U.S. patent application number 15/899038 was filed with the patent office on 2019-08-22 for augmented reality navigation systems for use with robotic surgical systems and methods of their use.
The applicant listed for this patent is GLOBUS MEDICAL, INC.. Invention is credited to Bessam Al Jewad, Neil Crawford, Jeffrey Forsyth, Weston Healy, Norbert Johnson, Ken Jones, Sanjay Joshi, Christine Russ.
Application Number | 20190254753 15/899038 |
Document ID | / |
Family ID | 65685116 |
Filed Date | 2019-08-22 |
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United States Patent
Application |
20190254753 |
Kind Code |
A1 |
Johnson; Norbert ; et
al. |
August 22, 2019 |
AUGMENTED REALITY NAVIGATION SYSTEMS FOR USE WITH ROBOTIC SURGICAL
SYSTEMS AND METHODS OF THEIR USE
Abstract
The present disclosure is directed to augmented reality
navigation systems and methods of their use that, inter alia,
address the need for systems and methods of robotic surgical system
navigation with reduced distraction to surgeons. Augmented reality
navigation systems disclosed herein enable a surgeon to maintain
focus on a surgical site and/or surgical tool being used in a
surgical procedure while obtaining a wide range of navigational
information relevant to the procedure. Navigational information can
appear in the augmented reality navigation system as being
presented on virtual displays that sit in a natural field of view
of a surgeon during a procedure. Navigational information can also
appear to be overlaid over a patient's anatomy. Augmented reality
navigation systems comprise a head mounted display comprising an at
least partially transparent display screen, at least one detector
connected to the head mounted display for identifying real-world
features, and a computer subsystem.
Inventors: |
Johnson; Norbert; (North
Andover, MA) ; Forsyth; Jeffrey; (Cranston, RI)
; Crawford; Neil; (Chandler, AZ) ; Joshi;
Sanjay; (Andover, MA) ; Al Jewad; Bessam;
(Madbury, NH) ; Healy; Weston; (Cambridge, MA)
; Russ; Christine; (Stoneham, MA) ; Jones;
Ken; (Wellesley, MA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
GLOBUS MEDICAL, INC. |
AUDUBON |
PA |
US |
|
|
Family ID: |
65685116 |
Appl. No.: |
15/899038 |
Filed: |
February 19, 2018 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
G06T 19/006 20130101;
A61B 2017/00207 20130101; A61B 2017/00203 20130101; A61B 2034/258
20160201; G02B 27/017 20130101; A61B 2034/254 20160201; G16H 50/50
20180101; A61B 2034/256 20160201; A61B 2090/3616 20160201; A61B
2090/374 20160201; G06F 3/011 20130101; A61B 34/30 20160201; A61B
2017/00216 20130101; A61B 2034/2057 20160201; A61B 2090/371
20160201; G16H 40/63 20180101; A61B 34/20 20160201; A61B 2034/107
20160201; A61B 2034/2048 20160201; A61B 2034/2074 20160201; A61B
2090/502 20160201; A61B 2090/365 20160201; A61B 2090/376 20160201;
G16H 20/40 20180101; A61B 2090/372 20160201; A61B 2034/2068
20160201; A61B 2090/378 20160201 |
International
Class: |
A61B 34/20 20060101
A61B034/20; G06T 19/00 20060101 G06T019/00; G06F 3/01 20060101
G06F003/01; G02B 27/01 20060101 G02B027/01 |
Claims
1. An augmented reality navigation system for use with a robotic
surgical system, the system comprising: a head mounted display
comprising an at least partially transparent display screen
configured to display augmentation graphics which appear to a user
to be superimposed on at least a portion of a natural field of view
of the user; at least one detector for identifying real-world
features, the at least one detector connected to the head mounted
display; a surgical tool having markers and configured to be
detected by at the at least one detector, wherein a representation
of at least a portion of the surgical tool and/or a trajectory of
the surgical tool is presented in the head mounted display, wherein
a detector input signal from the at least one detector corresponds
to a field of view of the at least one detector and the field of
view comprises at least a portion of anatomy of a patient during a
surgical procedure, wherein the detector input signal includes a
relative location and/or orientation for each of one or more of the
real-world features, wherein the surgical tool is inserted into or
connected to the robotic surgical system.
2. The augmented reality navigation system of claim 1, wherein a
camera system for detecting real-world features is electrically
coupled to the head mounted display.
3. The augmented reality navigation system of claim 1, wherein the
head mounted display provides a representation of the surgical tool
and a trajectory of the surgical tool overlaid on the anatomy of
the patient.
4. The augmented reality navigation system of claim 1, further
includes a motion sensor connected to the head mounted display for
outputting a motion signal based on measured motion of the head
mounted display.
5. The augmented reality navigation system of claim 1, wherein the
robotic surgical system includes an arm, an end effector coupled to
a first end of the arm and a base coupled to the second end of the
arm, wherein the arm moves the end effector that is configured to
receive the surgical tool to a trajectory selected by a user.
6. The augmented reality navigation system of claim 5, wherein the
robotic surgical system and the augmented reality navigation system
includes a haptic feedback system to control the robotic arm within
a selected trajectory.
7. The augmented reality navigation system of claim 6, wherein the
surgical tool includes a communicating with the haptic feedback
system that constrains the surgical tool to the user selected
trajectory.
8. The augmented reality navigation system of claim 1, wherein the
at least one detector comprises a detector with at least a minimum
field of view of 40 degrees.
9. The augmented reality navigation system of claim 1, wherein the
display screen has a resolution of at least 1280.times.720
pixels.
10. The augmented reality navigation system of claim 1, comprising
a pointer tool for making surgical planning selections, wherein the
pointer tool is configured to be detected by the at least one
detector.
11. The augmented reality navigation system of claim 1, wherein the
robotic surgical system registers anatomy of a patient with the
augmented reality navigation system, and an anatomical model of the
patient based on medical image data.
12. The augmented reality navigation system of claim 1, wherein the
at least one detector comprises a video camera and transmits a
video signal to the head mounted display to display augmentation
graphics which appear to the user to be superimposed on at least a
portion ao natural field of view of the user.
13. The augmented reality navigation system of claim 1, wherein the
surgical procedure comprises at least one of a spinal surgical
procedure, an orthopedic surgical procedure, an orthopedic trauma
surgical procedure, and a neurosurgical procedure.
14. An augmented reality navigation system for use with a robotic
surgical system, the system comprising: a head mounted display
comprising an at least partially transparent display screen
configured to display augmentation graphics which appear to a user
to be superimposed on at least a portion of a natural field of view
of the user; at least one detector for identifying real-world
features, the at least one detector connected to the head mounted
display; and a computer subsystem configured to generate and/or
access a representation of at least a portion of a surgical tool
and/or a trajectory of the surgical tool during a surgical
procedure, modify at least a portion of the representation based on
a relative position and/or orientation of one or more real-world
features in a detector input signal received from the at least one
detector, and display, on the display screen, surgical tool
augmentation graphics based on the modified representation, wherein
the surgical tool is inserted into or connected to the robotic
surgical system.
15. The augmented reality navigation system of claim 14, wherein
the computer subsystem is configured to render a surgical tool
augmentation graphic for each of a plurality of surgical tool
trajectories, and display, on the display screen, the plurality of
surgical tool augmentation graphics such that the surgical tool
augmentation graphics appear overlaid on the anatomy of the patient
and each of the trajectory augmentation graphics indicate a
physical trajectory that could be followed during the surgical
procedure.
16. The augmented reality navigation system of claim 14, wherein
the computer subsystem is configured to modify an anatomical model
of a patient based on one or more relative location(s) and/or
orientation(s) determined from the detected input signal, thereby
forming an updated anatomical model, and the computer subsystem is
configured to display, on the display screen, anatomical model
augmentation graphics corresponding to the updated anatomical model
such that the updated anatomical model appears overlaid on the
anatomy of the patient.
17. The augmented reality navigation system of claim 14,
comprising: a motion sensor connected to the head mounted display
for outputting a motion signal based on measured motion of the head
mounted display, wherein the computer subsystem is configured to
update the surgical tool augmentation graphics based on motion
detected by the motion sensor.
18. The augmented reality navigation system of claim 14, wherein
the computer subsystem is configured to determine a selected
trajectory based at least in part on a user input trajectory
selection signal that selects the selected trajectory from a set of
one or more planned trajectories, and automatically move a robotic
arm and/or end effector of the robotic surgical system to be
aligned with the selected trajectory.
19. The augmented reality navigation system of claim 18, wherein
the computer subsystem is configured to automatically move the
robotic arm and/or end effector of the robotic surgical system
along the trajectory.
20. The augmented reality navigation system of claim 18, wherein
the computer subsystem is configured to define a haptic feedback
system that comprises the trajectory and constrains motion of a
robotic arm and/or end effector such that motion of at least a
portion of a surgical tool attached to the robotic arm and/or end
effector is constrained to within the haptic feedback system.
Description
FIELD
[0001] The present invention relates generally to augmented reality
systems for use with robotic surgical systems and methods of their
use.
BACKGROUND
[0002] Robotic surgical systems are used in many surgical
procedures in order to assist surgeons in precisely and accurately
performing the procedures. Frequently, these procedures require
precise placement of one or more implants and can be performed
using minimally invasive techniques. Robotic surgical systems
follow pre-planned or intra-operatively planned trajectories that
assist the surgeon in placing implants while maintaining their
intended alignment. Navigation markers placed throughout the
surgical environment are used to register the environment (e.g.,
patient anatomy) with the robotic surgical system in order to
properly orient the robot to the pre-planned or intra-operatively
planned trajectories. Additionally, medical image data can be
registered to the robotic surgical system to provide a model of the
patient's anatomy for use in navigation.
[0003] Surgeons plan and monitor trajectories as well as monitor
status of a robotic surgical system and a patient's anatomy during
a procedure using a fixed display, for example, attached to or next
to the robotic surgical system. Such a fixed display is the primary
mechanism for navigating and monitoring a robotic surgical system
during a procedure. This is especially true for minimally invasive
procedures where a patient's anatomy obstructs direct view of the
surgical site. However, fixed displays require a surgeon to divert
his or her vision away from the surgical site and/or surgical tools
that he or she is manipulating in order to obtain navigational
information displayed on the screen. Moreover, the display screen
can physically obstruct a surgeon's view of a portion of the
surgical environment.
SUMMARY
[0004] There is a need for systems and methods for viewing
navigational information from a robotic surgical system that reduce
a surgeon's need to divert his or her vision while not obstructing
view of the surgical environment. The present disclosure is
directed to augmented reality navigation systems and methods of
their use that, inter alia, address the need for systems and
methods of robotic surgical system navigation with reduced
distraction to surgeons. Augmented reality navigation systems
disclosed herein enable a surgeon to maintain focus on a surgical
site and/or surgical tool being used in a surgical procedure while
obtaining a wide range of navigational information relevant to the
procedure. Navigational information includes, but is not limited
to, a model of a patient's anatomy derived from medical image data,
a trajectory or position of a surgical tool or robotic surgical
system, or a position and orientation of a surgical implant.
Navigational information can be sent to an augmented reality
navigation system as navigation input data from a robotic surgical
system. Navigational information can appear in the augmented
reality navigation system as being presented on virtual displays
that sit in a natural field of view of a surgeon during a
procedure. Navigational information can also appear to be overlaid
over a patient's anatomy. Navigational information can include
information otherwise not visible in a surgeon's natural field of
view, for example trajectories and or portions of a surgical tool
obscured by a patient's anatomy.
[0005] Augmented reality navigation systems comprise a head mounted
display comprising an at least partially transparent display
screen, at least one detector connected to the head mounted display
for identifying real-world features, and a computer subsystem. The
display screen displays augmentation graphics, for example
navigation augmentation graphics that provide navigational
information to a surgeon. The navigation augmentation graphics can
appear as a separate display in the field of view of a surgeon or
overlaid over a patient's anatomy. The at least one detector
identifies real-world features, wherein the real-world features can
be, for example fiducials and/or patient anatomy recognized via
image recognition methods. In this way, the at least one detector
mounted to the head mounted display acts as the detector in a
typical navigation system used during surgery (e.g., can be used to
register a patient's anatomy and a robotic surgical system) without
requiring an additional piece of equipment in the surgical
environment. The computer subsystem can be configured to perform a
variety of navigational tasks useful to a surgeon during a
procedure including, for example, trajectory planning and
execution. A motion sensor can optionally be included to detect
motion of the head of a surgeon wearing the augmented reality
navigation system providing additional functionality and/or
performance (e.g., a selection input means or drift
correction).
[0006] In certain embodiments, an augmented reality navigation
system eliminates the need for an auxiliary navigation subsystem
such as those commonly used with current robotic surgical systems.
The at least one detector in the augmented reality navigation
system detects real-world features (e.g., fiducials) in
sufficiently quantity and resolution as to properly register a
patient to a robotic surgical system and, optionally, one or more
models of patient anatomy derived from medical image data.
Therefore, the augmented reality navigation system acts as a
standalone system without the need for additional equipment.
Although, in certain embodiments, an auxiliary detector is used in
conjunction with the augmented reality navigation system. An
auxiliary detector may provide a larger registered field, improved
resolution of registration, and/or redundancy.
[0007] In one aspect, the invention is directed to an augmented
reality navigation system for use with a robotic surgical system,
the system comprising: a head mounted display comprising an at
least partially transparent display screen configured to display
augmentation graphics (e.g., semi-opaque images) (e.g., navigation
augmentation graphics) which appear to a user to be superimposed on
at least a portion of a natural field of view of the user; at least
one detector for identifying real-world features, the at least one
detector connected to the head mounted display [e.g., wherein the
at least one detector comprises at least one of an optical camera
(e.g., a video camera), an EMF detector, a LiDAR detector, an
acoustic detector, and an RF detector] [e.g., wherein the
real-world features comprises fiducials and/or identified patient
anatomy (e.g., wherein the real-world features are fiducials
connected to at least one of a patient, a surgical tool, and the
robotic surgical system (e.g., a robotic arm, a part of a robotic
arm, and/or an end-effector of a robotic arm))]; a processor of a
computing device; and a non-transitory computer readable medium
having instructions stored thereon, wherein the instructions, when
executed by the processor, cause the processor to: receive, by the
processor, a detector input signal from the at least one detector,
wherein the detector input signal corresponds to a field of view of
the at least one detector and the field of view comprises at least
a portion of anatomy of a patient during a surgical procedure,
determine, by the processor, a relative location and/or orientation
for each of one or more the real-world features in the detector
input signal, generate and/or access, by the processor, a
representation of at least a portion of a surgical tool and/or a
trajectory of the surgical tool, wherein the surgical tool is
inserted into or connected to the robotic surgical system (e.g.,
wherein the portion of the surgical tool is hidden from the natural
field of view of the user, e.g., within a patient), modify (e.g.,
least one of rotate, scale, and translate), by the processor, at
least a portion of the representation based on the relative
location and/or orientation of the one or more real-world features,
thereby forming an updated representation, render, by the
processor, surgical tool augmentation graphics based on the updated
representation, and display, by the processor, the surgical tool
augmentation graphics on the display screen (e.g., display, via the
at least partially transparent display screen of the head mounted
display, the surgical tool augmentation graphics superimposed on at
least a portion of the natural field of view of the user).
[0008] In some embodiments, the instructions cause the processor
to: render, by the processor, a surgical tool augmentation graphic
for each of a plurality of surgical tool trajectories (e.g.,
planned surgical tool trajectories); and display, by the processor,
on the display screen, the plurality of surgical tool augmentation
graphics such that the surgical tool augmentation graphics appear
overlaid on the anatomy of the patient and each of the trajectory
augmentation graphics indicate a physical trajectory that could be
followed during the surgical procedure.
[0009] In some embodiments, the instructions cause the processor
to: determine, by the processor, a relative location and/or
orientation for each of at least one real-world feature from the
detected input signal; modify, by the processor, (e.g., by at least
one of rotation, scaling, and translation) an anatomical model of a
patient (e.g., a 3D model) based on the relative locations and/or
orientations determined from the detected input signal, thereby
forming an updated anatomical model (e.g., that is registered to
the anatomy of the patient); render, by the processor, anatomical
model augmentation graphics based at least in part on the updated
anatomical model; and display, by the processor, on the display
screen, the anatomical model augmentation graphics such that the
updated anatomical model appears overlaid on the anatomy of the
patient.
[0010] In some embodiments, the augmented reality navigation system
comprises a motion sensor (e.g., an inertial motion unit (IMU))
connected to the head mounted display for outputting a motion
signal based on measured motion of the head mounted display and
wherein the instructions cause the processor to: update, by the
processor, the relative position and orientation of the determined
real-world features in the detector input signal based on motion
detected by the motion sensor; and update, by the processor, the
surgical tool augmentation graphics based on the updated relative
position and orientation.
[0011] In some embodiments, the instructions cause the processor
to: receive, by the processor, a user input trajectory selection
signal that selects a trajectory from a set of one or more planned
trajectories (e.g., one or more preoperatively or intraoperatively
planned trajectories) (e.g., wherein the user input trajectory
selection signal corresponds to a gesture or sound made by the user
or a position and/or orientation of a robotic arm and/or end
effector of the robotic surgical system); determine, by the
processor, a selected trajectory based at least in part on the user
input trajectory selection signal; and automatically move, by the
processor, a robotic arm and/or end effector of the robotic
surgical system to be aligned with the selected trajectory.
[0012] In some embodiments, the instructions cause the processor
to: automatically move, by the processor, the robotic arm and/or
end effector of the robotic surgical system along the selected
trajectory (e.g., towards the anatomy of the patient).
[0013] In some embodiments, the instructions cause the processor
to: define and/or update, by the processor, a haptic object that
comprises the selected trajectory; and constrain, by the processor,
motion of a robotic arm and/or end effector such that motion of at
least a portion of the surgical tool inserted into or attached to
the robotic arm and/or end effector is constrained to within the
haptic object.
[0014] In some embodiments, the at least one detector comprises a
detector with at least a minimum field of view of 40 degrees (e.g.,
as measured on a diagonal). In some embodiments, the display screen
has a resolution of at least 1280.times.720 pixels.
[0015] In some embodiments, the augmented reality navigation system
comprises a pointer tool for making surgical planning selections
(e.g., of a trajectory and/or position(s) and/or orientation(s)
that define a trajectory), wherein the pointer tool is configured
to be detected by the at least one detector.
[0016] In some embodiments, the instructions cause the processor to
register anatomy of a patient with the robotic surgical system, the
augmented reality navigation system, and, optionally, an anatomical
model of the patient based on medical image data (e.g., X-ray data,
CT data, MRI data, fluoroscopy data).
[0017] In some embodiments, the at least one detector comprises a
video camera and the instructions cause the processor to: generate,
by the processor, a video signal based on the detector input
signal; and output, by the processor, the video signal for display
on at least one of (i) a monitor and (ii) a second head mounted
display comprising an at least partially transparent display screen
configured to display augmentation graphics (e.g., semi-opaque
images) which appear to a user to be superimposed on at least a
portion of a natural field of view of the user.
[0018] In some embodiments, the system comprises one or more
fiducial markers connected to the head mounted display. In some
embodiments, the instructions cause the processor to: receive, by
the processor, a relative location and orientation of the one or
more fiducial markers connected to the head mounted display,
wherein the one or more fiducial markers are detected by a
secondary detector (e.g., not physically connected to the head
mounted display) (e.g., an EMF detector, an RF detector, an
acoustic detector, a LiDAR detector, an optical detector); and
modify (e.g., at least one of rotate, scale, and translate) at
least one of (i) an anatomical model, (ii) a representation of a
surgical implant, (iii) a representation of a trajectory of a
surgical tool, and (iv) a representation of at least a portion of a
surgical tool hidden from a natural field of view based on the one
or more fiducial markers detected by the secondary detector.
[0019] In some embodiments, the instructions cause the processor
to: receive, by the processor, a relative location and orientation
of one or more real-world features detected by a secondary detector
(e.g., not physically connected to the head mounted display) (e.g.,
an EMF detector, an RF detector, an acoustic detector, a LiDAR
detector, an optical detector); modify (e.g., at least one of
rotate, scale, and translate), by the processor, at least one of
(i) an anatomical model, (ii) a representation of a surgical
implant, (iii) a representation of a trajectory of a surgical tool,
and (iv) a representation of at least a portion of a surgical tool
hidden from a natural field of view based on the one or more
real-world features detected by the secondary detector; render
and/or update, by the processor, updated augmentation graphics
based at least in part on the modified at least one of (i), (ii),
(iii), and (iv); an display, by the processor, on the display
screen, the updated augmentation graphics.
[0020] In some embodiments, the surgical procedure comprises at
least one of a spinal surgical procedure, an orthopedic surgical
procedure, an orthopedic trauma surgical procedure, and a
neurosurgical procedure. In some embodiments, the surgical
procedure comprises a minimally invasive surgical procedure.
[0021] In one aspect, the invention is directed to an augmented
reality navigation system for use with a robotic surgical system,
the system comprising: a head mounted display comprising an at
least partially transparent display screen configured to display
augmentation graphics (e.g., semi-opaque images) (e.g., navigation
augmentation graphics) which appear to a user to be superimposed on
at least a portion of a natural field of view of the user; at least
one detector for identifying real-world features, the at least one
detector connected to the head mounted display [e.g., wherein the
at least one detector comprises at least one of an optical camera
(e.g., a video camera), an EMF detector, a LiDAR detector, an
acoustic detector, and an RF detector] [e.g., wherein the
real-world features comprises fiducials and/or identified patient
anatomy (e.g., wherein the real-world features are fiducials
connected to at least one of a patient, a surgical tool, and the
robotic surgical system (e.g., a robotic arm, a part of a robotic
arm, and/or an end-effector of a robotic arm))]; and a computer
subsystem configured to generate and/or access a representation of
at least a portion of a surgical tool and/or a trajectory of the
surgical tool during a surgical procedure, modify at least a
portion of the representation based on a relative position and/or
orientation of one or more real-world features in a detector input
signal received from the at least one detector, and display, on the
display screen, surgical tool augmentation graphics based on the
modified representation, wherein the surgical tool is inserted into
or connected to the robotic surgical system (e.g., wherein the
portion of the surgical tool is hidden from the natural field of
view of the user, e.g., within a patient).
[0022] In some embodiments, the computer subsystem is configured to
render a surgical tool augmentation graphic for each of a plurality
of surgical tool trajectories (e.g., planned surgical tool
trajectories), and display, on the display screen, the plurality of
surgical tool augmentation graphics such that the surgical tool
augmentation graphics appear overlaid on the anatomy of the patient
and each of the trajectory augmentation graphics indicate a
physical trajectory that could be followed during the surgical
procedure.
[0023] In some embodiments, the computer subsystem is configured to
modify (e.g., by at least one of rotation, scaling, and
translation) an anatomical model of a patient (e.g., a 3D model)
based on one or more relative location(s) and/or orientation(s)
determined from the detected input signal, thereby forming an
updated anatomical model (e.g., that is registered to the anatomy
of the patient), and the computer subsystem is configured to
display, on the display screen, anatomical model augmentation
graphics corresponding to the updated anatomical model such that
the updated anatomical model appears overlaid on the anatomy of the
patient.
[0024] In some embodiments, the augmented reality navigation system
comprises a motion sensor (e.g., an inertial motion unit (IMU))
connected to the head mounted display for outputting a motion
signal based on measured motion of the head mounted display,
wherein the computer subsystem is configured to update the surgical
tool augmentation graphics based on motion detected by the motion
sensor.
[0025] In some embodiments, the computer subsystem is configured to
determine a selected trajectory based at least in part on a user
input trajectory selection signal that selects the selected
trajectory from a set of one or more planned trajectories (e.g.,
one or more preoperatively or intraoperatively planned
trajectories) (e.g., wherein the user input trajectory selection
signal corresponds to a gesture or sound made by the user or a
position and/or orientation of a robotic arm and/or end effector of
the robotic surgical system), and automatically move a robotic arm
and/or end effector of the robotic surgical system to be aligned
with the selected trajectory.
[0026] In some embodiments, the computer subsystem is configured to
automatically move the robotic arm and/or end effector of the
robotic surgical system along the trajectory (e.g., towards the
anatomy of the patient).
[0027] In some embodiments, the computer subsystem is configured to
define a haptic object that comprises the trajectory and constrain
motion of a robotic arm and/or end effector such that motion of at
least a portion of a surgical tool attached to the robotic arm
and/or end effector is constrained to within the haptic object.
[0028] In some embodiments, the at least one detector comprises a
detector with at least a minimum field of view of 40 degrees (e.g.,
as measured on a diagonal). In some embodiments, the display screen
has a resolution of at least 1280.times.720 pixels. In some
embodiments, the augmented reality navigation system comprises a
pointer tool for making surgical planning selections, wherein the
pointer tool is configured to be detected by the at least one
detector.
[0029] In some embodiments, the computer subsystem is configured to
register anatomy of a patient with the robotic surgical system, the
augmented reality navigation system, and, optionally, an anatomical
model of the patient based on medical image data (e.g., X-ray data,
CT data, MRI data, fluoroscopy data).
[0030] In some embodiments, the computer subsystem is configured to
generate a video signal based on the detector input signal and
output the video signal for display on at least one of (i) a
monitor and (ii) a second head mounted display comprising an at
least partially transparent display screen configured to display
augmentation graphics (e.g., semi-opaque images) which appear to a
user to be superimposed on at least a portion of a natural field of
view of the user.
[0031] In some embodiments, the system comprises one or more
fiducial markers connected to the head mounted display. In some
embodiments, the computer subsystem is configured to receive a
relative location and orientation of the one or more fiducial
markers connected to the head mounted display detected by a
secondary detector (e.g., not physically connected to the head
mounted display) (e.g., an EMF detector, an RF detector, an
acoustic detector, a LiDAR detector, an optical detector) and
modify (e.g., at least one of rotate, scale, and translate) at
least one of (i) an anatomical model, (ii) a representation of a
surgical implant, (iii) a representation of a trajectory of a
surgical tool, and (iv) a representation of at least a portion of a
surgical tool hidden from a natural field of view based on the one
or more fiducial markers detected by the secondary detector.
[0032] In some embodiments, the computer subsystem is configured to
receive a relative location and orientation of one or more
real-world features detected by a secondary detector (e.g., not
physically connected to the head mounted display) (e.g., an EMF
detector, an RF detector, an acoustic detector, a LiDAR detector,
an optical detector) and modify (e.g., at least one of rotate,
scale, and translate) at least one of (i) an anatomical model, (ii)
a representation of a surgical implant, (iii) a representation of
the trajectory, and (iv) a representation of at least a portion of
a surgical tool hidden from a natural field of view based on the
one or more real-world features detected by the secondary detector,
and the computer subsystem is configured to display, on the display
screen, updated augmentation graphics based at least in part on the
modified at least one of (i), (ii), (iii), and (iv).
[0033] In some embodiments, the surgical procedure comprises at
least one of a spinal surgical procedure, an orthopedic surgical
procedure, an orthopedic trauma surgical procedure, and a
neurosurgical procedure. In some embodiments, the surgical
procedure comprises a minimally invasive surgical procedure.
[0034] In one aspect, the invention is directed to a method of
using an augmented reality navigation system with a robotic
surgical system, the method comprising: providing and/or accessing
the augmented reality navigation system, wherein the augmented
reality navigation system comprises: a head mounted display
comprising an at least partially transparent display screen
configured to display augmentation graphics (e.g., semi-opaque
images) (e.g., navigation augmentation graphics) which appear to a
user to be superimposed on at least a portion of a natural field of
view of the user; optionally, a motion sensor (e.g., an inertial
motion unit (IMU)) connected to the head mounted display for
outputting a motion signal based on measured motion of the head
mounted display; and at least one detector for identifying
real-world features, the at least one detector connected to the
head mounted display [e.g., wherein the at least one detector
comprises at least one of an optical camera (e.g., a video camera),
an EMF detector, a LiDAR detector, an acoustic detector, and an RF
detector] [e.g., wherein the real-world features comprises
fiducials and/or identified patient anatomy (e.g., wherein the
real-world features are fiducials connected to at least one of a
patient, a surgical tool, and the robotic surgical system (e.g., a
robotic arm, a part of a robotic arm, and/or an end-effector of a
robotic arm))]; receiving (e.g., by a processor of a computer
subsystem) a detector input signal from the at least one detector,
wherein the detector input signal corresponds to a field of view of
the at least one detector and the field of view comprises at least
a portion of anatomy of a patient during a surgical procedure,
determining (e.g., by a processor of a computer subsystem) a
relative location and/or orientation for each of one or more the
real-world features in the detector input signal, generating and/or
accessing (e.g., by a processor of a computer subsystem) a
representation of at least a portion of a surgical tool and/or a
trajectory of the surgical tool, wherein the surgical tool is
inserted into or connected to the robotic surgical system (e.g.,
wherein the portion of the surgical tool is hidden from the natural
field of view of the user, e.g., within a patient), modifying
(e.g., least one of rotating, scaling, and translating) (e.g., by a
processor of a computer subsystem) at least a portion of the
representation based on the relative location and orientation of
the one or more real-world features, thereby forming an updated
representation, rendering (e.g., by a processor of a computer
subsystem) surgical tool augmentation graphics based on the updated
representation, and displaying (e.g., by a processor of a computer
subsystem) the surgical tool augmentation graphics on the display
screen (e.g., displaying, via the at least partially transparent
display screen of the head mounted display, the surgical tool
augmentation graphics superimposed on at least a portion of the
natural field of view of the user).
[0035] In some embodiments, the method comprises: rendering (e.g.,
by a processor of a computer subsystem) a surgical tool
augmentation graphic for each of a plurality of surgical tool
trajectories (e.g., planned surgical tool trajectories); and
displaying (e.g., by a processor of a computer subsystem) on the
display screen, the plurality of surgical tool augmentation
graphics such that the surgical tool augmentation graphics appear
overlaid on the anatomy of the patient and each of the trajectory
augmentation graphics indicate a physical trajectory that could be
followed during the surgical procedure.
[0036] In some embodiments, the method comprises: determining
(e.g., by a processor of a computer subsystem) a relative location
and/or orientation for each of at least one real-world feature from
the detected input signal; modifying (e.g., by at least one of
rotating, scaling, and translating) (e.g., by a processor of a
computer subsystem) an anatomical model of a patient (e.g., a 3D
model) based on the relative locations and/or orientations
determined from the detected input signal, thereby forming an
updated anatomical model (e.g., that is registered to the anatomy
of the patient); rendering (e.g., by a processor of a computer
subsystem) anatomical model augmentation graphics based at least in
part on the updated anatomical model; and displaying, on the
display screen, (e.g., by a processor of a computer subsystem) the
anatomical model augmentation graphics such that the updated
anatomical model appears overlaid on the anatomy of the
patient.
[0037] In some embodiments, the method comprises: updating (e.g.,
by a processor of a computer subsystem) the relative position and
orientation of the determined real-world features in the detector
input signal based on motion detected by the motion sensor; and
updating (e.g., by a processor of a computer subsystem) the
surgical tool augmentation graphics based on the updated relative
position and orientation.
[0038] In some embodiments, the method comprises: receiving (e.g.,
by a processor of a computer subsystem) a user input trajectory
selection signal that selects a trajectory from a set of one or
more planned trajectories (e.g., one or more preoperatively or
intraoperatively planned trajectories) (e.g., wherein the user
input trajectory selection signal corresponds to a gesture or sound
made by the user or a position and/or orientation of a robotic arm
and/or end effector of the robotic surgical system); determining
(e.g., by a processor of a computer subsystem) a selected
trajectory based at least in part on the user input trajectory
selection signal; and automatically (e.g., by a processor of a
computer subsystem) moving a robotic arm and/or end effector of the
robotic surgical system to be aligned with the selected
trajectory.
[0039] In some embodiments, the method comprises: automatically
(e.g., by a processor of a computer subsystem) moving the robotic
arm and/or end effector of the robotic surgical system along the
selected trajectory (e.g., towards the anatomy of the patient). In
some embodiments, the method comprises: defining and/or updating
(e.g., by a processor of a computer subsystem) a haptic object that
comprises the selected trajectory; and constraining motion of a
robotic arm and/or end effector such that motion of at least a
portion of the surgical tool inserted into or attached to the
robotic arm and/or end effector is constrained to within the haptic
object.
[0040] In some embodiments, the at least one detector comprises a
detector with at least a minimum field of view of 40 degrees (e.g.,
as measured on a diagonal). In some embodiments, the display screen
has a resolution of at least 1280.times.720 pixels.
[0041] In some embodiments, the method comprises: registering
anatomy of a patient with the robotic surgical system, the
augmented reality navigation system, and, optionally, an anatomical
model of the patient based on medical image data (e.g., X-ray data,
CT data, MRI data, fluoroscopy data).
[0042] In some embodiments, the at least one detector comprises a
video camera and the method comprises: generating (e.g., by a
processor of a computer subsystem) a video signal based on the
detector input signal; and outputting (e.g., by a processor of a
computer subsystem) the video signal for display on at least one of
(i) a monitor and (ii) a second head mounted display comprising an
at least partially transparent display screen configured to display
augmentation graphics (e.g., semi-opaque images) which appear to a
user to be superimposed on at least a portion of a natural field of
view of the user.
[0043] In some embodiments, the system comprises one or more
fiducial markers connected to the head mounted display and the
method comprises: receiving (e.g., by a processor of a computer
subsystem) a relative location and orientation of the one or more
fiducial markers connected to the head mounted display, wherein the
one or more fiducial markers are detected by a secondary detector
(e.g., not physically connected to the head mounted display) (e.g.,
an EMF detector, an RF detector, an acoustic detector, a LiDAR
detector, an optical detector); and modifying (e.g., at least one
of rotating, scaling, and translating) (e.g., by a processor of a
computer subsystem) at least one of (i) an anatomical model, (ii) a
representation of a surgical implant, (iii) a representation of a
trajectory of a surgical tool, and (iv) a representation of at
least a portion of a surgical tool hidden from a natural field of
view based on the one or more fiducial markers detected by the
secondary detector.
[0044] In some embodiments, the method comprises: receiving (e.g.,
by a processor of a computer subsystem) a relative location and
orientation of one or more real-world features detected by a
secondary detector (e.g., not physically connected to the head
mounted display) (e.g., an EMF detector, an RF detector, an
acoustic detector, a LiDAR detector, an optical detector);
modifying (e.g., at least one of rotating, scaling, and
translating) (e.g., by a processor of a computer subsystem) at
least one of (i) an anatomical model, (ii) a representation of a
surgical implant, (iii) a representation of a trajectory of a
surgical tool, and (iv) a representation of at least a portion of a
surgical tool hidden from a natural field of view based on the one
or more real-world features detected by the secondary detector;
rendering and/or updating (e.g., by a processor of a computer
subsystem) updated augmentation graphics based at least in part on
the modified at least one of (i), (ii), (iii), and (iv); and
displaying (e.g., by a processor of a computer subsystem) on the
display screen, the updated augmentation graphics.
[0045] In some embodiments, the surgical procedure comprises at
least one of a spinal surgical procedure, an orthopedic surgical
procedure, an orthopedic trauma surgical procedure, and a
neurosurgical procedure. In some embodiments, the surgical
procedure comprises a minimally invasive surgical procedure.
Definitions
[0046] In order for the present disclosure to be more readily
understood, certain terms used herein are defined below. Additional
definitions for the following terms and other terms may be set
forth throughout the specification.
[0047] In this application, the use of "or" means "and/or" unless
stated otherwise. As used in this application, the term "comprise"
and variations of the term, such as "comprising" and "comprises,"
are not intended to exclude other additives, components, integers
or steps. As used in this application, the terms "about" and
"approximately" are used as equivalents. Any numerals used in this
application with or without about/approximately are meant to cover
any normal fluctuations appreciated by one of ordinary skill in the
relevant art. In certain embodiments, the term "approximately" or
"about" refers to a range of values that fall within 25%, 20%, 19%,
18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%,
4%, 3%, 2%, 1%, or less in either direction (greater than or less
than) of the stated reference value unless otherwise stated or
otherwise evident from the context (except where such number would
exceed 100% of a possible value).
[0048] The following description generally makes use of a Cartesian
coordinate system in describing positions, orientations, and
directions of travel of various elements of and relating to the
systems and methods described herein. However, it should be
understood that specific coordinates (e.g., "x, y, z") and related
conventions based on them (e.g., a "positive x-direction", an "x,
y, or z-axis", an "xy, xz, or yz-plane", and the like) are
presented for convenience and clarity, and that, as understood by
one of skill in the art, other coordinate systems could be used
(e.g., cylindrical, spherical) and are considered to be within the
scope of the claims.
[0049] Navigational information: As used herein, the term
"navigational information" means information useful in navigating
during a surgical procedure. In certain embodiments, navigating
includes navigating one or more surgical tools and/or implants (or
other surgical apparatus). The surgical tool(s) may be attached to
a robotic surgical system. Navigational information includes, but
is not limited to, one or more of surgical trajectories, positions
and/or orientations of (i) surgical tools and/or apparatus (e.g.,
implants) and/or surgical equipment (e.g., surgical tables),
patient anatomy and/or models thereof, medical image data, and
positions and/or orientations of a robotic surgical system. As used
herein, where an augmented reality navigation system is described
as displaying navigational information to a surgeon, it is
understood that other information not immediately relevant to
navigation, but relevant generally to a surgical procedure may also
be displayed (e.g., in a similar fashion). For example, patient
health information regarding a patient's vitals or condition (e.g.,
patient history) or status information related to a surgical
procedure (e.g., progress, instructions, or other information) may
be displayed (e.g., on a virtual display presented on a display
screen of an augmented reality navigation system). When
appropriate, navigational information can optionally appear
overlaid over a patient's anatomy.
[0050] Augmentation graphic: As used herein, the term "augmentation
graphic" refers to a graphic that is rendered by a processor and
displayed on a display screen of an augmented reality navigation
system such that the graphic appears superimposed on the natural
field of view of a surgeon as viewed through the display screen. In
certain embodiments, an augmentation graphic may also be rendered
for display on a remote monitor to allow third party observers to
observe what a surgeon is seeing (e.g., one that is mounted on a
wall of an operating room). An augmentation graphic may be a
standalone graphic that appears in the natural field of view (e.g.,
as a virtual display floating in the field of view of a surgeon).
An augmentation graphic may appear overlaid over one or more
objects (e.g., patient anatomy) in the natural field of view, such
that the augmentation graphic coincides with a physical object
(e.g., portion of a patient anatomy) that is represented by the
augmentation graphic (e.g., wherein the physical object or a
portion thereof is not otherwise seen by a surgeon). In certain
embodiments, an augmentation graphic may appear as a 3D object that
sits adjacent to the physical object that it represents (e.g., with
a common orientation but offset by a spatial translation). In some
embodiments, augmentation graphics comprise several graphics for
display in a chronological order such that they appear as a video
on a display screen that augments a surgeon's natural field of
view. For example, a surgeon can view a portion of a procedure as
it will occur overlaid over a patient's physical anatomy.
[0051] Medical image data: As used herein, medical image data
refers to image data that represents at least a portion of a
patient. Medical image data may be generated using any suitable
technique including, but not limited to, X-ray techniques,
radiography techniques (fluoroscopy techniques (e.g., generated
using an O-arm or C-arm)), tomographic techniques (e.g., X-ray
computed tomography, positron emission tomography (PET), or
magnetic resonance imaging (MRI)), ultrasound techniques, or
elastography techniques.
[0052] Pointer tool: As used herein, the term "pointer tool" refers
to a tool that is used to indicate a desired position and/or
orientation. A pointer tool may be configured to be inserted into a
robotic surgical system, for example, an end effector thereof or a
tool guide attached thereto. A pointer tool may be a specially
configured instrument solely used for pointing. A surgical tool may
be used as a pointer tool. For example, a drill bit, a drill guide,
a tool guide, an awl, or similar surgical tool may be used as a
pointer tool. A pointer tool may have one or more fiducials
attached to the tool (e.g., sufficient to determine a position and
orientation of the pointer tool (e.g., by triangulation)).
[0053] Real-world feature: As used herein, the term "real-world
feature" refers to a physical object or portion thereof that can be
detected by a detector such that spatial information about the
object can be determined. Spatial information comprises a position
and/or orientation. A real-world feature may be identified patient
anatomy (e.g., identified by reference to an anatomy database
(e.g., a database of images of patient anatomy)) that is detected
using one or more image-recognition techniques. A real-world
feature may be any suitable fiducial. A fiducial may be attached
to, for example, surgical equipment (e.g., an operating table), a
patient, a surgical tool, an implant, a robotic surgical system, or
an augmented reality navigation system (e.g., on the head mounted
display). A fiducial may comprise a plurality of markers to assist
in orienting the fiducial in the environment during navigation
(e.g., tracking). For example, in certain embodiments, a fiducial
comprises a plurality of spatially separated markers (e.g., 3
markers or 4 markers) attached to a rigid holding apparatus that is
attachable to an object, wherein each of the markers is configured
to be detected by a detector disposed on the head mounted display
(e.g., emit or alter an electromagnetic field for an EMF detector
or have a certain reflectivity for an optical detector). Real-world
features are used to determine position and orientation of objects
in a surgical environment. An example of a technique used to make
such a determination using the systems disclosed herein is
triangulation, however, it will be apparent to those of ordinary
skill in the art of patient registration that any of a number of
techniques may be used, alone or in combination, such as surface
matching or other similar correlation techniques.
[0054] Trajectory: As used herein, the term "trajectory" refers to
a path desired and/or intended to be followed. A trajectory may be
modeled and graphics representing the trajectory may be displayed
on a display screen of an augmented reality navigation system. A
trajectory may a linear trajectory (e.g., wherein all points along
the trajectory fall onto a line) or a non-linear trajectory. A
trajectory sent by a processor (e.g., to a robotic surgical system)
or stored on a computer readable medium (e.g., for manipulation by
a processor) may be represented by any data sufficient to define
the trajectory. Non-limiting examples of data used to define a
trajectory include a single coordinate in space and an orientation
(e.g., vector), a plurality of coordinates, and a functional
relationship (e.g., involving an x, y, and z variable). In certain
embodiments, a path may be followed using a robotic surgical system
(e.g., automatically) or manually by a surgeon.
[0055] Robotic surgical system: As used herein, the term "robotic
surgical system" refers to a system comprising a robotic arm
configured to assist in a surgical procedure. A robotic arm may
assist in a surgical procedure by holding and/or manipulating
(e.g., guiding and/or moving) one or more surgical tool(s). In
certain embodiments, a robotic surgical system comprises an active,
non-backdriveable robotic arm. In certain embodiments, a robotic
surgical system comprises a passive, backdriveable robotic arm. In
certain embodiments, a robotic surgical system is configured to be
manipulated directly by a surgeon (e.g., by grasping and
maneuvering). In certain embodiments, a robot is configured to be
manipulated remotely by a surgeon (e.g., similarly to a
master/slave system). In certain embodiments, a robotic arm of a
robotic surgical system is configured to assist in a surgical
procedure by preventing a surgeon from actively maneuvering a
surgical tool attached to the robotic arm outside of a defined
haptic object (i.e., haptic volume). In certain embodiments, a
robotic arm of a robotic surgical system is configured to
automatically move, upon input from a surgeon, onto and/or along a
trajectory, such as a trajectory pre-operatively or
intra-operatively planned using an augmented reality navigation
system in communication with the robotic surgical system. In
certain embodiments, a robotic surgical system and an augmented
reality navigation system have a common computer subsystem.
BRIEF DESCRIPTION OF THE DRAWING
[0056] Drawings are presented herein for illustration purposes, not
for limitation. The foregoing and other objects, aspects, features,
and advantages of the invention will become more apparent and may
be better understood by referring to the following description
taken in conjunction with the accompanying drawings, in which:
[0057] FIG. 1 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0058] FIG. 2 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0059] FIG. 3 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0060] FIG. 4 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0061] FIG. 5 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0062] FIG. 6 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0063] FIG. 7 illustrates a head mounted display apparatus that can
be worn on a user's head and operates in accordance with some
embodiments of the invention;
[0064] FIG. 8 illustrates operations and methods that may be
performed by an augmented reality navigation system that includes a
head mounted display to display virtual display panels through a
display screen of the head mounted display, according to some
illustrative embodiments of the invention;
[0065] FIG. 9 is a block diagram of electronic components of a
computer subsystem coupled to head mounted display in an augmented
reality navigation system, according to illustrative embodiments of
the invention;
[0066] FIG. 10 is a block diagram of components of an augmented
reality navigation system that tracks the location of equipment
(surgical tools, a surgeon's head mounted display, and parts of a
patient's anatomy, and generates a three dimensional (3D) model
from patient data that is displayed on the head mounted display to
be rendered super-imposed at a visually aligned location on the
patient's body in accordance with illustrative embodiments of the
invention;
[0067] FIG. 11 is another block diagram of the electronic
components and modules of an augmented reality surgical system, in
accordance with illustrative embodiments of the invention;
[0068] FIG. 12 is a block diagram of an exemplary method for using
an augmented reality navigation system to display a graphical
representation of a surgical tool and/or its trajectory, according
to illustrative embodiments of the invention;
[0069] FIG. 13 is a block diagram of an exemplary method for using
an augmented reality navigation system with fixed crosshairs,
according to illustrative embodiments of the invention;
[0070] FIG. 14 is a block diagram of an exemplary method for using
an augmented reality navigation system with a pointer tool,
according to illustrative embodiments of the invention;
[0071] FIG. 15 illustrates navigation information that may be
displayed on an augmented reality navigation system during a
surgical procedure, according to illustrative embodiments of the
invention;
[0072] FIG. 16 schematically illustrates portions of a model of a
patient anatomy and an implant being inserted along a pre-planned
or intra-operatively planned trajectory using a surgical tool
connected to a robotic surgical system that are otherwise not
visible to the wearer, as displayed on an augmented reality
navigation system, according to illustrative embodiments of the
invention;
[0073] FIG. 17 is a block diagram of an example network environment
for use in the methods and systems described herein, according to
illustrative embodiments of the invention; and
[0074] FIG. 18 is a block diagram of an example computing device
and an example mobile computing device, for use in illustrative
embodiments of the invention.
DETAILED DESCRIPTION
[0075] It is contemplated that systems, devices, methods, and
processes of the claimed invention encompass variations and
adaptations developed using information from the embodiments
described herein. Adaptation and/or modification of the systems,
devices, methods, and processes described herein may be performed
by those of ordinary skill in the relevant art.
[0076] Throughout the description, where articles, devices, and
systems are described as having, including, or comprising specific
components, or where processes and methods are described as having,
including, or comprising specific steps, it is contemplated that,
additionally, there are articles, devices, and systems of the
present invention that consist essentially of, or consist of, the
recited components, and that there are processes and methods
according to the present invention that consist essentially of, or
consist of, the recited processing steps.
[0077] It should be understood that the order of steps or order for
performing certain action is immaterial so long as the invention
remains operable. Moreover, two or more steps or actions may be
conducted simultaneously.
[0078] The mention herein of any publication, for example, in the
Background section, is not an admission that the publication serves
as prior art with respect to any of the claims presented herein.
The Background section is presented for purposes of clarity and is
not meant as a description of prior art with respect to any claim.
Headers are provided for the convenience of the reader and are not
intended to be limiting with respect to the claimed subject
matter.
Augmented Reality Navigation Systems and Components Thereof
[0079] The augmented reality navigation systems disclosed herein
comprise a head mounted display comprising an at least partially
transparent display screen, at least one detector connected to
(e.g., disposed on) the head mounted display for identifying
real-world features, and a computer subsystem. The computer
subsystem can be configured to perform a variety of navigational
tasks useful to a surgeon during a procedure including, for
example, trajectory planning and execution. A motion sensor can
optionally be included to detect motion of the head of a surgeon
wearing the augmented reality navigation system providing
additional functionality and/or performance (e.g., a selection
input means or drift correction). Augmented reality navigation
systems for use in certain surgical procedures that are in
accordance with certain embodiments of the present disclosure are
described in U.S. Patent Publication No. 2016-0225192 A1, published
on Aug. 4, 2016, the disclosure of which is hereby incorporated by
reference herein in its entirety.
[0080] Embodiments of the present disclosure are directed to an
augmented reality surgical system that includes a head mounted
display (HMD) apparatus that can be worn by a surgeon, physician,
or other personnel during a medical procedure. Throughout the
present disclosure, where an augmented reality navigation system is
described as being worn by or used by a wearer, user, or surgeon,
it is understood that any person assisting with, leading, or
observing a surgical procedure can equivalently interact with an
augmented reality navigation system in the same manner as is being
described. The user is not limited to any one particular individual
with a specific relationship to a surgical procedure. The HMD can
be configured to provide localized, real-time situational awareness
to the wearer. The HMD includes a display screen that can be
positioned within the natural line-of-sight and/or periphery field
of view (FOV) of the wearer to provide visual information that can
be organized and displayed as a single virtual display or as a
collection of virtual displays that a wearer can navigate between
to view using head movement, hand gestures, voice commands, eye
control, and/or other operations disclosed herein. In certain
embodiments, a display screen can be manipulated to be in or out of
a natural field of view of a surgeon (e.g., by flipping the screen
from an "in use" to "out of use" position").
[0081] In certain embodiments, a surgeon or other person can wear
an HMD to see a graphical representation of what is within the
patient's body but covered from view by skin, muscle, organs,
skeletal structure, etc. In certain embodiments, using an HMD can
enable a surgeon to minimize the size of an incision by observing
where the incision needs to be made to reveal a targeted portion of
the body. Similarly, an HMD can be used when replacing a bone with
prosthesis to enable a surgeon to observe a real-world feature that
aids with orienting and moving surgical tool(s) (e.g., attached to
a robotic surgical system) and/or a prosthesis during the
procedure. An HMD may operate to improve the efficiency,
productivity, throughput, and/or accuracy, and/or safety of the
wearer's performance of a medical procedure. Moreover, an HMD can
reduce mental fatigue by reducing or eliminating a need for the
wearer to reference remote display devices having substantial
angular offsets during a medical procedure.
[0082] In certain embodiments, an augmented reality navigation
system has an initialization time of under 10 minutes (e.g., under
5 minutes) thereby minimizing delay and interference of surgical
procedures. In certain embodiments, an augmented reality navigation
system can be comfortably word for a minimum of one hour and up to
four hours or more. In certain embodiments, an augmented reality
navigation system is compatible with surgeon's loupes. In certain
embodiments, an augmented reality navigation system is compatible
with personal prescription glasses. In certain embodiments, an
augmented reality navigation system provides a minimum field of
view of 40 degrees (e.g., 50 degrees, 60 degrees, 70 degrees, 90
degrees, or more) as measured on a diagonal. In certain
embodiments, an augmented reality navigation system comprises a
head mounted display and computer subsystem coupled together to
provide less than 50 millisecond latency (e.g., less than 20
millisecond latency) from the time that a display screen moves
until updated navigation information is received by the display
screen. In certain embodiments, a display screen can have a frame
rate of 30 frames per second or more (e.g., 60 frames per second or
120 frames per second).
[0083] The augmented reality navigation systems disclosed herein
comprise a head mounted display comprising an at least partially
transparent display screen. The head mounted display comprising an
at least partially transparent display screen can have a form
factor similar to eyeglasses. For example, it can be binocular or
monocular (i.e., the display screen can be used to augment vision
in one or both eyes). In certain embodiments, the head mounted
display is a binocular head mounted display. A binocular
arrangement may be made of one contiguous display screen at least
partially covering both eyes when worn or it may be two separate
display screens (i.e., one screen for each eye). The head mounted
display may be held on a wearer's head using armatures (as in a
typical pair of eyeglasses) or some other mounting means (e.g., a
strap, band, or fixture sized and shaped to be worn on a human
head). The at least partially transparent display screen configured
to display augmentation graphics can be any suitable commercially
available display screen, for example, those used in heads up
displays for piloting or athletics. The display screen is at least
partially transparent such that a wearer can see at least a portion
of their natural field of view through the display screen while
also seeing any augmentation graphics displayed on the screen. In
certain embodiments, the display screen is a high resolution
display screen (e.g., has a resolution of at least
1280.times.720).
[0084] The augmented reality navigation subsystems disclosed herein
comprise at least one detector. A detector is one suitable for use
in determining spatial information about real-world features in the
field of view of the detector(s). A detector can be an optical
camera (e.g., a video camera), an EMF detector, a LiDAR detector,
an acoustic detector, an RF detector, or similar energy sensor. The
detector receives information from the environment in the field of
view of the detector and produces a detector input signal that is
sent to the computing subsystem. In certain embodiments, a detector
is disposed (e.g., attached) to a head mounted display). In certain
embodiments, a detector is connected (e.g., electrically) but
spatially remote from the head mounted display. In certain
embodiments, fiducials of an appropriate type are selected and used
during a surgical procedure based on the type of detector connected
to the head mounted display. For example, fiducials that output an
EMF signal are detected by an EMF detector mounted to the head
mounted display. One or more fiducials may be disposed on a head
mounted display for tracking and/or orienting the head mounted
display in the surgical environment (e.g., as detected by an
auxiliary detector or a second augmented reality navigation
system). In certain embodiments, the detector is an optical camera
and image recognition is performed by the computer subsystem on the
detector input signal in order to determine one or more real-world
features. Detectors of different types can be used in combination
in a single augmented reality navigation system. Two detectors of
the same type may be disposed on a head mounted display and
spatially separated thereon (e.g., in order to triangulate
real-world features). In certain embodiments, a detector is
removable such that it can be replaced by a detector of a different
type. In certain embodiments, a detector coupled with a computer
subsystem enables patient registration accurate to within 2 mm
(e.g., within 1.5 mm or within 1 mm) RMS for each position degree
of freedom. In certain embodiments, one or more detector(s) (e.g.,
disposed on a head mounted display) are configured to provide
accurate registration throughout a period of time (e.g., a surgical
procedure) over a certain spatial volume in a surgical environment
(e.g., a volume larger than a spherical volume of 2 foot radius, 4
foot radius, 6 foot radius, or larger). In certain embodiments,
such a volume may further be defined by a cone whose apex is
located at the head mounted display.
[0085] In certain embodiments, an augmented reality navigation
system comprises a motion sensor. The motion sensor can track
motion of a wearer's head over time. Such tracking can be used to,
for example, smooth, or even remove, jitter of augmentation
graphics generated by natural small movements of a wearer's head.
In certain embodiments, a motion sensor also provides a means for
determining motion of a wearer's head and provides a new
orientation and/or position of the head mounted display to the
computer subsystem in order to update augmentation graphics
displayed on a display screen of the head mounted display. In
certain embodiments, a motion sensor is configured to provide a
less than 2 cm (e.g., less than 1 cm) drift in the position of
augmentation graphics from their baseline position (i.e., as
determined by the registration of the augmented reality navigation
system to a patient's anatomy), as measured in an open loop. In
certain embodiments, the motion sensor coupled with a detector in
an augmented reality navigation system provides optically
calibrated (i.e., closed loop) sub-millimeter drift per hour. In
certain embodiments, a motion sensor is used to record user input
used for making selections (e.g., a head nod or shake).
[0086] In certain embodiments, an augmented reality navigation
system comprises a microphone. The microphone may be disposed on
the head mounted display. The microphone may be used to receive
surgeon commands (i.e., verbal commands) for use in controlling the
augmented reality navigation system. For example, verbal commands
may serve as user input for making a selection, modify or update
settings or graphics of the display screen, or other similar tasks.
For example, verbal commands may be used to rearrange virtual
display panels displayed on a display screen of a head mounted
display or to change the navigational information displayed on a
virtual display. Similarly, graphics overlaid may be modified by
verbal commands (e.g., to change brightness, color, or data source
for the overlaid graphics).
[0087] In some embodiments, in addition to or in place of verbal
commands or commands input by motion of a motion sensor, gestures
made by a surgeon may be used to signal selections or control an
augmented reality navigation system. For example, in certain
embodiments, a surgeon can make swipe, click, resize, or refresh
type gestures (e.g., similar to those used with smartphones or
other touch control devices) to control the augmented reality
navigation system. Such gestures may be made in a manner that is
detectable by a detector of the augmented reality navigation
system. For example, gestures may be detected using
image-recognition type procedures (e.g., when a detector is an
optical camera). For example, a surgeon may wear or hold a fiducial
detectable by the augmented reality navigation system when making a
gesture such that the gesture is detected based on motion of the
fiducial. In certain embodiments, alternatively or additionally, an
auxiliary mechanical input (e.g., foot pedal) may be used as an
input (e.g., selection) device.
[0088] The augmented reality navigation systems disclosed herein
comprise a computer subsystem. The computer subsystem, inter alia,
processes (e.g., renders) augmentation graphics for display on a
display screen of an augmented reality navigation system. The
computer subsystem can be remote. For example, a computer subsystem
can be connected to a head mounted display through a cable with a
quick disconnect. Such a cable can also provide power to components
of a head mounted display (e.g., a display screen). In certain
embodiments, a computer subsystem is disposed partially or entirely
on a head mounted display (e.g., that operates using battery
power). In certain embodiments, a computer subsystem is configured
to receive navigation input data that comprises navigational
information from a robotic surgical system. For example, a
trajectory stored in the robotic surgical system and/or coordinates
stored in the robotic surgical system (e.g., recorded using the
robotic surgical system). In certain embodiments, a computer
subsystem can control a robotic surgical system using output (such
as trajectory data output) from an augmented reality navigation
system.
[0089] In certain embodiments, a computer subsystem is configured
to assist in pre-operative and/or intra-operative planning (e.g.,
trajectory planning). In certain embodiments, the computer
subsystem is configured to perform trajectory planning using a
pointer tool and/or trajectory selection guidance augmentation
graphic (e.g., crosshair) displayed on a display screen. In certain
embodiments, a computer subsystem comprises a model module that,
inter alia, stores, accesses, and/or updates a model of patient
anatomy (e.g., derived from medical image data). In certain
embodiments, a computer subsystem comprises a coordinate module
that, inter alia, creates, stores, accesses, and/or updates a
reference coordinate system used for navigation. Such a reference
coordinate system may be defined during a registration method
(e.g., at the start of a surgical procedure). A coordinate module
may be used to perform reregistration that may happen continuously
or periodically during a surgical procedure, wherein the
registration may be performed using the augmented reality
navigation system.
[0090] In certain embodiments, an augmented reality navigation
system operates cooperatively with an auxiliary navigation
subsystem. For example, an auxiliary detector in a surgical
environment may be used to provide additional detection of
real-world features in a surgical environment (in addition to those
detected by a detector disposed on a head mounted display). In this
way, in certain embodiments, an augmented reality navigation system
is couple with an existing navigation system used in conjunction
with a robot surgical system in order to navigate during a surgical
procedure. For example, a registration performed by an augmented
reality navigation system can be compared to a registration
performed by an auxiliary detector to determine accuracy of the
registration being used by the augmented reality navigation system
during navigation of a surgical procedure. A computer subsystem can
perform a reregistration to minimize error between a registration
according to an augmented reality navigation system and an
auxiliary detector. When an auxiliary detector is used,
registration precision and tracking during a procedure may be
improved, for example, due to each detector detecting real-world
features that are otherwise obfuscated from the other detector(s).
In certain embodiments, an auxiliary detector is a detector
disposed on a head mounted display of a second augmented reality
navigation system. An auxiliary detector, when present, may be used
to detect one or more fiducials disposed on a head mounted display
(e.g., to assist in registration, jitter correction and/or drift
correction).
[0091] In certain embodiments, two or more augmented reality
navigation systems are used cooperatively and/or conjunctively
(e.g., simultaneously). For example, two surgeons may each wear a
head mounted display during a surgical procedure. In certain
embodiments, navigational information from one head mounted display
(e.g., detector input data from a detector mounted to the head
mounted display) may be provided to the other head mounted display,
for example, in order to share a common registration or provide a
video input feed for display on a display screen of one head
mounted display from a detector of another head mounted display. In
certain embodiments, a video input feed is provided to an external
monitor (e.g., on a nearby wall or in a remote location, such as a
class room) for view by other persons (e.g., in the same surgical
environment), either in addition to or in alternative to being
provided to a second augmented reality navigation system. In
certain embodiments, fiducials disposed on each head mounted
display assist in co-registering two augmented reality navigation
systems used in a single surgical environment. Two or more
augmented reality navigation systems may share a common computer
subsystem (e.g., each be connected by its own cable to a common
computer subsystem).
Exemplary Augmented Reality Navigation Systems
[0092] FIG. 1 illustrates an augmented reality navigation system
100 (also referred to as "HMD 100") configured according to some
embodiments of the present disclosure. Referring to FIG. 1, the HMD
100 includes a semitransparent display screen 110 connected to a
display module that processes and displays augmentation graphics
(e.g., video and other images) on the display screen 110 (e.g., a
LCD display, a reflective screen on which the display module
projects images, etc.) for viewing by a user. The display module
may be within a housing 118 of the HMD 100 or may be contained
within a communicatively connected computer subsystem.
[0093] In the illustrated embodiment, the HMD 100 is mounted to a
headband 120 and positioned so that the display screen 110 extends
within the peripheral vision of the user. The housing 118 encloses
electronic components that display information on the display
screen 110 and may operate in combination with a remote but
communicatively connected computer equipment and/or with computer
equipment integrated within the housing 118 to sense and interpret
movement of the head, sense and interpret gestures made by a user's
hands or other objects, and/or sense and interpret voice commands
by the user. The display screen 110 can provide a monocular
see-through display or a stereo set of see-through displays so that
the user can view information displayed on the display while
looking through the display to view other objects. The headband 120
may include a headlamp, camera, or other apparatus that can be worn
on a user's head.
[0094] The user is illustrated as wearing glasses 150 that include
through-the-lens (TTL) loupes 152, protruding from lenses of the
glasses 150, that provide magnified viewing to the user. The
display screen 110 extends downward from the housing 118 and is
positionable by the user to be in the user's field-of-view or
immediately adjacent to the TTL loupes 152 within the user's
peripheral vision. The display screen 110 can be a see-through
display device allowing the user to see video superimposed on the
environment seen through the display screen 110.
[0095] The TTL loupes 152 may not be included in the HMD 100 when
the display screen 110 is configured to be in the direct
line-of-sight of the user. Alternatively, the display screen 110
can be positioned adjacent to the TTL loupes 152 so that the user
can make a minor upward shift in eye line-of-sight from looking
through the TTL loupes 152 to instead view information displayed on
the display screen 110. In some embodiments the display screen 110
may be incorporated within one or both TTL loupes 152 so that the
user can look through the TTL loupes 152 to view graphical images
super-imposed on objects within the FOV of the TTL loupe 152. The
HMD 100 may be configured to be attachable to any type of eyeglass
frames, including prescription glasses, protective glasses, frames
without lenses, transparent or protective shields, etc.
[0096] The display screen 110 can be moved by a user to a location
providing convenient visual reference through a two-arm friction
joint linkage 112 that provides telescopic and up-and-down
adjustment of location of the housing 118. A ball-and-socket joint
114 is connected between the linkage 112 and the housing 118 to
provide planar adjustment for the display screen 110. A pivot joint
116 connected between the ball-and-socket joint 114 and the housing
118 allows the user to pivot the housing 118 and connected display
screen 110. The display screen 110 can thereby be flipped-up
outside the user's peripheral vision when not being used.
[0097] The HMD 100 may include a motion sensor such as an inertial
sensor or one or more other sensors, such as a gyroscope,
accelerometer (e.g., a multi-axis accelerometer), and/or
magnetometer that output a signal indicating a measurement of
movement or static orientation of the user's head while wearing the
HMD 100. For example, the motion sensor may output a head motion
signal that indicates yaw (i.e., rotation of the user's head left
or right), pitch (i.e., rotation of the user's head up or down),
and/or roll (i.e., side-to-side tilt of the user's head). The
sensors may be spaced apart on the headband 120 or enclosed within
the housing 118.
[0098] The HMD 100 may include an optical camera (e.g., acting as
the detector or in addition to other detector(s)) facing away from
the user that outputs video and/or other images for processing and
relay to other HMDs 100 worn by other personnel assisting with the
procedure, to other display devices, and/or to a video server for
storage. For example, the camera may be configured to be aligned
with the user's line-of-sight when the user has adjusted the
display screen 110 to be comfortably viewed by the user. When more
than one camera is connected to the HMD 100, video streams from the
cameras can be provided to an operational function that estimates
distance to an object viewed by the cameras. The operational
function can include triangulation of distance to the object based
on angular offset of the object viewed in the video streams and a
known distance between the cameras.
[0099] The camera (or another detector) may be connected to a
gesture interpretation module configured to sense gestures made by
a user's hands or other objects, recognize a gesture as
corresponding to one of a plurality of defined commands, and
trigger operation of the command. The HMD 100 may include a
microphone connected to a voice interpretation module configured to
recognize a received voice command as corresponding to one of a
plurality of defined voice commands, and trigger operation of the
command.
[0100] The headband 120 may have a plurality of attachment points
where inertial sensor(s), detector(s) (e.g., optical camera(s)),
microphone, etc. can be releasably attached. Some of the attachment
points may have rigid supporting structures between them to
maintain a defined physical alignment between the attached inertial
sensors, detectors etc.
[0101] FIG. 2 illustrates a side view of another exemplary HMD 200
with a display screen 210 and electronic components 214 (shown
without a housing) which are configured according to some
embodiments of the present disclosure. The display screen 210
extends downward from the electronic components 214 to be in the
user's line-of-sight or immediately adjacent TTL loupes 152 within
the user's peripheral vision. The electronic components 214 are
connected to the headband 120 via a pivot 212 allowing the
electronic components 214 and connected display screen 210 to be
flipped-down to a deployed position as shown in FIG. 2 and
flipped-up to a stored position when the user does not desire to
view the display screen 210.
[0102] FIG. 3 illustrates another exemplary HMD 300 configured
according to some embodiments of the present disclosure. The HMD
300 includes a display screen illustrated behind a protective
shield 310 that extends downward from a housing 318 enclosing
electronic components. The display screen and/or the protective
shield 310 may include a coating that provides variable contrast to
enhance viewability of displayed information while subject to a
range of ambient brightness. The protective shield 310 may provide
a variable focal point (diopter). The protective shield 310 can be
flipped from a stored up-position to a protective down-position (as
shown in FIG. 3) to cover an outside surface of the display screen
that faces a patient and function to protect the display screen
from fluids and other materials occurring during a procedure. The
display screen can be moved by a user through a two-arm
friction-joint linkage 312 that provides telescopic and up-and-down
adjustment of location of the housing 318 to enable a user to
position the display screen at a location providing convenient
visual reference. A ball-and-socket joint 316 is connected between
the linkage 312 and the housing 118 to provide planar adjustment
for the display screen. The linkage 312 is connected to the
headband 120 through a pivot joint 314 to allow the user to flip
the housing 318 and connected display screen up and down. The
display screen can thereby be flipped-up outside the user's
line-of-sight or the user's peripheral vision when not being
used.
[0103] FIG. 4 illustrates another exemplary HMD 400 configured
according to some embodiments of the present disclosure. The HMD
400 includes a display screen 410 that extends downward from a
housing 418 enclosing electronic components. The display screen 410
and housing 418 are connected to a ball-and-socket joint 416 which
provides planar adjustment for the display screen 410. The
ball-and-socket joint 416 is connected to a pivot 414 that allows
the housing 418 and connected display screen 410 to be pivoted up
and down, so that the display screen 410 can be flipped-up outside
the user's line-of-sight or the user's peripheral vision when not
being used. The pivot 414 is connected to a sliding arm 412 that
connects to the headband 120. The sliding arm 412 provides
telescoping adjustment to allow user placement of the display
screen 410 a desired distance from an eye.
[0104] FIG. 5 illustrates a front view of the HMD 400 of FIG. 4
with the housing 418 removed to expose printed circuit boards
(PCBs) 450 which operationally connect electronic components
mounted thereon (e.g., a display screen, a detector, and optionally
a microphone and motion sensor). Some of the electronic components
are used to display images on the display screen 410, and may
operate in combination with integrated or remote computer equipment
to sense and interpret movement of the head, sense and interpret
gestures made by a user's hands, eyes, or other objects, and/or
sense and interpret voice commands by the user. In some
embodiments, the PCBs 450 are tilted at a defined non-zero angle
relative to vertical to reduce the profile cross-section of the
housing 418. For example, the PCBs 450 can extend generally
diagonally across the housing 418.
[0105] FIG. 6 illustrates another HMD 500 having a single display
screen connectable to an eyeglass frame to provide monocular
viewing by the user. FIG. 7 illustrates another HMD 502 including a
pair of display screens that are connectable to opposite sides of
an eyeglass frame to provide binocular viewing. Although the
display screens in FIGS. 6 and 7 are shown as being opaque, they
may instead allow a user to see through the display screen while
viewing information displayed thereon.
[0106] FIG. 8 shows certain exemplary functionality of certain
augmented reality navigation systems. An augmented reality
navigation system allows a surgeon or other user to see one or more
virtual displays (several in the example shown in FIG. 8) of
different medical information without looking away from the
surgical site and focusing far away to view physical monitors that
may be mounted across the surgical environment or elsewhere
adjacent to a patient. In some embodiments, three operational
"modes" of the virtual displays are selectively activated based
upon pitch of the surgeon's head and the corresponding viewing
line-of-sight of the user. The three operations may be separately
activated by increasing pitch angle of an HMD 750 through three
corresponding ranges of viewing angles, such as low (directly at
the surgical space), medium, high (horizontal eye-level). In
certain embodiments, the viewing angle of the surgeon can be
determined from the head motion signal output by a motion sensor of
HMD 750.
[0107] A full-screen operational mode may be triggered when it is
determined (e.g., by a motion sensor) that a surgeon is looking
down at an operation site, which may be determined by when the
pitch is below a first pitch threshold (e.g., about -45.degree.).
The first pitch threshold may be defined and/or adjusted by the
surgeon based on a voice command, entered through a physical user
interface, etc. In the full-screen operational mode, a defined one
of the video streams (e.g., a primary video stream received via an
HDMI channel) is displayed, using augmentation graphics, full
screen through a display screen 752 of the HMD 750. A surgeon's
corresponding preference settings may be saved in a configuration
file stored in the memory 630 of a computer subsystem with an
identifier for the surgeon, so that the surgeon's preferred
settings can be automatically retrieved upon recognition of the
surgeon (e.g., via a login process through the computer equipment
620).
[0108] FIG. 9 is a block diagram of electronic components of an
exemplary computer subsystem, in accordance with certain
embodiments of augmented reality navigation systems disclosed
herein, that includes modules 600 for processing data input from
and output to a head mounted display, computer processing equipment
620, and a surgical video server 650 (e.g., that provides input
data streams). The video server 650 can be connected via a data
network 640 to a patient database 642, imaging equipment 644, and
other electronic equipment 646, for example. The HMD 600 may
correspond to any of the HMDs of FIGS. 1-7, for example. Although
the computer equipment 620 is illustrated as being separate from
the HMD 600, some or all of the operations disclosed herein as
being performed by the computer equipment 620 may additionally or
alternatively be performed by one or more processors residing
within the HMD 600. Similarly, some of the operations disclosed
herein as being performed by the HMD 600 may additionally or
alternatively be performed by one or more processors residing
within the computer equipment 620.
[0109] The video server 650 can receive, store, and route
information, video streams between a patient database 642, imaging
equipment 644, and other electronic equipment 646 and the HMD 600.
As used herein, a video stream can include any type of information
that can be provided to a display device for display, including
without limitation a still image (e.g., digital photo), a sequence
of still images, and video having frames provided at a defined
frame rate. A video stream may comprise navigational information.
Imaging equipment 644 may include endoscope cameras, magnetic
resonance imaging equipment, computed tomography scanning
equipment, three-dimensional ultrasound equipment, endoscopic
equipment, and/or computer modeling equipment which can generate
multidimensional (e.g., 3D) model based on combining images from
imaging equipment. A patient database 642 can retrievably store
information relating to a patient's medical history, and may store
patient images from earlier procedures conducted via the imaging
equipment 644. Other equipment 646 may provide information relating
to real-time monitoring of a patient, including, for example,
hemodynamic, respiratory, and electrophysiological signals.
[0110] Computer equipment 620 operationally interfaces HMD 600 to
the video server 650. Computer equipment 620 includes a video
capture card 622 that can simultaneously receive a plurality (N) of
video streams and information (e.g., textual descriptions, audio
signals, etc.) from video server 650 and/or directly from imaging
equipment 644, patient database 642, and/or the other equipment
646. Computer equipment 620 may communicate with video server 650,
HMD 600, and other equipment of the system via a wireless and/or
wired network interface 628 using any appropriate communication
medium, including but not limited to a wireless air interface
(e.g., 3GPP Long Term Evolution (LTE), WLAN (IEEE 802.11), WiMax,
etc.), wireline, optical fiber cable, or any combination thereof.
In the example embodiment of FIG. 9, the video capture card 622
simultaneously receives up to 4 video streams via 4 HDMI
interfaces. In some embodiments, HMD 600 is communicatively
connected to computer equipment 620 via an HDMI cable, a USB or RS
422 cable connected to the motion sensor 604 and/or gesture sensor
602, and a USB 3.0 or firewire cable connected to the camera 610.
Gesture sensor 602 may be motion sensor 604, detector 610, or a
distinct sensor for detecting and processing gestures. A microphone
612 can be connected to the computer equipment 620. The video
and/or sensor signaling may alternatively be communicated between
HMD 600 and computer equipment 620 through a wireless air
interface, such as network interface 628.
[0111] HMD 600 includes a display module 606 that processes and
displays video and other images on the display screen 608 for
viewing by a user. The video streams received by the video capture
card 622 are processed by a graphics processing unit (GPU) 638,
conditioned by a display driver 614, and provided to the display
module 606 for display on the display screen 608. A symbol
generator 624 may add graphical indicia and/or textual information
to the video stream(s) provided to the HMD 600 based on information
received from the video server 650 (e.g., via the patient database
642).
[0112] Display driver 614 may reside in the computer equipment 620
or the HMD 600. In some embodiments, display driver 614 receives
video via a HDMI interface from GPU 638, and converts a digital
video signal to an analog video signal which is output as
low-voltage differential signaling (LVDS) to display module 606.
Display driver 614 may also provide power and/or other signaling to
display module 606 via an LED drive signal.
[0113] HMD 600 can include a detector (e.g., optical camera) 610,
or a plurality of detectors 610, facing away from a wearer that
outputs video and/or other images via a wireless and/or wired
network interface 628, illustrated as a HDMI cable in FIG. 9, to
GPU 638 for processing and relay to video server 650 for storage
and possible further relay to other HMDs 600 worn by other
personnel assisting with a procedure. For example, detector 610 may
be configured to be aligned with a wearer's line-of-sight when the
wearer has adjusted the display screen 608 to be comfortably viewed
by the wearer. In certain embodiments, a video signal from detector
610 can be processed through computer equipment 620 and provided to
video server 650 for recording what the wearer is viewing during a
procedure and/or can be provided as a real-time video stream to
other HMDs 600 worn by personnel assisting with the procedure so
that the personnel can observe what the user is seeing. A video
signal from detector 610 may be augmented by symbol generator 624
with one or more designation symbols such that augmentation
graphics displayed on a display screen (e.g., of an HMD worn by
another wearer) comprise both the video signal and one or more
symbols. Augmentation graphics comprising one or more symbols may,
for example, identify the first wearer as the source of the video
stream and/or be added to a video stream by a wearer to identify
observed features, such as a patient's anatomy.
[0114] The HMD 600 may include a motion sensor 604 and/or a gesture
sensor 602. Motion sensor 604 may be an inertial motion unit (IMU),
gyroscope, accelerometer (e.g., a multi-axis accelerometer), and/or
tilt sensor that outputs a head motion signal indicating a
measurement of movement of the user's head while wearing the HMD
600. Motion sensor 604 may be powered by computer equipment 620 and
may output a head motion signal via a communication interface, such
as a RS-422 serial digital interface. For example, motion sensor
604 may output a head motion signal that indicates yaw movement
(i.e., rotation of the user's head left or right) and/or indicates
pitch movement (i.e., rotation of the user's head up or down).
[0115] Motion sensor 604 may be a sourceless orientation sensor. A
head motion signal output by a motion sensor may be processed by
HMD 600 and/or by computer equipment 620 to compensate for drift
error introduced by the motion sensor 604. In some embodiments, one
directional reference (e.g., yaw) component of a head motion signal
is corrected toward zero responsive to another reference component
(e.g., pitch) of the head motion signal being within a threshold
offset of a defined value. For example, yaw drift error in the head
motion signal can be determined based on monitoring yaw values of
the motion signal while the user is looking down at a defined pitch
(e.g., pitch being within a threshold range of a defined value) to
align the user's eyes with an object (e.g., when a surgeon
repetitively looks down to view a surgical site of a patient). In
some embodiments, responsive to the pitch component of the head
motion signal indicating that a surgeon is looking down for at
least a threshold time that is indicative of the surgeon visually
concentrating on a surgical site, computer equipment 620 assumes
that HMD 600 is stabilized along the yaw axis and computes yaw
drift error based on measured change in the yaw component over a
defined time interval. The head motion signal is then compensated
to remove the determined yaw drift error. In some embodiments,
computer equipment 620 measures drift in the yaw component of a
head motion signal while a static image is displayed on the display
screen, assuming that the surgeon's head is stabilized along the
yaw axis, and then compensates the head motion signal to remove the
measured drift in the yaw component.
[0116] A head motion signal may be processed by HMD 600 and/or by
computer equipment 620 to identify an origin for one or more
directional reference components from which movement is referenced.
For example, an origin location from which yaw is measured may be
identified based on an average (e.g., median or mode) of a yaw
component of the head motion signal during times when the user is
looking down at a defined pitch to align the user's eyes with an
object (e.g., surgeon looking down to view a surgical site).
[0117] The directional reference (e.g., pitch or yaw) of a head
motion signal, which is defined to trigger compensation for drift
error and/or which is defined as a reference origin for movement
measurement, may be identified based on the user maintaining a
substantially constant orientation of HMD 600 for a threshold time
(e.g., dwell time). For example, when a surgeon has maintained a
relatively constant head position while viewing a surgical site of
a patient for a threshold time, the directional reference (e.g.,
pitch or yaw) of the head motion signal during that dwell time can
be used as a basis for compensating for drift error and/or setting
as a reference origin for display of virtual display panels (e.g.,
as illustrated in FIG. 8) and/or other augmentation graphics (e.g.,
that appear overlaid over a physical object, such as patient
anatomy). In some embodiments, a head motion signal may be
processed by the HMD 600 and/or by the computer equipment 620 to
estimate gyroscope bias(es) giving rise to yaw drift and/or pitch
drift accumulating over time based on pseudo-measurements of the
yaw and/or the pitch provided by the head motion signal which is
expected to be nearly zero each time the surgeon looks down at the
same surgical site and steadies the head to center the
line-of-sight at a same location on the patient.
[0118] Gesture sensor 602 may include any type of sensor that can
sense a gesture made by a user. In a surgical environment, use of a
gesture sensor 602 to receive a gesture-based command from a
surgeon or other OR personnel can be advantageous because it avoids
a need for the user to touch a non-sterile surface of the HMD 600
or other device. The gesture sensor 602 may be or include detector
610 which outputs signal (e.g., RGB-D video) displaying movement of
a user's hand, fingers, arms or other objects moved by the user
along a pathway that the user knows will define a command
identifiable by an operational surgical program (OSP) 632 and/or
another component of the system. Detector 610 or another camera may
be directed toward one of the user's eyes to identify a dwell time
of the eye, blink timing, and/or movement of the eye to generate a
command from the user to control what is displayed on the display
screen 608.
[0119] Gesture sensor 602 may alternatively or additionally include
one or more photoelectric motion and/or proximity sensors. In some
embodiments, gesture sensor 602 has one or more infrared emitters
and one or more of photodiodes (e.g., at least a portion of which
may additionally function as a detector for navigation). For
example, adjacent pairs of an infrared emitter and a photodiode can
be spaced apart and arranged to form a directional array facing
outward from a housing of HMD 600 to sense presence of a user's
hand adjacent to the array and/or to sense a direction of movement
as the user's hand is moved across the array. A user may, for
example, swipe a hand in a first direction across the array
(without touching the housing) to input a first type of gesture
recognized by OSP 632 processed by processor 626 which triggers a
first type of operation by OSP 632, swipe the hand in a second
direction about opposite to the first direction across the array to
input a second type of gesture recognized by OSP 632 which triggers
a second type of operation by OSP 632, swipe the hand in a third
direction about perpendicular to the first direction across the
array to input a third type of gesture recognized by OSP 632 which
triggers a third type of operation by OSP 632, and so on with other
directions of movement being identifiable as other types of
gestures provided by the user to trigger other types of operations
by OSP 632.
[0120] In some embodiments, gesture sensor 602 includes an
ultrasonic echo ranging transducer that senses signal echo
reflections from a user's hand and outputs a signal to the
processor 626 which identifies gestures formed by movement of the
hand. In some embodiments, gesture sensor 602 includes a capacitive
sensor that senses presence of a user's hand through capacitive
coupling between a charge plate and the user's hand. A plurality of
capacitive sensors may be spaced apart to form gesture sensor 602
and configured to sense a direction of movement of the user's hand
relative to the array of charge plates (e.g., sense an order with
which plates experienced increased coupling to the user's hand).
Different sensed directions of movement can be interpreted by OSP
632 and/or another component of the system as representing
different commands selected by the user for operation.
[0121] HMD 600 can include a microphone 612 configured to receive
voice commands from a user. The processor 626 executing OSP 632
and/or another component of the system can be configured to
recognize a received voice command as corresponding to one of a
plurality of defined voice commands, and trigger operation of a
command corresponding to the recognized voice command to control
information (e.g., navigational information) displayed on a display
screen (i.e., via augmentation graphics).
[0122] In some embodiments, video signal from detector 610 is
displayed on display device 608 of an HMD 600, and symbol generator
624 in combination with OSP 632 processed by the processor 626 may
operate to display trajectory selection guidance augmentation
graphics (e.g., reticle such as crosshairs) that can be positioned
within a plane of the video stream by a surgeon (e.g., responsive
to recognition of voice commands via a microphone 612 or to
gestures via gesture sensor 602). In this manner, a surgeon may
orient his or her natural field of view to a surgical site, steer a
trajectory selection guidance augmentation graphic to be aligned
with a point-of-interest (e.g., in a patient's anatomy), and
trigger capture of data that represents a position and/or
orientation (e.g., of a trajectory) of interest that is indicated
by the trajectory selection guidance augmentation graphic. For
example, using an augmented reality navigation system registered to
a patient anatomy, a trajectory can be planned by orienting and/or
positioning a trajectory selection guidance augmentation graphic
(e.g., through movement of a surgeon's head or movement of the
augmentation graphic) and providing a user input that captures a
position and/or orientation indicated by the trajectory selection
guidance augmentation graphic. A trajectory selection guidance
augmentation graphic may be fixed in position on a display screen
or may be moveable. In some embodiments, a pointer tool is used to
determine such a point of interest.
[0123] FIG. 10 is a block diagram of components of an augmented
reality surgical system that include a position tracking system 810
(e.g., one or more detectors mounted on a head mounted display and,
optionally, cameras spaced apart in the operating room) that track
the location of a patient's anatomy, surgical tool 800 and/or
surgical apparatus (e.g., an implant or other object used as part
of a surgical procedure). Generally, any object comprising a
real-world feature capable of being identified by a detector (e.g.,
mounted on a head mounted display) can be tracked and used in
navigation with an augmented reality navigation system in
accordance with embodiments disclosed herein. In certain
embodiments, computer subsystem 820 uses patient data from imaging
equipment 830 to generate a two dimensional (2D) or three
dimensional (3D) model. Imaging equipment 830 may include, without
limitation, x-ray equipment, endoscope cameras, magnetic resonance
imaging equipment, computed tomography scanning equipment,
three-dimensional ultrasound equipment, endoscopic equipment,
and/or computer modeling equipment which can generate a
multidimensional (e.g., 2D or 3D) model of a targeted site of a
patient. The patient data can include real-time feeds and/or
earlier stored data from imaging equipment 830, and may include an
anatomical database specific for the particular patient or more
generally for humans.
[0124] The model can include representations of real-world features
that assist with performing correlations (e.g., registrations)
between virtual locations of the representations of real-world
features in the patient model and physical locations of the
real-world features (e.g., on the patient's body). Computer
subsystem 820 can use (i) present locations of HMD 100, surgical
site 804, and surgical tool 800 and/or surgical apparatus 802
obtained by position tracking system 810 by detecting one or more
real-world features and (ii) the real-world feature representations
contained in a patient model to transform the patient model to a
present perspective view of a wearer of HMD 100. Some or all of the
transformed patient model can then be displayed on a display screen
of HMD 100 using augmentation graphics, for example, to provide the
surgeon with an augmentation graphical overlay that is precisely
oriented and scaled on the surgical site 804 or other target
location on a patient.
[0125] Computer subsystem 820 may augmentation graphics
representing a patient model, a surgical tool and/or a surgical
apparatus on a display screen 110 of an HMD 100. Augmentation
graphics may be portions of a surgical tool and/or a surgical
apparatus that are otherwise not viewable by a surgeon during at
least a portion of a surgical procedure (e.g., are covered by
patient anatomy such as a patient's skin). Computer subsystem 820
may additionally be configured to animate movement of a displayed
patient mode, tool and/or surgical apparatus (e.g., to illustrate a
planned procedure relative to a defined location of the surgical
site 804 or other target location on the patient's body). The HMD
100 may be communicatively connected to the computer subsystem 820
through a wireless transceiver and/or wired network interface.
[0126] Computer subsystem 820 may compare patterns of objects in a
detector input signal (e.g., video stream) from a detector (e.g.,
camera) on the HMD 100 to patterns of real-world features in the
patient model to identify levels of correspondence, and may control
transformation of the patient model responsive to identifying a
threshold level of correspondence between the compared objects. For
example, real-time video captured by an HMD-mounted camera during
surgery of a patient may be processed by computer subsystem 820 and
compared to video captured by one or more other sources, e.g., an
auxiliary detector of imaging equipment 830. The pattern matching
may be constrained to characteristics of an object or a set of
objects defined by a surgeon as being relevant to a present
procedure.
[0127] The computer subsystem 820 can control transformation of a
patient model for display on the display screen 110 using
augmentation graphics based on the pattern matching (e.g., with or
without comparing to a detector input signal from auxiliary imaging
equipment). The computer subsystem 820 may display on the display
screen 110 an indicia (e.g., a crosshair or color marker) aligned
with an identified object within the video from the HMD camera to
assist the surgeon with identifying the corresponding location on
the patient. In one embodiment, the computer subsystem 820 displays
a graphical indicia on the display screen 110 aligned with one of
the anatomical objects displayed on the display screen 110 from the
rotated and scaled three dimensional anatomical model responsive to
identifying a threshold level of correspondence between a pattern
of the one of the anatomical objects and a pattern of one of the
anatomical objects in the video stream from the video camera.
[0128] Computer subsystem 820 may similarly receive other data and
video streams from a patient database and other electronic
equipment, which can be selectively displayed on one or more
display screens of an HMD 100 using augmentation graphics. As used
herein, a video stream can include any type of information that can
be provided to a display device for display, including without
limitation a still image (e.g., digital photo), a sequence of still
images, and video having frames provided at a defined frame rate.
Computer subsystem 820 can retrieve patient health information
relating to a patient's medical history and data obtained by
real-time monitoring of a patient, including, for example,
hemodynamic, respiratory, and electrophysiological signals. Such
information can be displayed on a display screen using augmentation
graphics and, moreover, can appear to be displayed on a virtual
display screen and/or overlaid over an object in a surgical
environment (e.g., patient anatomy or surgical equipment).
[0129] In certain embodiments, computer subsystem 820 is physically
separate (e.g., remote) from a connected HMD 100. In some
embodiments, some or all of the operations disclosed herein as
being performed by a computer subsystem 820 are additionally or
alternatively performed by one or more processors residing within
an HMD 100. Likewise, in some embodiments, some or all of the
operations disclosed herein as being performed by an HMD 100 are
additionally or alternatively performed by one or more processors
residing within a computer subsystem 820.
[0130] FIG. 11 is a block diagram of electronic components in an
augmented reality surgical system according to some embodiments of
the present disclosure. Referring to FIG. 11, the navigation system
810 can include at least one detector 902 that tracks at least one
of, for example, real-world features identifying and/or attached to
a surgical table 904, real-world features identifying and/or
attached to patient 906 (e.g., adjacent to a surgical or other
target site), real-world features identifying and/or attached to a
surgery tool and/or surgical apparatus (e.g., implant) and/or
robotic surgical system 908, and, optionally real-world features
attached to an HMD 910. In some embodiments, the detectors used for
navigation (e.g., tracking) are exclusively attached to a HMD
(i.e., no auxiliary detector(s) are used). In these embodiments,
the volume over which a robotic surgical system and a patient and,
optionally, a patient model, are registered is defined by a volume
at least temporarily within the field of view of the detectors
attached to the HMD. In some embodiments, auxiliary detector(s) not
attached to a HMD are used for navigation. For example, in some
embodiments, the at least one detector 902 includes a plurality of
cameras that are spaced apart at defined locations within an
operating room and each having a field of view that can observe
objects to be tracked. In the illustrated example, the camera
system 902 includes two sets of cameras spaced apart by a known
distance and relative orientation. The navigation system 810 may
use, for example and without limitation, active optical real-world
features (e.g., light emitting sources) or passive optical
real-world features (e.g., light reflectors). Navigation system 810
may additionally or alternatively use electromagnetic field or
radiation based navigational tracking, ultrasonic based
navigational tracking or the like (e.g., depending on a type of
detector mounted to a head mounted display and/or a type of
auxiliary detector).
[0131] In some embodiments, positioning data of an HMD 100 can
include navigation coordinate system data determined from a
location of real-world features attached to an HMD 910 and/or
inertial coordinate system data from a motion sensor attached to
the HMD. In some embodiment, the navigation coordinate system data
and the inertial coordinate system data can be compensated for
initial calibration and drift correction over time by a calibration
module 912 and combined by a fusion module 914 to output combined
HMD position data. The calibration component and fusion component
may be modules of a computer subsystem.
[0132] A relative positioning module 916 identifies the relative
position and angular orientation of each of the tracked real-world
features 904-910 and the combined HMD position data. A relative
positioning component may be a component of a computer subsystem.
The module 916 may perform coordinate transformations of relative
coordinate systems of, for example, a surgical table, a patient, a
surgical tool (and/or a pointer tool), and an HMD 100 to a unified
(common) coordinate system. In some embodiments, a relative
positioning module 916 outputs sight coordinates data, patient
model coordinates data, and tool coordinates data to an
augmentation graphics generator module 918 and/or a robotic
surgical system. An augmentation graphics generator module 918 may
be part of a computer subsystem of an augmented reality navigation
system. Sight coordinates data can be generated based on the
combined HMD position data transformed to the unified coordinate
system. In some embodiments, a spatial position of an HMD (e.g., a
position on the HMD, such as a position of a detector mounted to
the HMD) is taken to be an origin of a unified coordinate system
and additional spatial coordinates determined from various
real-world features are registered to the HMD using the unified
coordinate system with that position as the origin. Accordingly, in
some embodiments, a registration is updated [e.g., continuously
(e.g., at a certain refresh rate)] to account for movements of an
HMD throughout a surgical procedure that cause the position of the
origin of the unified coordinate system in the physical space of a
surgical environment to be changed. Movement of an HMD may be
determined by a motion sensor or a change in a fixed position
real-world feature (e.g., a real-world feature identified by or
attached to a surgical table). Patient model coordinates data can
be generated based on the position and/or orientation of real-world
features identified from or attached to a patient 906 transformed
to the unified coordinate system. Tool coordinates data can be
generated based on a position and/or orientation of real-world
features identified from or attached to a surgical tool 908
transformed to the unified coordinate system. Tool coordinates data
can be generated based on a position and/or orientation of
real-world features identified from or attached to a surgical tool
908 transformed to the unified coordinate system. In some
embodiments, robotic surgical system coordinates data and tool
coordinates data are equivalent (i.e., one coordinate system is
used for a surgical tool and a robotic surgical system
simultaneously, for example, when the surgical tool is attached to
the robotic surgical system).
[0133] In certain embodiments, augmentation graphics generator
module 918 transforms (e.g., scales, rotates, translates) a patient
model (e.g., derived from medical image data) to a present
perspective view of a wearer of an HMD 100 (e.g., mapped to a
corresponding object within the FOV of a display screen 110).
Likewise, a model of, for example, a robotic surgical system, a
surgical tool, a surgical apparatus, or a trajectory of the same,
may be transformed by an augmentation graphics generator module, in
some embodiments. In some embodiments, a graphics augmentation
generator module 918 may provide video generated based on the
transformed patient model to a display screen of an HMD 100 for
display as a visual model that is dynamically oriented and scaled
as a graphical overlay on a surgical site 804 or elsewhere to a
corresponding location on the patient where the wearer of the HMD
100 is presently looking and which contains a corresponding object
which is modeled by the patient model.
[0134] For example, in some embodiments, an augmentation graphics
generator module 918 determines whether any portion of a patient's
body is presently within the field of view of what the surgeon sees
through the display screen 110 (e.g., using a detector mounted to
the same HMD as the display screen) that corresponds to any portion
of the transformed patient model. In some embodiments, when a
portion of a transformed (e.g., scaled, translated, rotated)
patient model corresponds to a portion of the patient's body within
the surgeon's field of view through the display screen 110, the
image generator 918 generates augmentation graphics for display on
the display screen 110 based on the corresponding portion of the
transformed patient model, while translating and/or rotating the
portion of the transformed patient model and scaling size of the
portion of the transformed patient model to provide an accurately
scaled graphical representation of the object that was, for
example, imaged from the patient or modeled from another source
such as an anatomical database.
[0135] Thus, for example, in some embodiments, when a surgeon's
head is rotated so that a portion of a patient's body having a bone
that is modeled through CT imagery data becomes within the field of
view of the display screen 110 (e.g., within a field of view of a
detector mounted to the same HMD as the display screen 110)), an
augmentation graphics generator module 918 transforms a patient
model of the bone to generate an augmentation graphical
representation of the bone that is displayed in the display screen
110 as a graphical overlay that matches the orientation and size of
the bone from the perspective of the surgeon as-if the surgeon
could view the bone through intervening layers of tissue and/or
organs. Likewise, in some embodiments, at least a portion of a
surgical tool, at least a portion of a surgical apparatus, and/or
at least a portion of a robotic surgical system (e.g., that is
covered by a patient's anatomy) can appear as a graphical overlay
matching the orientation and size of the physical object to the
surgeon using augmentation graphics, in some embodiments.
[0136] In the example illustration of block 920, a leg bone model
that has been generated, e.g., based on a CT scan of the leg, is
transformed and displayed on a display screen 110 to have an
accurate orientation and size (e.g., six degree of freedom
positioning) relative to the leg bone when viewed augmentation
graphics of the leg bone 922 superimposed on a skin surface of the
leg. In this example, the surgeon therefore sees the skin surface
of the leg through the semitransparent display screen 110 of the
HMD 100 with an graphically illustrated representation of the leg
bone model overlaid thereon.
[0137] Although the augmentation graphics of the leg bone 922 are
illustrated in FIG. 11 as being displayed in a superimposed
position on a skin surface of the leg, the augmentation graphics
922 can be displayed at other locations which may be controllable
by a surgeon. The surgeon may, for example, select to have the
graphical representation 922 displayed with a defined offset
distance above or below the leg. Moreover, the surgeon may control
the size of the displayed augmentation graphics 922 relative to the
leg. The surgeon may, for example, temporarily magnify augmentation
graphics 922 to view certain details and then return augmentation
graphics 922 to be scaled and aligned with the leg. Additionally,
augmentation graphics 922 may be modified to appear to be displayed
on a virtual display screen hovering near the surgical site.
Augmentation graphics 922 may be modified to also display a portion
of a surgical tool, at least a portion of a surgical apparatus, at
least a portion of a robotic surgical system, and/or a trajectory
of any of the same, either overlaid over the patient's leg or in a
virtual display screen.
Use of Augmented Reality Navigation Systems in Surgical
Procedures
[0138] Augmented reality navigation systems in accordance with
embodiments disclosed herein may be used in methods of performing
surgical procedures in order to provide and/or assist in navigation
during the procedures. As such, navigation input data can be
provided to a robotic surgical system, obtained from a robotic
surgical system, or both in certain embodiments. Generally, in
methods disclosed herein, at least one detector mounted on (e.g.,
attached to) a head mounted display is used in order to determine
coordinate systems used for navigation based on real-world features
detected by the at least one detector. In some embodiments, an
augmented reality navigation system displays augmentation graphics
that show portions of a surgical tool, surgical apparatus, and/or
robotic surgical system otherwise hidden from the natural field of
view of a surgeon. The surgical tool may be attached to or inserted
into a robotic surgical system (e.g., through a tool guide attached
thereto). In some embodiments, an augmented reality navigation
system receives navigation input data from a robotic surgical
system (e.g., comprising a position and/or orientation of the
robotic surgical system, a model stored thereon or created
therewith, and/or one or more trajectories that could be followed
by the robotic surgical system). In some embodiments, an augmented
reality navigation system is used in conjunction with a pointer
tool in order to define a trajectory that a robotic surgical system
can follow. The pointer tool may be attached to or inserted in the
robotic surgical system. In some embodiments, an augmented reality
navigation system is configured to display a trajectory selection
guidance augmentation graphic in order to use the graphic to
determine a trajectory that a robotic surgical system can
follow.
[0139] The methods and systems disclosed herein can be used with
robotic surgical systems to perform surgical procedures using a
particular robotic surgical system. In certain embodiments,
portions or all of a particular surgical procedure are performed
without the use of a robotic surgical system. For example, one or
more surgical tools may be manipulated in a "free-hand" manor by a
surgeon, wherein the surgeon holds the tool(s) or the tool(s) are
held by an apparatus not connected to a robotic surgical system.
Such free-hand manipulation may occur simultaneously with, before,
after, or in place of any action performed by a robotic surgical
system (e.g., automatically) or with the assistance of a robotic
surgical system. In any such case, an augmented reality navigation
system in accordance with one or more embodiments of the present
disclosure can be used to display navigational information related
to the free-hand manipulation of any surgical tool or implant, such
as tracking and trajectory planning of such an implant or surgical
tool (e.g., with or without use of any additional and/or auxiliary
navigation subsystem). It will be appreciated by one of ordinary
skill in the art that, in the following described exemplary
methods, where reference is made to a surgical tool attached to or
inserted into a robotic surgical system, it may be possible for the
augmented reality navigation system being used in the particular
exemplary method being describe to likewise perform the same
function for a tool being held by a surgeon.
[0140] Referring now to the block flow diagram shown in FIG. 12,
exemplary method 1200 is a method of using an augmented reality
navigation system in accordance with some embodiments of the
present disclosure. Exemplary method 1200 is a method whereby an
augmented reality navigation system is used to display augmentation
graphics representing a surgical tool (e.g., attached to or
inserted into a robotic surgical system) and/or its trajectory. It
is understood that such an exemplary method can also be adapted to
display augmentation graphics representing at least a portion of a
surgical apparatus (e.g., implant) that is, for example, attached
directly or indirectly to a robotic surgical system. For example,
an implant such as a screw may be attached to drill bit that is
attached to a robotic surgical system. The apparatus may comprise
one or more real-world features (e.g., a fiducial attached
thereto). The computational steps of exemplary method 1200 may be
performed by a computer subsystem of an augmented reality
navigation system.
[0141] In step 1202, one or more detectors mounted on a head
mounted display of an augmented reality navigation system generate
a detector input signal that is received by a computer subsystem of
the augmented reality navigation system. The detector input signal
represents a field of view of the one or more detectors that
comprises at least a portion of a patient anatomy (e.g., relevant
to a surgical procedure to be performed). In step 1204, a relative
position and/or orientation for one or more real-world features in
the detector input signal (i.e., in the field of view represented
by the detector input signal) are determined. The relative position
and/or orientation may be determined in real time or may be taken
as an absolute position and/or orientation represented in a unified
coordinate system that resulted from a registration of an augmented
reality navigation system and a surgical environment (e.g., a
registration between the augmented reality navigation system and
objects in the surgical environment such as a patient, a surgical
tool, and a robotic surgical system, for example). The detector
input signal may be received by a computer subsystem from one or
more detectors mounted to a head mounted display of the augmented
reality navigation system, one or more detectors mounted to a head
mounted display of a second augmented reality navigation system,
and/or one or more auxiliary detectors positioned throughout a
surgical environment. In step 1206, a representation of at least a
portion of a surgical tool connected to and/or inserted into a
robotic surgical system and/or a trajectory (e.g., actual or
planned trajectory) of the surgical tool is generated and/or
accessed. The at least a portion of the surgical tool may be hidden
from the natural field of view of a surgeon using the augmented
reality navigation system. In step 1208, the representation is
modified (e.g., scaled, translated, and/or rotated) by the relative
position and/or orientation of the one or more real-world features
determined in step 1204. In step 1210, augmentation graphics
corresponding to the representation are rendered and displayed on a
display screen of the head mounted display of the augmented reality
navigation system. Optionally, at least a portion of the surgical
tool not hidden from a natural field of view of a surgeon may also
be displayed, such that the augmentation graphics show a
representation of a larger portion of the surgical tool (e.g., the
entire surgical tool) wherein some of the tool is hidden and some
of the tool is not hidden. Such a method may also be used for
surgical apparatus (e.g., implants). Likewise, the surgical tool
augmentation graphics can also be used to show a surgical tool (or
portion thereof) that is not physically present (e.g., has not yet
been inserted into a robotic surgical system). Additionally, in
some embodiments, a position of a surgical tool and/or its
trajectory can be visualized over a period of time using
augmentation graphics such that a surgeon can watch how a tool will
move along a trajectory during at least a portion of a
procedure.
[0142] The generating and/or accessing a representation step may
comprise determining a relative position and/or orientation of one
or more real-world features corresponding to the surgical tool of
interest. For example, the surgical tool may have a fiducial
affixed thereto. The representation may be a stored model (e.g., a
CAD model or illustration) of the surgical tool imported into or
accessed by the computer subsystem (e.g., provided to the computer
subsystem by the robotic surgical system as navigational
information). Similarly, in some embodiments, a trajectory of a
surgical tool that is otherwise hard to visualize (due to
interference from a patient's anatomy) may be displayed on a
display screen of a head mounted display as surgical tool
augmentation graphics such that the surgeon can view one or more
planned trajectories intraoperatively to better visualize the one
or more trajectories and therefore better navigate a robotic
surgical system. The trajectories for the surgical tool may be
provided to the computer subsystem by a robotic surgical system.
For example, a surgeon may move a robotic surgical system to a
desired position and orientation and save a corresponding
trajectory representation that is then later provided to a
augmented reality navigation system in generating and/or accessing
step 1204. The representation of at least a portion of a surgical
tool and/or trajectory that is displayed on a display screen in
exemplary method 1200 may be selected using input from a surgeon,
for example, using a gesture, motion, or signal input as described
herein above.
[0143] Exemplary method 1200 includes optional steps 1212 and 1214.
Either or both of the optional steps may be a part of a method. In
optional step 1212, a haptic object comprising the trajectory
represented by the surgical tool augmentation graphics displayed in
step 1210 is defined. The haptic object may be determined by the
augmented reality navigation system (e.g., using relative
position(s) and/or orientation(s) of real-world features detected
by a detector of the system) and provided to a robotic surgical
system by the computer subsystem of the augmented reality
navigation system. The robotic surgical system may then be confined
in its motion such that at least a portion of a surgical tool
connected to or inserted into the robotic surgical system (e.g.,
the surgical tool corresponding to the representation generated
and/or accessed in step 1206) cannot move outside of the haptic
object (e.g., due to haptic feedback provided to a surgeon
operating the robotic surgical system). In optional step 1214,
output from the augmented reality navigation system causes the
robotic surgical system to automatically align with the represented
trajectory and/or automatically move along the trajectory. In some
embodiments, representations of multiple trajectories may be
displayed simultaneously and a surgeon may select one of the
represented trajectories to have the robotic surgical system align
to (e.g., using a pointer tool). In some embodiments, whether one
or multiple representations of trajectories are displayed, the
augmentation graphics used may appear overlaid over a patient
anatomy to give a surgeon an accurate view of how the trajectory
intersects a patient's anatomy. In some embodiments, portions of a
surgical tool and/or its trajectories appear on a virtual display
screen viewed through a display screen of a head mounted display
(e.g., in spatial correspondence with a model of patient anatomy
such that the trajectory representation, portion of a surgical
tool, and model appear to have the same relative position and
orientation as physical reality). For example, a virtual display
screen may appear as panel A or panel B of FIG. 15. Overlaid
augmentation graphics may appear as the sketch in FIG. 16
illustrates.
[0144] Referring now to the block flow diagram shown in FIG. 13,
exemplary method 1300 is a method of using an augmented reality
navigation system in accordance with some embodiments of the
present disclosure. Exemplary method 1300 is a method whereby an
augmentation reality navigation system uses a trajectory selection
guidance augmentation graphic (e.g., a crosshair) to assist in
planning and/or updating one or more trajectories corresponding to
a surgical procedure. The computational steps of exemplary method
1300 may be performed by a computer subsystem of an augmented
reality navigation system.
[0145] In step 1302, a trajectory selection augmentation graphic
(e.g., crosshair) is displayed on a display screen of an augmented
reality navigation system. The trajectory selection guidance
augmentation graphic may appear fixed in position on the display
screen (e.g., such that motion of the associated head mounted
display does not result in the augmentation graphic moving position
in a surgeon's field of view). In some embodiments, a trajectory
selection guidance augmentation graphic is positionable (e.g., pre-
and/or intra-operatively) by a surgeon. For example, a surgeon may
prefer the augmentation graphic to appear in a certain location
(e.g., center or corner of a display screen) and may position it
accordingly using a selection input. In step 1304, a detector input
signal is received where the detector input signal corresponds to a
field of view of one or more detectors connected to a head mounted
display of an augmented reality navigation system, wherein the
field of view comprises at least a portion of a patient's
anatomy.
[0146] In step 1306, a relative position and/or orientation of one
or more real-world features (i.e., in the field of view represented
by the detector input signal) are determined based on a detector
input signal from one or more detectors connected to a head mounted
display. The relative position and/or orientation may be determined
in real time or may be taken as an absolute position and/or
orientation represented in a unified coordinate system that
resulted from a registration of an augmented reality navigation
system and a surgical environment (e.g., a registration between the
augmented reality navigation system and objects in the surgical
environment such as a patient, a surgical tool, and a robotic
surgical system, for example). The detector input signal may be
received by a computer subsystem from one or more detectors mounted
to a head mounted display of the augmented reality navigation
system, one or more detectors mounted to a head mounted display of
a second augmented reality navigation system, and/or one or more
auxiliary detectors positioned throughout a surgical environment.
In step 1308, a physical position and/or orientation indicated by
the trajectory selection guidance augmentation graphic is
determined. For example, a surgeon may position and orient a head
mounted display such that a trajectory selection guidance
augmentation graphic appears to indicate a position of a patient
along a preferred orientation (e.g., the position resides within
crosshairs on a display screen). The physical position and/or
orientation are determined using the relative position(s) and/or
orientation(s) determined in step 1308. For example, the
coordinates of the physical position and/or orientation indicated
by the trajectory may be determined using a unified coordinate
system defined during a registration procedure. In step 1310, a
user input signal is received by the computer subsystem, wherein
the user input signal is generated due to an action (e.g., gesture)
by a surgeon using the augmented reality navigation system and the
action is made when the trajectory selection guidance augmentation
graphic is in a desired position and/or orientation. For example,
any user input mechanism described herein above may be used.
[0147] In step 1312, a trajectory is determined based on the
physical position and/or orientation determined in step 1308.
Accordingly, in some embodiments, step 1308 is only performed in
response to step 1310. Also accordingly, in some embodiments, step
1308 is performed continuously over a period of time [e.g., with a
certain frequency (e.g., more than about once a second)] and the
trajectory is determined based on the most recent physical position
and/or orientation determined when the user input signal is
received. In step 1314, the trajectory is output to a robotic
surgical system (e.g., for use in performing a surgical procedure).
In optional step 1316, trajectory augmentation graphics that
represent the trajectory determined in step 1312 are displayed on a
display screen of the augmented reality navigation system, for
example, in accordance with the embodiments discussed above (in
reference to exemplary method 1200). The trajectory augmentation
graphics may be modified (e.g., using a registration and/or unified
coordinate system) prior to display on a display screen.
[0148] Exemplary method 1300 includes optional steps 1318 and 1320.
Either or both of the optional steps may be a part of a method. In
step optional 1318, a haptic object comprising the trajectory
determined in step 1312 is defined. The haptic object may be
determined by the augmented reality navigation system (e.g., using
relative position(s) and/or orientation(s) of real-world features
detected by a detector of the system) and provided to a robotic
surgical system by the computer subsystem of the augmented reality
navigation system. The robotic surgical system may then be confined
in its motion such that at least a portion of a surgical tool
connected to or inserted into the robotic surgical system cannot
move outside of the haptic object (e.g., due to haptic feedback
provided to a surgeon operating the robotic surgical system). In
optional step 1320, output from the augmented reality navigation
system causes the robotic surgical system to automatically align
with the represented trajectory and/or automatically move along the
trajectory. In some embodiments, representations of multiple
trajectories may be displayed simultaneously and a surgeon may
select one of the represented trajectories to have the robotic
surgical system align to (e.g., using a pointer tool). In some
embodiments, whether one or multiple representations of
trajectories are displayed, the augmentation graphics used may
appear overlaid over a patient anatomy to give a surgeon an
accurate view of how the trajectory intersects a patient's anatomy.
In some embodiments, portions of a surgical tool and/or its
trajectories appear on a virtual display screen viewed through a
display screen of a head mounted display (e.g., in spatial
correspondence with a model of patient anatomy such that the
trajectory representation, portion of a surgical tool, and model
appear to have the same relative position and orientation as
physical reality). For example, a virtual display screen may appear
as panel A or panel B of FIG. 15. Overlaid augmentation graphics
may appear as the sketch in FIG. 16 illustrates.
[0149] A model of patient anatomy may be displayed as overlaid
augmentation graphics during exemplary method 1300 in order to
assist a surgeon in defining a trajectory. A plurality of desired
trajectories may be defined. A trajectory selection guidance
augmentation graphic may also be used to select one of a plurality
of defined trajectories (e.g., pre- and/or intra-operatively
defined trajectories) by orienting a head mounted display such that
a trajectory selection guidance augmentation graphic appears to
coincide with one of the plurality of trajectories. A previously
defined trajectory may also be updated using exemplary method 1300
by loading and/or selecting the predefined trajectory and then
following exemplary method 1300 to revise a position and/or
orientation of the trajectory.
[0150] Referring now to the block flow diagram shown in FIG. 14,
exemplary method 1400 is a method of using an augmented reality
navigation system in accordance with some embodiments of the
present disclosure. Exemplary method 1400 is a method whereby an
augmentation reality navigation system detects a pointer tool to
assist in planning and/or updating one or more trajectories
corresponding to a surgical procedure. In some embodiments, an
augmented reality navigation system comprises a pointer tool. The
computational steps of exemplary method 1400 may be performed by a
computer subsystem of an augmented reality navigation system.
[0151] In step 1402, one or more detectors mounted on a head
mounted display of an augmented reality navigation system generate
a detector input signal that is received by a computer subsystem of
the augmented reality navigation system. The detector input signal
represents a field of view of the one or more detectors that
comprises at least a portion of a patient anatomy (e.g., relevant
to a surgical procedure to be performed). In step 1404, a relative
position and/or orientation for one or more real-world features in
the detector input signal (i.e., in the field of view represented
by the detector input signal) corresponding to a pointer tool are
determined. The relative position and/or orientation may be
determined in real time or may be taken as an absolute position
and/or orientation represented in a unified coordinate system that
resulted from a registration of an augmented reality navigation
system and a surgical environment (e.g., a registration between the
augmented reality navigation system and objects in the surgical
environment such as a patient, a surgical tool, and a robotic
surgical system, for example). The detector input signal may be
received by a computer subsystem from one or more detectors mounted
to a head mounted display of the augmented reality navigation
system, one or more detectors mounted to a head mounted display of
a second augmented reality navigation system, and/or one or more
auxiliary detectors positioned throughout a surgical environment.
In step 1406, a position and/or an orientation of the pointer tool
are determined based on the relatively position and/or orientation
for the real-world features determined in step 1404. For example,
the coordinates of the physical position and/or orientation of the
pointer tool may be determined using a unified coordinate system
defined during a registration procedure.
[0152] In optional step 1408, augmentation graphics corresponding
to a representation of a portion of the pointer tool hidden from
the natural field of view of the surgeon are displayed on a display
screen of the head mounted display. The augmentation graphics may
appear overlaid over a patient anatomy such that a surgeon can
accurately visual the hidden portion of the pointer tool while
positioning and/or orienting it. Augmentation graphics
corresponding to a model of a patient anatomy may additionally be
overlaid over the patient anatomy to provide further navigational
information. Alternatively or additionally, the pointer tool
augmentation graphics may appear on a virtual display screen
alongside an oriented model of patient anatomy such that the
position and orientation of the pointer tool relative to the model
(e.g., medical image data) in the virtual display accurately
represents the true physical relationship between the pointer tool
and the patient's anatomy.
[0153] In step 1410, a trajectory is determined and/or updated
based, at least in part, on the position and/or orientation of the
pointer tool determined in step 1406. In some embodiments, a
pointer tool may be used to select a plurality of points in space
that are then used to collectively determine a trajectory (e.g., a
linear or non-linear trajectory). The trajectory may be determined
in step 1410 in response to a user input signal received by the
computer subsystem, wherein the user input signal is generated due
to an action (e.g., gesture) by a surgeon using the augmented
reality navigation system and the action is made when the pointer
tool is in a desired position and/or orientation. For example, any
user input mechanism described herein above may be used. In some
embodiments, steps 1402-1410 are repeated one or more times in
order to define a plurality of trajectories. In step 1412, the
trajectory (or plurality of trajectories) is output to a robotic
surgical system (e.g., for use in performing a surgical procedure).
In optional step 1414, trajectory augmentation graphics that
represent the trajectory determined in step 1412 are displayed on a
display screen of the augmented reality navigation system, for
example, in accordance with the embodiments discussed above (in
reference to exemplary method 1200). The trajectory augmentation
graphics may be modified (e.g., using a registration and/or unified
coordinate system) prior to display on a display screen.
[0154] Exemplary method 1400 additionally includes optional steps
1416 and 1418. Either or both of the optional steps may be a part
of a method. In optional step 1416, a haptic object comprising the
trajectory determined in step 1410 is defined. The haptic object
may be determined by the augmented reality navigation system (e.g.,
using relative position(s) and/or orientation(s) of real-world
features detected by a detector of the system) and provided to a
robotic surgical system by the computer subsystem of the augmented
reality navigation system. The robotic surgical system may then be
confined in its motion such that at least a portion of a surgical
tool connected to or inserted into the robotic surgical system
cannot move outside of the haptic object (e.g., due to haptic
feedback provided to a surgeon operating the robotic surgical
system). In optional step 1418, output from the augmented reality
navigation system causes the robotic surgical system to
automatically align with the represented trajectory and/or
automatically move along the trajectory. In some embodiments,
representations of multiple trajectories may be displayed
simultaneously and a surgeon may select one of the represented
trajectories to have the robotic surgical system align to (e.g.,
using a pointer tool). In some embodiments, whether one or multiple
representations of trajectories are displayed, the augmentation
graphics used may appear overlaid over a patient anatomy to give a
surgeon an accurate view of how the trajectory intersects a
patient's anatomy. In some embodiments, portions of a surgical tool
and/or its trajectories appear on a virtual display screen viewed
through a display screen of a head mounted display (e.g., in
spatial correspondence with a model of patient anatomy such that
the trajectory representation, portion of a surgical tool, and
model appear to have the same relative position and orientation as
physical reality). For example, a virtual display screen may appear
as panel A or panel B of FIG. 15. Overlaid augmentation graphics
may appear as the sketch in FIG. 16 illustrates.
[0155] A single augmented reality navigation system may be
configured to perform, inter alia, each of exemplary method 1200,
exemplary method 1300, and exemplary 1400. A choice of a particular
method to define a trajectory or a particular type of augmentation
graphic to display may depend on the surgical procedure being
performed. For example, surgeons may prefer augmentation graphics
and/or trajectories definition methods when performing certain
minimally invasive surgery (MIS) procedures that are different than
those used when performing an equivalent traditional (i.e.,
non-MIS) procedure. Likewise, methods and graphics may depend on
particular surgeon performing a procedure or a particular patient.
Thus, in certain embodiments, an augmented reality navigation
system can store settings on a per procedure, per patient, and/or
per surgeon basis. In some embodiments, patient health information
is displayed on one or more virtual display screens while
navigational information is displayed using overlaid augmentation
graphics and, optionally, on an additional virtual display.
[0156] The following is a description of an exemplary use of an
illustrative embodiment of an augmented reality navigation system.
After the augmented reality navigation system receives a patient's
medical image data, a user interface displayed on a display screen
of the augmented reality navigation system enables planning of a
surgical procedure by allowing the surgeon to navigate a model
derived from the medical image data and position virtual
representations of surgical implants and/or trajectories as
desired. Positioning may occur using surgeon input (e.g., via a
motion sensor or an auxiliary input device). The augmented reality
navigation system is then used to track positions of a robotic arm
and one or more real-world features associated with the patient
(e.g., as detected by a detector). Throughout, the augmented
reality navigation system synchronizes its coordinate system with
that of the patient anatomy and robotic surgical system (for
example, by periodic or continuous re-registration). Upon receiving
input from the surgeon, for example, via a motion sensor, the
augmented reality navigation system causes the end-effector of the
robotic arm to be automatically positioned in alignment with a
planned trajectory, compensating at all times for shifts in the
position of the patient and allowing treatment while avoiding
critical anatomical structures.
[0157] In another exemplary use, a model derived from medical image
data is registered in order to plan an implant trajectory. In
certain embodiments, a medical image itself (corresponding to the
medical image data) is used as a model of patient anatomy. A
particular registration method may be chosen based on the imaging
technique used to generate the medical image data. The imaging may
be done pre- or intra-operatively. Once registered, the surgeon
will use augmentation graphics displayed on a display screen of a
head mounted display to determine necessary trajectories and
locations for surgical implants. Once planning is complete, input
from the surgeon can cause a robotic arm of a robotic surgical
system to move automatically onto a planned trajectory. If multiple
trajectories are planned, the surgeon may move the end effector
close to the first planned trajectory. Alternatively, the first
planned trajectory can be selected using user input (e.g., into a
motion sensor). The augmented reality navigation system will
indicate which planned trajectory is in range on the display screen
and the system will slowly move the robotic arm onto the selected
(e.g., proximal) planned trajectory. Augmentation graphics can be
used to indicate once the selected planned trajectory has been
achieved and motion can be limited along that trajectory. The
surgeon will then use surgical tool(s) connected to the robotic
surgical system to insert the desired surgical implant. The
navigation camera will track the positions of the tool(s) in real
time and display the models on the display screen, for example,
appearing overlaid over the patient anatomy.
[0158] In certain embodiments, augmented reality navigation systems
disclosed herein can be used by medical specialties that can
benefit from both augmented reality visualization and precision
motion tracking (e.g., trauma, navigated spine, pre-planned
cranial). In certain embodiments, augmented reality navigation
systems disclosed herein can be used in open, percutaneous,
minimally invasive surgical (MIS) procedures performed in the
operating room or interventional outpatient procedures, all of
which may contain some form of patient imaging. In certain
embodiments, augmented reality navigation systems disclosed herein
will be valuable in any such procedure which requires the
surgeon(s) to view remote displays with critical navigational
information and to mentally translate that information into the
surgical space or within the patient. For example, a surgical
procedure in which an augmented reality navigation system disclosed
herein is used may be a spinal procedure, an orthopedic procedure,
an orthopedic trauma procedure, a neurosurgical procedure, a
minimally invasive procedure or any combination thereof. In certain
embodiments, augmented reality navigation systems are used for
training, for example, in simulations of surgical procedures using
a cadaver or prosthetic model of patient anatomy.
[0159] Exemplary embodiments of systems and methods disclosed
herein were described above with reference to computations
performed locally by a computing device. However, computations
performed over a network are also contemplated. FIG. 17 shows an
illustrative network environment 1700 for use in the methods and
systems described herein. In brief overview, referring now to FIG.
17, a block diagram of an exemplary cloud computing environment
1700 is shown and described. The cloud computing environment 1700
may include one or more resource providers 1702a, 1702b, 1702c
(collectively, 1702). Each resource provider 1702 may include
computing resources. In some implementations, computing resources
may include any hardware and/or software used to process data. For
example, computing resources may include hardware and/or software
capable of executing algorithms, computer programs, and/or computer
applications. In some implementations, exemplary computing
resources may include application servers and/or databases with
storage and retrieval capabilities. Each resource provider 1702 may
be connected to any other resource provider 1702 in the cloud
computing environment 1700. In some implementations, the resource
providers 1702 may be connected over a computer network 1708. Each
resource provider 1702 may be connected to one or more computing
device 1704a, 1704b, 1704c (collectively, 1704), over the computer
network 1708.
[0160] The cloud computing environment 1700 may include a resource
manager 1706. The resource manager 1706 may be connected to the
resource providers 1702 and the computing devices 1704 over the
computer network 1708. In some implementations, the resource
manager 1706 may facilitate the provision of computing resources by
one or more resource providers 1702 to one or more computing
devices 1704. The resource manager 1706 may receive a request for a
computing resource from a particular computing device 1704. The
resource manager 1706 may identify one or more resource providers
1702 capable of providing the computing resource requested by the
computing device 1704. The resource manager 1706 may select a
resource provider 1702 to provide the computing resource. The
resource manager 1706 may facilitate a connection between the
resource provider 1702 and a particular computing device 1704. In
some implementations, the resource manager 1706 may establish a
connection between a particular resource provider 1702 and a
particular computing device 1704. In some implementations, the
resource manager 1706 may redirect a particular computing device
1704 to a particular resource provider 1702 with the requested
computing resource.
[0161] FIG. 18 shows an example of a computing device 1800 and a
mobile computing device 1850 that can be used in the methods and
systems described in this disclosure. The computing device 1800 is
intended to represent various forms of digital computers, such as
laptops, desktops, workstations, personal digital assistants,
servers, blade servers, mainframes, and other appropriate
computers. The mobile computing device 1850 is intended to
represent various forms of mobile devices, such as personal digital
assistants, cellular telephones, smartphones, and other similar
computing devices. The components shown here, their connections and
relationships, and their functions, are meant to be examples only,
and are not meant to be limiting.
[0162] The computing device 1800 includes a processor 1802, a
memory 1804, a storage device 1806, a high-speed interface 1808
connecting to the memory 1804 and multiple high-speed expansion
ports 1810, and a low-speed interface 1812 connecting to a
low-speed expansion port 1814 and the storage device 1806. Each of
the processor 1802, the memory 1804, the storage device 1806, the
high-speed interface 1808, the high-speed expansion ports 1810, and
the low-speed interface 1812, are interconnected using various
busses, and may be mounted on a common motherboard or in other
manners as appropriate. The processor 1802 can process instructions
for execution within the computing device 1800, including
instructions stored in the memory 1804 or on the storage device
1806 to display graphical information for a GUI on an external
input/output device, such as a display 1816 coupled to the
high-speed interface 1808. In other implementations, multiple
processors and/or multiple buses may be used, as appropriate, along
with multiple memories and types of memory. Also, multiple
computing devices may be connected, with each device providing
portions of the necessary operations (e.g., as a server bank, a
group of blade servers, or a multi-processor system). Also,
multiple computing devices may be connected, with each device
providing portions of the necessary operations (e.g., as a server
bank, a group of blade servers, or a multi-processor system). Thus,
as the term is used herein, where a plurality of functions are
described as being performed by "a processor", this encompasses
embodiments wherein the plurality of functions are performed by any
number of processors (e.g., one or more processors) of any number
of computing devices (e.g., one or more computing devices).
Furthermore, where a function is described as being performed by "a
processor", this encompasses embodiments wherein the function is
performed by any number of processors (e.g., one or more
processors) of any number of computing devices (e.g., one or more
computing devices) (e.g., in a distributed computing system).
[0163] The memory 1804 stores information within the computing
device 1800. In some implementations, the memory 1804 is a volatile
memory unit or units. In some implementations, the memory 1804 is a
non-volatile memory unit or units. The memory 1804 may also be
another form of computer-readable medium, such as a magnetic or
optical disk.
[0164] The storage device 1806 is capable of providing mass storage
for the computing device 1800. In some implementations, the storage
device 1806 may be or contain a computer-readable medium, such as a
floppy disk device, a hard disk device, an optical disk device, or
a tape device, a flash memory or other similar solid state memory
device, or an array of devices, including devices in a storage area
network or other configurations. Instructions can be stored in an
information carrier. The instructions, when executed by one or more
processing devices (for example, processor 1802), perform one or
more methods, such as those described above. The instructions can
also be stored by one or more storage devices such as computer- or
machine-readable mediums (for example, the memory 1804, the storage
device 1806, or memory on the processor 1802).
[0165] The high-speed interface 1808 manages bandwidth-intensive
operations for the computing device 1800, while the low-speed
interface 1812 manages lower bandwidth-intensive operations. Such
allocation of functions is an example only. In some
implementations, the high-speed interface 1808 is coupled to the
memory 1804, the display 1816 (e.g., through a graphics processor
or accelerator), and to the high-speed expansion ports 1810, which
may accept various expansion cards (not shown). In the
implementation, the low-speed interface 1812 is coupled to the
storage device 1806 and the low-speed expansion port 1814. The
low-speed expansion port 1814, which may include various
communication ports (e.g., USB, Bluetooth.RTM., Ethernet, wireless
Ethernet) may be coupled to one or more input/output devices, such
as a keyboard, a pointing device, a scanner, or a networking device
such as a switch or router, e.g., through a network adapter.
[0166] The computing device 1800 may be implemented in a number of
different forms, as shown in the figure. For example, it may be
implemented as a standard server 1820, or multiple times in a group
of such servers. In addition, it may be implemented in a personal
computer such as a laptop computer 1822. It may also be implemented
as part of a rack server system 1824. Alternatively, components
from the computing device 1800 may be combined with other
components in a mobile device (not shown), such as a mobile
computing device 1850. Each of such devices may contain one or more
of the computing device 1800 and the mobile computing device 1850,
and an entire system may be made up of multiple computing devices
communicating with each other.
[0167] The mobile computing device 1850 includes a processor 1852,
a memory 1864, an input/output device such as a display 1854, a
communication interface 1866, and a transceiver 1868, among other
components. The mobile computing device 1850 may also be provided
with a storage device, such as a micro-drive or other device, to
provide additional storage. Each of the processor 1852, the memory
1864, the display 1854, the communication interface 1866, and the
transceiver 1868, are interconnected using various buses, and
several of the components may be mounted on a common motherboard or
in other manners as appropriate.
[0168] The processor 1852 can execute instructions within the
mobile computing device 1850, including instructions stored in the
memory 1864. The processor 1852 may be implemented as a chipset of
chips that include separate and multiple analog and digital
processors. The processor 1852 may provide, for example, for
coordination of the other components of the mobile computing device
1850, such as control of user interfaces, applications run by the
mobile computing device 1850, and wireless communication by the
mobile computing device 1850.
[0169] The processor 1852 may communicate with a user through a
control interface 1858 and a display interface 1856 coupled to the
display 1854. The display 1854 may be, for example, a TFT
(Thin-Film-Transistor Liquid Crystal Display) display or an OLED
(Organic Light Emitting Diode) display, or other appropriate
display technology. The display interface 1856 may comprise
appropriate circuitry for driving the display 1854 to present
graphical and other information to a user. The control interface
1858 may receive commands from a user and convert them for
submission to the processor 1852. In addition, an external
interface 1862 may provide communication with the processor 1852,
so as to enable near area communication of the mobile computing
device 1850 with other devices. The external interface 1862 may
provide, for example, for wired communication in some
implementations, or for wireless communication in other
implementations, and multiple interfaces may also be used.
[0170] The memory 1864 stores information within the mobile
computing device 1850. The memory 1864 can be implemented as one or
more of a computer-readable medium or media, a volatile memory unit
or units, or a non-volatile memory unit or units. An expansion
memory 1874 may also be provided and connected to the mobile
computing device 1850 through an expansion interface 1872, which
may include, for example, a SIMM (Single In Line Memory Module)
card interface. The expansion memory 1874 may provide extra storage
space for the mobile computing device 1850, or may also store
applications or other information for the mobile computing device
1850. Specifically, the expansion memory 1874 may include
instructions to carry out or supplement the processes described
above, and may include secure information also. Thus, for example,
the expansion memory 1874 may be provided as a security module for
the mobile computing device 1850, and may be programmed with
instructions that permit secure use of the mobile computing device
1850. In addition, secure applications may be provided via the SIMM
cards, along with additional information, such as placing
identifying information on the SIMM card in a non-hackable
manner.
[0171] The memory may include, for example, flash memory and/or
NVRAM memory (non-volatile random access memory), as discussed
below. In some implementations, instructions are stored in an
information carrier and, when executed by one or more processing
devices (for example, processor 1852), perform one or more methods,
such as those described above. The instructions can also be stored
by one or more storage devices, such as one or more computer- or
machine-readable mediums (for example, the memory 1864, the
expansion memory 1874, or memory on the processor 1852). In some
implementations, the instructions can be received in a propagated
signal, for example, over the transceiver 1868 or the external
interface 1862.
[0172] The mobile computing device 1850 may communicate wirelessly
through the communication interface 1866, which may include digital
signal processing circuitry where necessary. The communication
interface 1866 may provide for communications under various modes
or protocols, such as GSM voice calls (Global System for Mobile
communications), SMS (Short Message Service), EMS (Enhanced
Messaging Service), or MMS messaging (Multimedia Messaging
Service), CDMA (code division multiple access), TDMA (time division
multiple access), PDC (Personal Digital Cellular), WCDMA (Wideband
Code Division Multiple Access), CDMA2000, or GPRS (General Packet
Radio Service), among others. Such communication may occur, for
example, through the transceiver 1868 using a radio-frequency. In
addition, short-range communication may occur, such as using a
Bluetooth.RTM., Wi-Fi.TM., or other such transceiver (not shown).
In addition, a GPS (Global Positioning System) receiver module 1870
may provide additional navigation- and location-related wireless
data to the mobile computing device 1850, which may be used as
appropriate by applications running on the mobile computing device
1850.
[0173] The mobile computing device 1850 may also communicate
audibly using an audio codec 1860, which may receive spoken
information from a user and convert it to usable digital
information. The audio codec 1860 may likewise generate audible
sound for a user, such as through a speaker, e.g., in a handset of
the mobile computing device 1850. Such sound may include sound from
voice telephone calls, may include recorded sound (e.g., voice
messages, music files, etc.) and may also include sound generated
by applications operating on the mobile computing device 1850.
[0174] The mobile computing device 1850 may be implemented in a
number of different forms, as shown in the figure. For example, it
may be implemented as a cellular telephone 1880. It may also be
implemented as part of a smart-phone 1882, personal digital
assistant, or other similar mobile device.
[0175] Various implementations of the systems and techniques
described here can be realized in digital electronic circuitry,
integrated circuitry, specially designed ASICs (application
specific integrated circuits), computer hardware, firmware,
software, and/or combinations thereof. These various
implementations can include implementation in one or more computer
programs that are executable and/or interpretable on a programmable
system including at least one programmable processor, which may be
special or general purpose, coupled to receive data and
instructions from, and to transmit data and instructions to, a
storage system, at least one input device, and at least one output
device.
[0176] These computer programs (also known as programs, software,
software applications or code) include machine instructions for a
programmable processor, and can be implemented in a high-level
procedural and/or object-oriented programming language, and/or in
assembly/machine language. As used herein, the terms
machine-readable medium and computer-readable medium refer to any
computer program product, apparatus and/or device (e.g., magnetic
discs, optical disks, memory, Programmable Logic Devices (PLDs))
used to provide machine instructions and/or data to a programmable
processor, including a machine-readable medium that receives
machine instructions as a machine-readable signal. The term
machine-readable signal refers to any signal used to provide
machine instructions and/or data to a programmable processor.
[0177] To provide for interaction with a user, the systems and
techniques described here can be implemented on a computer having a
display device (e.g., a CRT (cathode ray tube) or LCD (liquid
crystal display) monitor) for displaying information to the user
and a keyboard and a pointing device (e.g., a mouse or a trackball)
by which the user can provide input to the computer. Other kinds of
devices can be used to provide for interaction with a user as well;
for example, feedback provided to the user can be any form of
sensory feedback (e.g., visual feedback, auditory feedback, or
tactile feedback); and input from the user can be received in any
form, including acoustic, speech, or tactile input.
[0178] The systems and techniques described here can be implemented
in a computing system that includes a back end component (e.g., as
a data server), or that includes a middleware component (e.g., an
application server), or that includes a front end component (e.g.,
a client computer having a graphical user interface or a Web
browser through which a user can interact with an implementation of
the systems and techniques described here), or any combination of
such back end, middleware, or front end components. The components
of the system can be interconnected by any form or medium of
digital data communication (e.g., a communication network).
Examples of communication networks include a local area network
(LAN), a wide area network (WAN), and the Internet.
[0179] The computing system can include clients and servers. A
client and server are generally remote from each other and
typically interact through a communication network. The
relationship of client and server arises by virtue of computer
programs running on the respective computers and having a
client-server relationship to each other.
[0180] In some implementations, modules or computational subsystems
(e.g. a position tracking module and user input module) described
herein can be separated, combined or incorporated into single or
combined modules. Modules and arrangements thereof depicted in
figures are not intended to limit the systems and methods described
herein to the software architectures shown therein.
[0181] Certain embodiments of the present invention were described
above. It is, however, expressly noted that the present invention
is not limited to those embodiments, but rather the intention is
that additions and modifications to what was expressly described
herein are also included within the scope of the invention.
Moreover, it is to be understood that the features of the various
embodiments described herein were not mutually exclusive and can
exist in various combinations and permutations, even if such
combinations or permutations were not made express herein, without
departing from the spirit and scope of the invention. In fact,
variations, modifications, and other implementations of what was
described herein will occur to those of ordinary skill in the art
without departing from the spirit and the scope of the invention.
As such, the invention is not to be defined only by the preceding
illustrative description.
[0182] Having described certain implementations of augmented
reality navigation systems for use with a robotic surgical system
and methods of their use, it will now become apparent to one of
skill in the art that other implementations incorporating the
concepts of the disclosure may be used. Therefore, the disclosure
should not be limited to certain implementations, but rather should
be limited only by the spirit and scope of the following
claims.
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