be placed in
either a first or second mode by a Surgeon using voice commands,
switches physically placed on or near the Master Input Devices 107,
108, Foot Pedals 105, 106 on the Console, or Surgeon selection of
appropriate icons or other graphical user interface selection means
displayed on the Master Display 104 or an auxiliary display (not
shown).
[0049] When Control Switch Mechanism 211 is placed in the first
mode, it causes Master Controller 202 to communicate with Slave
Controller 203 so that manipulation of the Master Input 107 by the
Surgeon results in corresponding movement of Tool 138 by Slave Arm
121, while the Endoscope 140 is locked in position. On the other
hand, when Control Switch Mechanism 211 is placed in the second
mode, it causes Master Controller 202 to communicate with Slave
Controller 233 so that manipulation of the Master Input 107 by the
Surgeon results in corresponding movement of Endoscope 140 by Slave
Arm 123, while the Tool 138 is locked in position.
[0050] Similarly, when Control Switch Mechanism 231 is placed in
the first mode, it causes Master Controller 108 to communicate with
Slave Controller 223 so that manipulation of the Master Input 108
by the Surgeon results in corresponding movement of Tool 139 by
Slave Arm 122. In this case, however, the LUS Probe 150 is not
necessarily locked in position. Its movement may be guided by an
Auxiliary Controller 242 according to stored instructions in Memory
240. The Auxiliary Controller 242 also provides haptic feedback to
the Surgeon through Master Input 108 that reflects readings of a
LUS Probe Force Sensor 247. On the other hand, when Control Switch
Mechanism 231 is placed in the second mode, it causes Master
Controller 108 to communicate with Slave Controller 243 so that
manipulation of the Master Input 108 by the Surgeon results in
corresponding movement of LUS Probe 150 by Slave Arm 124, while the
Tool 139 is locked in position.
[0051] Before a Control Switch Mechanism effects a switch back to
its first or normal mode, its associated Master Input Device is
preferably repositioned to where it was before the switch.
Alternatively, the Master Input Device may remain in its current
position and kinematic relationships between the Master Input
Device and its associated Tool Slave Arm readjusted so that upon
the Control Switch Mechanism switching back to its first or normal
mode, abrupt movement of the Tool does not occur. For additional
details on control switching, see, e.g., commonly owned U.S. Pat.
No. 6,659,939 entitled "Cooperative Minimally Invasive Telesurgical
System," which is incorporated herein by this reference.
[0052] A third Control Switch Mechanism 241 is provided to allow
the user to switch between an image capturing mode and an image
manipulating mode while the Control Switch Mechanism 231 is in its
second mode (i.e., associating the Master Input Device 108 with the
LUS Probe 150). In its first or normal mode (i.e., image capturing
mode), the LUS Probe 150 is normally controlled by the Master Input
Device 108 as described above. In its second mode (i.e., image
manipulating mode), the LUS Probe 150 is not controlled by the
Master Input Device 108, leaving the Master Input Device 108 free
to perform other tasks such as the displaying and manipulating of
auxiliary images on the Display Screen 104 and in particular, for
performing certain user specified functions as described herein.
Note however that although the LUS Probe 150 may not be controlled
by the Master Input Device 108 in this second mode of the Control
Switch Mechanism 241, it may still be automatically rocked or
otherwise moved under the control of the Auxiliary Controller 242
according to stored instructions in Memory 240 so that a 3D volume
rendering of a proximate anatomic structure may be generated from a
series of 2D ultrasound image slices captured by the LUS Probe 150.
For additional details on such and other programmed movement of the
LUS Probe 150, see commonly owned U.S. patent application Ser. No.
11/447,668 entitled "Laparoscopic Ultrasound Robotic Surgical
System," filed Jun. 6, 2006, which is incorporated herein by this
reference.
[0053] The Auxiliary Controller 242 also performs other functions
related to the LUS Probe 150 and the Endoscope 140. It receives
output from a LUS Probe Force Sensor 247, which senses forces being
exerted against the LUS Probe 150, and feeds the force information
back to the Master Input Device 108 through the Master Controller
222 so that the Surgeon may feel those forces even if he or she is
not directly controlling movement of the LUS Probe 150 at the time.
Thus, potential injury to the Patient is minimized since the
Surgeon has the capability to immediately stop any movement of the
LUS Probe 150 as well as the capability to take over manual control
of its movement.
[0054] Another key function of the Auxiliary Control 242 is to
cause processed information from the Endoscope 140 and the LUS
Probe 150 to be displayed on the Master Display 104 according to
user selected display options. Examples of such processing include
generating a 3D ultrasound image from 2D ultrasound image slices
received from the LUS Probe 150 through an Ultrasound Processor
246, causing either 3D or 2D ultrasound images corresponding to a
selected position and orientation to be displayed in a
picture-in-picture window of the Master Display 104, causing either
3D or 2D ultrasound images of an anatomic structure to overlay a
camera captured image of the anatomic structure being displayed on
the Master Display 104, and performing the methods described below
in reference to FIGS. 4-12.
[0055] Although shown as separate entities, the Master Controllers
202, 222, Slave Controllers 203, 233, 223, 243, and Auxiliary
Controller 242 are preferably implemented as software modules
executed by the Processor 102, as well as certain mode switching
aspects of the Control Switch Mechanisms 211, 231, 241. The
Ultrasound Processor 246 and Video Processor 236, on the other
hand, may be software modules or separate boards or cards that are
inserted into appropriate slots coupled to or otherwise integrated
with the Processor 102 to convert signals received from these image
capturing devices into signals suitable for display on the Master
Display 104 and/or for additional processing by the Auxiliary
Controller 242 before being displayed on the Master Display
104.
[0056] Although the present example assumes that each Master Input
Device is being shared by only one pre-assigned Tool Slave Robotic
Arm and one pre-assigned Image Capturing Device Robotic Arm,
alternative arrangements are also feasible and envisioned to be
within the full scope of the present invention. For example, a
different arrangement wherein each of the Master Input Devices may
be selectively associated with any one of the Tool and Image
Capturing Device Robotic Arms is also possible and even preferably
for maximum flexibility. Also, although the Endoscope Robotic Arm
is shown in this example as being controlled by a single Master
Input Device, it may also be controlled using both Master Input
Devices to give the sensation of being able to "grab the image" and
move it to a different location or view. Still further, although
only an Endoscope and LUS Probe are show in this example, other
Image Capturing Devices such as those used for capturing camera,
ultrasound, magnetic resonance, computed axial tomography, and
fluoroscopic images are also fully contemplated within the System
100, although each of these Image Capturing Devices may not
necessarily be manipulated by one of the Master Input Devices.
[0057] FIG. 3 illustrates a side view of one embodiment of the LUS
Probe 150. The LUS Probe 150 is a dexterous tool with preferably
two distal degrees of freedom. Opposing pairs of Drive Rods or
Cables (not shown) physically connected to a proximal end of the
LUS Sensor 301 and extending through an internal passage of
Elongated Shaft 312 mechanically control pitch and yaw movement of
the LUS Sensor 301 using conventional push-pull type action.
[0058] The LUS Sensor 301 captures 2D ultrasound slices of a
proximate anatomic structure, and transmits the information back to
the Processor 102 through LUS Cable 304. Although shown as running
outside of the Elongated Shaft 312, the LUS Cable 304 may also
extend within it. A Clamshell Sheath 321 encloses the Elongate
Shaft 312 and LUS Cable 304 to provide a good seal passing through
a Cannula 331 (or trocar). Fiducial Marks 302 and 322 are placed on
the LUS Sensor 301 and the Sheath 321 for video tracking
purposes.
[0059] FIG. 4 illustrates, as an example, a flow diagram of a
method for displaying the effect of a therapeutic procedure or
treatment on the Display Screen 104. In 401, a primary image of an
anatomic structure is captured by an image capturing device. As an
example, FIG. 5 illustrates a primary image which has been captured
by the Endoscope 140 and includes an anatomic structure 501 and
therapeutic instrument 511 that has been partially inserted into
the anatomic structure 501 in order to perform a therapeutic
procedure at a therapy site within the anatomic structure 501. In
another application, the therapeutic instrument 511 may only need
to touch or come close to the anatomic structure 501 in order to
perform a therapeutic procedure.
[0060] The primary image may be captured before or during the
therapeutic procedure. A primary image captured before the
procedure is referred to as being a "pre-operative" image, and a
primary image captured during the procedure is referred to as being
an "intra-operative" image. When the primary image is a
pre-operative image, the image is generally not updated during the
procedure, so that the method generally only employs one primary
image. On the other hand, when the primary image is an
intra-operative image, the image is preferably updated periodically
during the procedure, so that the method employs multiple primary
images in that case.
[0061] Pre-operative images are typically captured using techniques
such as Ultrasonography, Magnetic Resonance Imaging (MRI), or
Computed Axial Tomography (CAT). Intra-operative images may be
captured at the surgical or therapeutic site by image capturing
devices such as the stereoscopic Endoscope 140 or LUS Probe 150, or
they may be captured externally by techniques such as those used to
capture the pre-operative images.
[0062] In 402 of FIG. 4, the therapeutic instrument is turned on,
or otherwise activated or energized, so as to be capable of
applying therapy to the anatomic structure within the patient. The
instrument generally has a tip for applying the therapeutic energy
to abnormal tissue such as diseased or damaged tissue. As one
example of such a therapeutic procedure, Radio Frequency Ablation
(RFA) may be used to destroy diseased tissue such as a tumor
located in an anatomic structure such as the liver by applying heat
to the diseased tissue site using an RFA probe. Examples of other
procedures include High Intensity Focused Ultrasound (HIFU) and
Cauterization. The therapeutic instrument may be one of the Tools
138, 139 attached to Slave Arms 121, 122 so that it may be moved to
and manipulated at the therapy site through the master/slave
control system by the Surgeon.
[0063] In 403, an auxiliary image is generated, wherein the
auxiliary image indicates the effect of the therapeutic procedure
on the anatomic structure. The auxiliary image may be an actual
image of the anatomic structure that has been provided by or
generated from information captured by a sensing device which is
capable of sensing the effect of the therapeutic procedure.
Alternatively, the auxiliary image may be a computer model
indicating the effect of the therapy, which may be generated using
an empirically derived or otherwise conventionally determined
formula of such effect. In this latter case, the computer model is
generally a volumetric shape determined by such factors as the
geometry of the tip of the therapeutic instrument, the heat or
energy level being applied to the anatomic structure by the tip of
the therapeutic instrument, and the features of the surrounding
tissue of a therapy site being subjected to the therapeutic
procedure in the anatomic structure.
[0064] As an example of an auxiliary image provided or otherwise
derived from information captured by a sensing device, FIG. 6
illustrates a three-dimensional ultrasound image of an anatomic
structure 601 which has been conventionally derived from
two-dimensional ultrasound slices captured by the LUS probe 150. In
this example, an ablation volume 621 is shown which represents the
effect of a therapeutic procedure in which a tip 613 of an RFA
probe 612 is being applied to a tumor site of the anatomic
structure 601. The growth of the ablation volume in this case is
viewable due to changes in tissue properties from the heating and
necrosis of the surrounding tissue at the tumor site.
[0065] In 404, the primary and auxiliary images are registered so
as to be of the same scale and refer to a same position and
orientation in a common reference frame. Registration of this sort
is well known. As an example, see commonly owned U.S. Pat. No.
6,522,906 entitled "Devices and Methods for Presenting and
Regulating Auxiliary Information on an Image Display of a
Telesurgical System to Assist an Operator in Performing a Surgical
Procedure," which is incorporated herein by this reference.
[0066] In 405, the primary image is displayed on the Display Screen
104 while the therapeutic procedure is being performed, with the
registered auxiliary image preferably overlaid upon the primary
image so that corresponding structures or objects in each of the
images appear as the same size and at the same location and
orientation on the Display Screen 104. In this way, the effect of
the therapeutic procedure is shown as an overlay over the anatomic
structure that is being subjected to the procedure.
[0067] As an example, FIG. 7 shows an exemplary Display Screen 104
in which an auxiliary image, distinguished as a dotted line for
illustrative purposes, is overlaid over the primary image of FIG.
5. When the auxiliary image is provided by or derives from
information captured by a sensing device, the therapy effect 521,
therapeutic instrument 512, and instrument tip 513 is provided by
or derived from the captured information. On the other hand, when
the therapy effect 521 is generated as a volumetric shaped computer
model using an empirically determined formula, the therapeutic
instrument 512 and instrument tip 513 may be determined using
conventional tool tracking computations based at least in part upon
joint positions of its manipulating slave arm.
[0068] In 406 of FIG. 4, the method then checks whether the
therapeutic instrument has been turned off. If it has, then this
means that the therapeutic procedure is over, and the method ends.
On the other hand, if the therapeutic instrument is still on, then
the method assumes that the therapeutic procedure is still being
performed, and proceeds in 407 to determine whether a new primary
image has been captured. If no new primary image has been captured,
for example, because the primary image is a pre-operative image,
then the method jumps back to 403 to update the auxiliary image and
continue to loop through 403-407 until the therapeutic procedure is
determined to be completed by detecting that the therapeutic
instrument has been turned off. On the other hand, if a new primary
image has been captured, for example, because the primary image is
an intra-operative image, then the method updates the primary image
in 408 before jumping back to 403 to update the auxiliary image and
continue to loop through 403-408 until the therapeutic procedure is
determined to be completed by detecting that the therapeutic
instrument has been turned off.
[0069] FIG. 8 illustrates, as an example, a flow diagram of a
method for displaying an auxiliary image of an anatomic structure
as a registered overlay to a primary image of the anatomic
structure at a user specified magnification in a window defined as
the lens area of a magnifying glass whose position and orientation
as displayed on the Display Screen 104 is manipulatable by the user
using an associated pointing device.
[0070] In 801, the method starts out by associating the magnifying
glass with the pointing device so that as the pointing device
moves, the magnifying glass being displayed on the Display Screen
104 (and in particular, its lens which may be thought of as a
window) moves in a corresponding fashion. The association in this
case may be performed by "grabbing" the magnifying glass in a
conventional manner using the pointing device, or by making the
magnifying glass effectively the cursor for the pointing device.
Since the Display Screen 104 is preferably a three-dimensional
display, the pointing device is correspondingly preferably a
three-dimensional pointing device with orientation indicating
capability.
[0071] In 802, current primary and auxiliary images are made
available for processing. The primary image in this example is
captured by the Endoscope 140 and the auxiliary captured by the LUS
Probe 150. However, other sources for the primary and auxiliary
images are also usable and contemplated in practicing the
invention, including primary and auxiliary images captured from the
same source. As an example of this last case, a high resolution
camera may capture images at a resolution greater than that being
used to display images on a display screen. In this case, the high
resolution image captured by the camera may be treated as the
auxiliary image, and the downsized image to be displayed on the
display screen may be treated as the primary image.
[0072] In 803, a user selectable magnification factor is read. The
magnification factor is user selectable by, for example, a dial or
wheel type control on the pointing device. Alternatively, it may be
user selectable by user selection of item in a menu displayed on
the Display Screen 104, or any other conventional user selectable
parameter value scheme or mechanism. If the user fails to make a
selection, then a default value is used, such as a magnification
factor of 1.0.
[0073] In 804, the primary and auxiliary images are registered so
as to be of the same scale and refer to a same position and
orientation in a common reference frame so that corresponding
structures and objects in the two images have the same
coordinates.
[0074] In 805, the primary image is displayed on the Display Screen
104 such as a three-dimensional view of the anatomic structure, in
which case, a portion of a two-dimensional slice of the auxiliary
image of the anatomic structure may be displayed as an overlay in
the lens of the magnifying glass. The portion of the
two-dimensional slice in this case is defined by a window area
having a central point that has the same position and orientation
of as the central point of the lens of the magnifying glass, and an
area determined by the magnification factor so that the portion of
the two-dimensional slice may be enlarged or reduced so as to fit
in the lens of the magnifying glass. Since the position and
orientation of the magnifying glass is manipulatable by the
positioning device to any position in the three-dimensional space
of the Display Screen 104, including those within the volume of the
anatomic structure, the two-dimensional slice can correspond to any
user selected depth within the anatomic structure. Unlike a
physical magnifying glass, its view is not limited to inspecting
only the exterior of the anatomic structure. For additional details
on 805, see the description below in reference to FIG. 9.
[0075] In 806, the method then determines whether the magnifying
glass command has been turned off by, for example, the user
releasing a "grabbed" image of the magnifying glass, or otherwise
switching off the association between the magnifying glass and the
pointing device by the use of a conventional switch mechanism of
some sort. If it has, then the method ends. On the other hand, if
it has not, then the method jumps back to 802 and continues to loop
through 802-806 until the magnifying glass command is detected to
have been turned off. Note that each time the method loops through
802-806, updated versions, if any, of the primary and auxiliary
images are processed along with updated values, if any, for the
user selectable magnification factor. Thus, if the method proceeds
through the looping in a sufficiently fast manner, the user will
not notice any significant delay if the user is turning a dial or
knob to adjust the magnification factor while viewing the anatomic
structure at a selected position and orientation of the magnifying
glass.
[0076] FIG. 9 illustrates, as an example, a flow diagram of a
method for displaying an auxiliary image view of an anatomic
structure at a specified magnification factor as an overlay to a
primary image view of the anatomic structure in the lens of a user
movable magnifying glass. As previously explained, this method may
be used to perform 805 of FIG. 8.
[0077] In 901, the current position and orientation of a central
point of the lens of the magnifying glass are determined in the
three-dimensional space of the Display Screen 104. In 902, a
two-dimensional slice of the registered volumetric model of the
auxiliary image is taken from the perspective of that position and
orientation, and a portion of the two-dimensional slice is taken as
defined in an auxiliary view window having a central point
preferably at that same position and orientation. The area of the
auxiliary view window in this case is inversely proportional to
that of the lens according to the current magnification factor for
the magnifying glass. In 903, the portion of the two-dimensional
slice defined by the auxiliary view window is then enlarged by the
magnification factor so that it fits in the lens area of the
magnifying glass, and in 904, the primary image of the anatomic
structure is displayed on the Display Screen 104 with the enlarged
portion of the two-dimensional slice of the auxiliary image
overlaid in the lens area of the magnifying glass being displayed
on the Display Screen 104.
[0078] As a pictorially example of 901-904, in FIGS. 10-11, a
two-dimensional slice 1001 of an auxiliary image of an anatomic
structure is shown along with two circular windows 1021, 1022 on
the two-dimensional slice as illustrated in FIG. 10. Each of the
windows 1021, 1022 in this case corresponds in shape to and having
a central point equal to that of a lens 1121 of a magnifying glass
1120 which is being displayed along with a primary image of an
external view 1101 of the anatomic structure on the Display Screen
104 as illustrated in FIG. 11. In this example, the area of the
window 1021 is equal to the area of the lens 1121, so that if the
magnification factor was 1.0, then window 1021 would be selected
for use in 902. On the other hand, the area of the window 1022 is
less than the area of the lens 1121, so that if the magnification
factor is greater than 1.0, then the window 1022 may be selected
for use in 902. Note that although the lens 1121 of the magnifying
glass 1120 is depicted as being circularly shaped, it may also have
other common shapes for a magnifying glass, such as a rectangular
shape.
[0079] FIG. 12 illustrates, as an example, a flow diagram of a
method performed by a processor in a medical robotic system for
manipulating image objects displayed on a computer display screen
of the medical robotic system in response to corresponding
manipulation of an associated master input device when the master
input device is in an image manipulating mode.
[0080] As a preface to the method, the medical robotic system
includes an image capturing device to capture images (such as
either the Endoscope 140 or the LUS Probe 150); a robotic arm
holding the image capturing device (such as the Slave Arm 123 or
the Slave Arm 124 respectively holding the Endoscope 140 and the
LUS Probe 150); a computer display screen (such as the Display
Screen 104); a master input device adapted to be manipulatable by a
user in multiple degrees-of-freedom movement (such as the Master
Input Device 107 or the Master Input Device 108); and a processor
(such as the Auxiliary Controller 242) that is configured to
control movement of the image capturing device according to user
manipulation of the master input device when the master input
device is in an image capturing mode, and control the displaying of
images derived from the captured images on the computer display
screen according to user manipulation of the master input device
when the master input device is in the image manipulating mode.
[0081] In 1201, the processor detects that the user has placed the
master input device into its image manipulating mode. One way that
this may be implemented is using a master clutch mechanism provided
in the medical robotic system, which supports disengaging the
master input device from its associated robotic arm so that the
master input device may be repositioned. When this mode is
activated by some mechanism such as the user depressing a button on
the master input device, pressing down on a foot pedal, or using
voice activation, the associated robotic arm is locked in position,
and a cursor (nominally an iconic representation of a hand, e.g. )
is presented to the user on the computer display screen. When the
user exits this mode, the cursor is hidden and control of the
robotic arm may be resumed after readjusting its position if
required.
[0082] In 1202, the processor determines whether a control input
such as that generated by depressing a button on a conventional
mouse has been activated by the user. The control input in this
case may be activated by depressing a button provided on the master
input device, or it may be activated by some other fashion such as
squeezing a gripper or pincher formation provided on the master
input device. For additional details on clutching, and gripper or
pincher formations on a master input device, see, e.g., commonly
owned U.S. Pat. No. 6,659,939 entitled "Cooperative Minimally
Invasive Telesurgical System," which has been previously
incorporated herein by reference. If the control input is not
determined to be "on" (i.e., activated) in 1202, then the processor
waits until it either receives an "on" indication or the image
manipulating mode is exited.
[0083] In 1203, after receiving an indication that the control
input is "on", the processor checks to see if the cursor is
positioned on (or within a predefined distance to) an object being
displayed on the computer display screen. If it is not, then in
1204, the processor causes a menu of user selectable items or
actions to be displayed on the computer display screen, and in
1205, the processor receives and reacts to a menu selection made by
the user.
[0084] Examples of user selectable menu items include: magnifying
glass, cut-plane, eraser, and image registration. If the user
selects the magnifying glass item, then an image of a magnifying
glass is displayed on the computer display screen and the method
described in reference to FIG. 8 may be performed by the processor.
When the user is finished with the magnifying glass function, then
the user may indicate exiting of the function in any conventional
manner and the processor returns to 1202.
[0085] If the user selects the cut-plane item, then a plane (or
rectangular window of fixed or user adjustable size) is displayed
on the computer display screen. The master input device may then be
associated with the plane so that the user may position and
orientate the plane in the three-dimensional space of the computer
display screen by manipulating the master input device in the
manner of a pointing device. If the plane is maneuvered so as to
intersect a volume rendering of an anatomic structure, then it
functions as a cut-plane defining a two-dimensional slice of the
volume rendering at the intersection. Alternatively, the master
input device may be associated with the volume rendering of the
anatomic structure, which may then be maneuvered so as to intersect
the displayed plane to define the cut-plane. Association of the
plane or volume rendering with the pointing device may be performed
in substantially the same manner as described in reference to the
magnifying glass with respect to 801 of FIG. 8.
[0086] The two-dimensional slice may then be viewed either in the
plane itself, or in a separate window on the computer display
screen such as in a picture-in-picture. The user may further select
the cut-plane item additional times to define additional
two-dimensional slices of the volume rendering for concurrent
viewing in respective planes or picture-in-picture windows on the
computer display screen. So as not to clutter the computer display
screen with unwanted cut-plane slices, a conventional delete
function is provided so that the user may selectively delete any
cut-planes and their corresponding slices. When the user is
finished with the cut-plane function, then the user may indicate
exiting of the function in any conventional manner and the
processor returns to 1202.
[0087] If the user selects the eraser item, then an eraser is
displayed on the computer display screen. The master input device
is then associated with the eraser so that the user may position
and orientate the eraser in the three-dimensional space of the
computer display screen by manipulating the master input device in
the manner of a pointing device. Association of the eraser with the
pointing device in this case may be performed in substantially the
same manner as described in reference to the magnifying glass with
respect to 801 of FIG. 8. If the eraser is maneuvered so as to
intersect a volume rendering of an anatomic structure, then it
functions to either completely or partially erase such rendering
wherever it traverses the volume rendering. If partial erasing is
selected by the user (or otherwise pre-programmed into the
processor), then each time the eraser traverses the volume
rendering, less detail of the anatomic structure may be shown. Less
detail in this case may refer to the coarseness/fineness of the
rendering, or it may refer to the stripping away of layers in the
three-dimensional volume rendering. All such characteristics or
options of the erasing may be user selected using conventional
means. If the user inadvertently erases a portion of the volume
rendering, a conventional undo feature is provided to allow the
user to undo the erasure. When the user is finished with the
erasing function, then the user may indicate exiting of the
function in any conventional manner and the processor returns to
1202.
[0088] In addition to an eraser function as described above, other
spatially localized modifying functions are also contemplated and
considered to be within the full scope of the present invention,
including selectively sharpening, brightening, or coloring portions
of a displayed image to enhance its visibility in, or otherwise
highlight, a selected area. Each such spatially localized modifying
function may be performed using substantially the same method
described above in reference to the eraser function.
[0089] If the user selects the image registration item, then the
processor records such selection for future action as described
below in reference to 1212 before jumping back to process 1202
again. Image registration in this case typically involves manually
registering an auxiliary image of an object such as an anatomic
structure with a corresponding primary image of the object.
[0090] As an alternative to the above described menu approach,
icons respectively indicating each of the selectable items as
described above may be displayed on the computer display screen
upon entering image manipulating mode and selected by the user
clicking on them, after which, the processor proceeds to perform as
described above in reference to selection of their corresponding
menu items.
[0091] Now continuing with the method described in reference to
FIG. 12, after receiving an indication that the control input is on
in 1201 and determining that the cursor is positioned on or near an
object (not an icon) being displayed on the computer display screen
in 1202, the processor preferably changes the cursor from an iconic
representation of a hand, for example, to that of a grasping hand
to indicate that the object has been "grabbed" and is ready to be
moved or "dragged" to another position and/or orientation in the
three-dimensional space of the computer display screen through user
manipulation of the master input device.
[0092] In 1206, the processor then determines whether the user has
indicated that a display parameter of the selected object is to be
adjusted, and if the user has so indicated, in 1207, the processor
performs the display adjustment. As an example, a dial on the
master input device may be turned by the user to indicate both that
a display adjustment for a display parameter associated with dial
is to be adjusted according to the amount of rotation of the dial
on the selected object. Alternatively, if the master input device
is equipped with a gripper, the gripper may be rotated so as to
function as a dial. Examples of display parameters that may be
adjusted in this manner include: brightness, contrast, color, and
level of detail (e.g., mesh coarseness/fineness, or voxel size
and/or opaqueness) of the selected object being displayed on the
computer display screen.
[0093] The processor then proceeds to 1208 to determine whether the
cursor has moved since "grabbing" the selected object after an
affirmative determination in 1203. If it has not moved, then the
processor jumps back to 1202 since the user may only have wanted to
adjust a display parameter of a selected object at this time. On
the other hand, if the cursor has moved since "grabbing" the
selected object, then in 1209, the processor moves the selected
object to the new cursor position. Since the cursor operates in the
three-dimensional space of the computer display screen, when it
moves "into" the display screen, it may indicate such movement by,
for example, getting progressively smaller in size. Where the
three-dimensional nature of the computer display screen is achieved
through the use of right and left two-dimensional views of the
object with disparities of common points between the two views
indicating depth values, decreasing of the depth values for images
of the cursor in the right and left views indicates that the cursor
is moving "into" the display screen.
[0094] Optionally, in 1210, haptic feedback may be provided back to
the master input device so that the user may sense reflected forces
while the "grabbed" object is being moved in 1209. As an example,
user interactions with the object may be reflected haptically back
to the user by associating a virtual mass and inertial properties
with the object so that the user feels a reflected force when
coming into contact with the object or when translating or rotating
the object as it is accelerated/decelerated. The haptic feedback
performed in this 1210 may only be performed for some types of
objects and not for others, or it may take effect only in certain
circumstances. Use of such haptic feedback may also be applied to
the movement of the magnifying glass and/or the plane used for
defining cut-planes as described above. In such cases, however, the
haptic feedback may be restricted to only occurring after the
magnifying glass or the plane enters into an anatomic structure of
interest.
[0095] In 1211, the processor determines whether the control input
is still in an "on" state. If the control is still "on", then the
processor jumps back to 1208 to track and respond to cursor
movement. On the other hand, if the control has been turned off by,
for example, the user releasing a button that was initially
depressed to indicate that control was turned "on", then in 1212,
the processor performs a selected menu action.
[0096] For example, if the image registration item had been
selected by the user in response to the processor displaying the
menu in 1204 (or alternatively, the user clicking an icon
indicating that item), then the object that has been moved is
registered with another image of the object that is now aligned
with and is being displayed on the computer display screen at the
time so that they have the same coordinate and orientation values
in a common reference frame such as that of the computer display
screen. This feature facilitates, for example, manual registration
of an auxiliary image of an anatomic structure (such as obtained
using the LUS Probe 150) with a primary image of the anatomic
structure (such as obtained using the Endoscope 140). After the
initial registration, changes to the position and/or orientation of
the corresponding object in the primary image may be mirrored so as
to cause corresponding changes to the selected object in the
auxiliary image so as to maintain its relative position/orientation
with respect to the primary image. When the user is finished with
the image registration function, then the processor returns to
1202.
[0097] Although the various aspects of the present invention have
been described with respect to a preferred embodiment, it will be
understood that the invention is entitled to full protection within
the full scope of the appended claims.
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