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  Method and device for the representation of an operation area during laser operationsUSPTO Application #: 20060217689Title: Method and device for the representation of an operation area during laser operations Abstract: The invention relates to a device for the three-dimensional representation of an operation area, in particular an eye, during laser operations, comprising a spatial recording system (10), an image-processing system (15) and a spatial display unit (20). (end of abstract) Agent: Darby & Darby P.C. - New York, NY, US Inventors: Manfred Dick, Juergen Kuehnert, Holger Maeusezahl USPTO Applicaton #: 20060217689 - Class: 606004000 (USPTO) Related Patent Categories: Surgery, Instruments, Light Application, Ophthalmic The Patent Description & Claims data below is from USPTO Patent Application 20060217689. Brief Patent Description - Full Patent Description - Patent Application Claims
[0001] The present invention relates to a method and a device for the representation of an operation area during laser operations. [0002] In ophthalmology, it is known in the case of poor eyesight to shape the cornea by the ablation of tissue. As methods, the so-called PRK (photorefractive keratectomy) and LASIK (laser-assisted in situ keratomileusis) methods have established themselves, in which initially a small flap of epithelium, Bowman membrane and stroma is cut and unfolded and then the PRK is carried out in the stroma bed. [0003] Lasers of suitable wavelength are used for ablation. The excimer laser with a wavelength of 193 nm is particularly suitable for this purpose. However, other lasers such as Er:YAG solid-state lasers are also already used for this. [0004] The data for the extent of the defective vision are established by sight tests, by means of refractometers and recently also by the evaluation of measurements of the wavefront. Other methods and devices are also known, which can be used to calculate firing coordinates for the actual operative procedure from these measurement values. [0005] A laser operation is monitored by the surgeon or doctor usually by observing the operation area by means of a microscope. The doctor thus obtains a spatial impression of the operation area. However, the view through the microscope allows only one person a spatial impression. [0006] Representation on a monitor etc. by means of a camera is also known. However, in this case the spatial impression of the operation area is lost. In the case of an operation using a slit scanner, the progress of the operation and the sequence of the ablation steps can be very well perceived and monitored by the doctor. The doctor can thus detect abnormalities in the ablation process early and counteract these, for example stop the operation, etc. [0007] With today's modern spot scanners, the ablation process is no longer easy to understand due to various factors. Firstly, the firing frequency of the lasers is increasing all the time and lies well above the perceptive capability of the surgeon. The ablation process is also patient-dependent and the steering and placement of the spot in the ablation area is subject to complex algorithms which attempt to solve the most varied tasks and problems of the ablation process (thermal load, smoke). An ablation algorithm for example breaks down the necessary firings for a complete correction into many small individual corrections, with the aim that the operation can be aborted at any time and it can be guaranteed that an optically satisfactory result is achieved (cf. the valuable contribution to the state of the art in the patent specification DE 197 27 573). Therefore, in the case of more modern spot scanners, it is no longer possible for a surgeon to monitor the complex ablation process--by checking the correct positioning of the laser beam on the area to be operated on--by "looking through the microscope". [0008] The field of vision is also seriously limited when "looking through the microscope" because of the design. In order to use operation equipment, to ascertain status information or progress information for equipment, the doctor must stop looking through the operation microscope and therefore take his eyes off the operation area. [0009] When representing the operation area for several observers (teaching purposes, monitoring etc.), the operation area can be represented by means of a camera and a monitor. Because of the principle involved, however, the spatial impression is lost in this case. However, this is of decisive importance during such microsurgical procedures. [0010] The ablation processes in PRK using a spot scanner are so complex that the doctor is scarcely in a position to tell whether the operation is progressing correctly or to detect, early, problems which arise, so as to act to correct them. In order to control equipment etc., the doctor must take his eyes off the operation area, in order to use the equipment or to record status information. [0011] It is therefore the aim and object of the invention to make available devices and methods which allow the doctor to be able to clearly monitor the progress of the operation and thus to consciously control the operation. [0012] This object is achieved by a device according to the independent device claim and also by a method according to the independent method claim. Advantageous further developments are defined in the dependent claims. [0013] In particular, the object is achieved by a device for the three-dimensional representation of an operation area, in particular an eye, during laser operations, comprising a spatial recording system (10), an image-processing system (15) and a spatial display unit (20). This device makes it possible to three-dimensionally represent the operation area and to clearly monitor the progress of the operation, even when not looking through the microscope. In particular, in this way several observers can observe the operation area simultaneously, without losing the three-dimensional impression. [0014] The spatial recording system is preferably a camera system, with which image information or data of an object can be obtained typically from several observation angles. These data then allow the reconstruction of a three-dimensional representation of this object, i.e. the operation area. [0015] The image-processing system evaluates the obtained data and processes them so that they are suitable for the following spatial display unit for the representation of a three-dimensional or spatial image. The image-processing system can be a chip, a computer, software or a microprocessor. [0016] The spatial display unit is preferably a 3-D display, a hologram or a three-dimensional representation unit generated by laser. Particularly preferably, it is an arrangement for three-dimensional representation according to DE 198 25 950. The spatial extent of the starting position, i.e. the position before the operative procedure, and also the spatial extent of the position after an operation can be advantageously represented by means of such a display. [0017] In a preferred embodiment of the present invention, the device according to the invention also comprises a control module (30); at least one item of medical equipment (40) and a bus system which connects the spatial display unit (20) and the control module (30), so that data and information can be displayed on the display unit (20). It is hereby possible that additional information relating to the operation or the operation laser etc. can be displayed by the three-dimensional or spatial representation of the operation area which is to be observed. The surgeon and other observers can thus record valuable additional information without having to take their eyes off the spatially represented operation area. [0018] The control module is preferably a computer, a calculator, a microcontroller. [0019] The item of medical equipment preferably comprises an operation laser for refractive surgery. In addition, further devices such as eye trackers, online topography sensors, online wavefront sensors, illumination units and also eye identification systems (including rotation control and identification according to the application DE 10052201 of 20.10.2000) can be used. This equipment sends data regarding its own status via the bus system to the control unit and also receives instructions from the control device via the bus system. Particularly preferably, the algorithm for the processing of the operation program and the data of the planned operation are also on the control unit or are fed into this or made available to this. [0020] Data and information are particularly preferably data relating to the operation area, preferably a laser for refractive corneal surgery (such as firing rate, energy, pulse shape, etc.) or data regarding the operation (such as patient data, temperature of the tissue or operation area, operation time already elapsed, remaining time of the operation, operation laser settings, etc.) or status information (limits of the area of the eye tracker, limits of the operating range of the laser, progress of the operation, energy status, etc.). [0021] In another preferred embodiment of the present invention, the device according to the invention also comprises a touch-sensitive display overlay. It is thereby possible for the surgeon to input control commands or equipment control functions via the touch-sensitive display overlay. These can be passed on to the control unit and from there be used to control the medical equipment. [0022] In another preferred embodiment of the present invention, image data relating to the operation area, additional data and information and also control panels can be represented on the display unit (20). This representation of all relevant and interesting data for the operation makes it possible for the surgeon to keep his eye on all parameters and circumstances of the operation, without having to take his eye off the spatially represented operation area. These various data can be represented as a PIP (picture in a picture) or overlaid. The images and data can also be displayed in a multi-window technique. [0023] In addition, it is possible to display several different views of the operation area simultaneously. These can be different observation angles, different perspectives, clips or magnification scales. It is also possible to represent images of different time domains next to each other, which is preferable in particular if the chronology of an operation is to be displayed. This is particularly interesting for teaching events in which the data and the course of previous operations is to be presented, without foregoing the spatial impression. [0024] In particular panels and symbols, which can be activated by touching the touch-sensitive display overlay, are provided as control panels. These are preferably symbols for controlling a magnification of the image, in particular for infinitely variable magnification (digital zoom). Camera guiding symbols for selecting the perspective and the observation angle are also preferably provided, and symbols for selecting from the individual windows, etc. Continue reading... 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