SpineMap 3D Installation Instructions

Transcription

SpineMap™ 3D Navigation
OrthoMap® 3D Navigation
Installation Instructions
Version 1.0
c
1275
File in your maintenance records
Rev. A
2008-12-18
SpineMap 3D Navigation: TD6002650760
OrthoMap 3D Navigation: TD6005650760
Table of Contents
Change Record
Revision
A
Comment
Initial revision
Date
16. Dec 08
Author
H. Rath
Table of Contents
1
Introduction
1.1
1.2
How to use this document
Representation of User Interface Elements
3
3
3
2
Glossary
3
3
Navigation System I
4
4
Navigation System II
5
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13
5
Remote Planning System
5.1
5.2
5.3
5.4
5.5
5.6
6
Installation of the operating system
5
Install SpineMap™ 3D/OrthoMap® 3D
6
Optional ATI Driver Update on Navigation System with Matrox graphics card
7
Optional ATI Driver Update on Navigation System without Matrox graphics card 16
Application Manager Setup
21
Required Navigation System II-Camera Firmware
22
License Installation
23
User Settings
25
User Password Management
26
Application Settings
27
Image Import
28
Backup/Restore
31
Additional Settings
32
SpineMap™ 3D/OrthoMap® 3D Installation
Put SpineMap™ 3D/OrthoMap® 3D into Service
Import of images with GEYMS and Philips Hitachi formats
Setup without Ziehm and Siemens C-arms
Setup without Ziehm C-arms
Setup without Siemens C-arms
Calibrate C-arms
6.1
6.2
6.3
6.4
Ziehm Vision Vario 3D and Ziehm Vision FD Vario 3D calibration
Troubleshooting
Siemens ARCADIS® Orbic calibration
Siemens Siremobil Iso-C calibration
33
33
33
34
35
37
38
39
39
61
62
81
Page 2 of 104
Introduction
1
Introduction
This document is intended to guide through the installation of the SpineMap™
3D/OrthoMap® 3D system.
For the configuration of the present operating systems refer to the Installation Instructions of
the corresponding operating system.
1.1
How to use this document
Carefully read this document prior to installation. For informative background information,
refer to the user documentation supplied with the product.
For detailed instructional steps to install related components, refer to installation instructions
posted to the Technical Corner of www.strykereurope.com/navigation (password protected).
The words “CAUTION” and “NOTE” in this document carry special meanings and should be
observed with care.
CAUTION
NOTE
CAUTION indicates any measure, which is intended to avoid potential
malfunction and/or product damage.
This provides special information to make important instructions clearer.
An exclamation mark within a triangle is intended to alert the user to the
presence of important operating instructions.
1.2
Representation of User Interface Elements
GUI elements are represented with cursive type style.
Literals (to be input exactly by the technician) and variables (to be selected by the technician)
are written in bold.
Examples:
 Logon as NavigationAdmin [literal].
 If message System Settings Change [GUI element]… appears enter Yes [variable].
2
LMS
DIU
ENT
CD
DVD
MOD
UPS
Glossary
License Management System
Device Identification Utility. A software tool for collecting data
necessary for license generation for Stryker® Navigation Systems
Ear Nose Throat
Compact Disk
Digital Video Disk
Magneto Optical Disk
Uniterruptable Power Supply
Page 3 of 104
Navigation System I
3
Navigation System I
Installation of SpineMap™ 3D/OrthoMap® 3D Software 1.0 on a Navigation System I
platform is neither supported nor released!
DO NOT try to install SpineMap™ 3D/OrthoMap® 3D Software 1.0 on a Navigation System I
platform.
Page 4 of 104
4
4.1
Installation of the operating system
To install the operating system refer to the corresponding Installation Instructions.
Page 5 of 104
4.2
Install SpineMap™ 3D/OrthoMap® 3D
Stryker® Navigation System II is delivered with pre-installed up-to-date software at the time of
shipment. First, login as NavigationAdmin and check if the software package and version you
expect is already installed. If you see the package name “SpineMap™ 3D/OrthoMap® 3D” or
“SpineMap™ 3D/OrthoMap® 3D” grayed out in the Application Manager you can activate the
package by licensing – refer to Chapter 4.7. Once licensed, start the package and check the
package version using the “About” button.
To install SpineMap™ 3D/OrthoMap® 3D, follow this procedure:

Logon as NavigationAdmin

Click Shutdown …

Click Windows Desktop

Insert the SpineMap™ 3D/OrthoMap® 3D CD in the DVD drive.

Notice: The file c:\winnt\system32\autoexnt.bat for the service to start the DICOM
receiver will be overwritten each time a new installation of an image-based Stryker®
Navigation package is made. Backup the file if necessary and restore it after
installation. Refer to Chapter 4.11. Image Import on how to configure the data import
via DICOM network. 1,2

Execute install_all.bat from the CD drive

Prior to the installation of the application the installation automatically checks
whether the Stryker® Device Identification Utility (DIU) and Stryker® Application
Manager requires an update and installs it automatically, if required. Just follow the
steps of the installation workflow.

On some systems the SpineMap™ 3D/OrthoMap® 3D installation will force you to
update the ATI driver prior to the installation of the application:
In this case you must follow the instructions given in chapter 4.3 and 4.4 and then repeat this
chapter.

After successful installation indicated by Installation complete press any key to reboot
the computer. After reboot remove the iNtellect SpineMap - 3D/OrthoMap® -3D
Navigation CD.
1
If the DICOM receiver “simple storage” is currently running, close it by either clicking on X in the top-right corner of the
console of the DICOM receiver, or open the Task Manager, select start_dicom_receiver.bat, and click End Task.
2
If the message Cannot find the file ‘c:\programs\Stryker_Leibinger\spine3D\bin\start_dicom_receiver.bat’ appears, enter
OK. The file will be installed during package installation.
Page 6 of 104
ATI Driver Update with Matrox graphics card
4.3
Optional ATI Driver Update on Navigation System with Matrox graphics
card
Attention: Update of the ATI Driver is only required if installation requests it. Otherwise skip
this chapter. This patch may only be installed on a Navigation System II W670 OS V1.0-4.





If connected: detach any external DVI monitor (e.g. Plasma screen connected to the
Systems external DVI output socket) before you start the system.
Login as NavigationAdmin
Click into Application Manager and close it using ALT-F4
Run 1_uninst_ati.bat on the installation CD (in directory ATI_Patch_2006_08_01)
When the following message is displayed:
select Yes

select No
Page 7 of 104

select Remove, Next >, OK

select No, Finish
Page 8 of 104

select OK

select No


Press any key to close the command window.
Uninstall the Matrox G450 graphics board: MyComputerManageDevice Manager
select Display adapters - Matrox G400/G450 - Uninstall...
Page 9 of 104
and confirm removal by selecting OK

select No



Shutdown the PC, and start it again. It starts up in VGA mode. Login as
NavigationAdmin
The following message is displayed twice
Each time select Cancel
Page 10 of 104



In C:\Dell\DRIVERS\R108753 execute Setup.exe
Select Next, Yes, Custom
Select both ATI Display Driver and ATI Control Panel, then Next >

Select No, Finish


Shutdown the PC, and start it again. Login as NavigationAdmin
Click into Application Manager and close it using ALT-F4.
Page 11 of 104

Select Next >

Select Search for a suitable driver for my device (...), and Next >
Page 12 of 104

Remove the checkmark for Floppy disk drives, then select Next >

select Next >
Page 13 of 104

Select Finish

Select No

Run 2_apply_stryker_settings.bat on the installation CD (in directory
ATI_Patch_2006_08_01)
Page 14 of 104

When the “ATI update finished” message appear in the command window
Press any key to shutdown the system.



Start it again. Login as NavigationAdmin
To ensure that the display screen area is set correctly follow these steps:
In the Application Manager select Shutdown–>Windows Desktop.
Right-click into the desktop and select Properties–>Settings.
Select screen area 1280 by 1024 pixels and select OK to close dialog.
Congratulations, the ATI driver update is done.
Page 15 of 104
ATI Driver Update without Matrox graphics card
4.4
Optional ATI Driver Update on Navigation System without Matrox graphics
card
Update of the ATI Driver is only required if installation requests it. Otherwise skip this chapter.
This patch may only be installed on a NavSuite II W670 OS 1.0-4.





If connected: detach any external DVI monitor (e.g. Plasma screen connected to the
Systems external DVI output socket) before you start the system.
Run 1_uninst_ati.bat on the installation CD (in directory ATI_Patch_2006_08_01)
select Yes

select No
Page 16 of 104

select Remove, Next >, OK

select No, Finish
Page 17 of 104

select OK

select No




Press any key to close the command window
Shutdown the PC, and start it again. It starts up in VGA mode. Login as NavigationAdmin
The following message is displayed:
Select Cancel


In C:\Dell\DRIVERS\R108753 execute Setup.exe
Select Next >, Yes, Custom
Page 18 of 104

Select both ATI Display Driver and ATI Control Panel, then Next >

Select No, Finish



Shutdown the PC, and start it again. Login as NavigationAdmin
Run 2_apply_stryker_settings.bat on the installation CD (in directory
ATI_Patch_2006_08_01)
Page 19 of 104

When the “ATI update finished” message appear in the command window
Press any key to shutdown the system.



Start it again. Login as NavigationAdmin
To ensure that the display screen area is set correctly follow these steps:
In the Application Manager select Shutdown–>Windows Desktop
Right-click into the desktop and select Properties–>Settings
Select screen area 1280 by 1024 pixels and select OK to close dialog.
Congratulations, the ATI driver update is done.
Page 20 of 104
4.5


Click Tools button.

Click Edit appman_user.def of NavigationAdmin User

Edit the application list in section [main_group] so that the surgeons
preferred applications are addressed which are supposed to be present
on the application manager screen. The entry appman_spine3d.def
refers to ‘SpineMap 3D’; the entry appman_oncology.def refers to
‘OrthoMap 3D’ entry.

Example 3 :
Application
Manager Setup
Admin user
[main_group]
entry30=c:\programs\stryker_leibinger\spine3D\system_settings\appman_spine3d.def
;entry02=c:\programs\stryker_leibinger\ieknee\system_settings\appman_oncology.def
NOTE: The order of the entries has no influence on the order in which
the applications are shown in the application manager. To change that
order, renumber the entries but don’t create duplicate numbers.

Save the file and close editor.

Repeat the above steps for the Navigation User (Click Edit
appman_user.def of Navigation User). For further details refer to the
Installation Instructions of the operating system.
Other Users
3
Please note: if there is only one application configured in the [main_group] list this application is started automatically when the
“Navigation” user logs on. The application manager does not show up in that case.
Page 21 of 104
Required Navigation System II-Camera
Firmware
4.6
Required Navigation System II-Camera Firmware
SpineMap™ 3D/OrthoMap® 3D requires a Navigation System II-Camera firmware revision 20 or
higher. In case a Navigation System II-Camera firmware revision below 20 is installed, the message
Wrong Navigation Device Revision will pop up when entering the Setup System dialog. The latest
firmware revision is on the SpineMap™ 3D/OrthoMap® 3D installation CD. Refer to the
corresponding Installation Instructions in the “FP6000 V1.0-21 Update Kit” folder for an update.
NOTE: DO NOT downgrade a camera from firmware revision 21 to 20, since the camera will not
work after downgrading. In this case you have to upgrade to 21 again.
Page 22 of 104
4.7
A license may be generated using the web-based Stryker® License Management System (LMS). If
you do not have authorization to use the LMS, please contact Operations. The web application for
license generation can be found at https://license.stryker.com.
If the Stryker® Navigation System for which the license is to be generated is not in the LMS
Database, perform the steps as described in 4.7.2, 4.7.3 and 4.7.4. If you are uncertain as to
whether the Navigation System is in the LMS Database perform step 4.7.1.
If the Stryker® Navigation System for which the license is to be generated is in the LMS Database,
perform the steps as described in 4.7.3 and 4.7.4.
4.7.1



4.7.2







Verify Navigation System is recorded in LMS Database
Go to https://license.stryker.com
Login with username and password as provided by Operations.
Click License Manager, Edit Devices, and verify that the serial number
of the Navigation System for which a license is to be generated is listed.
If not present, device identification data must be obtained from the
Navigation System using the Device Identification Utility. See 4.7.2.
Verify
Navigation
System is
recorded in
LMS Database
Device Identification Utility (DIU)
Click Tools button.
Click Device Identification Utility
Enter the Serial Number 4 of the Navigation System and select the
correct Model Number.
Click Save to store the data on the Navigation System.
Click Save to File to store all the displayed information to a file. It is
recommended that the data is saved to a USB stick.
This file along with the customer id/country can now be uploaded to
the Stryker® LMS Database (next chapter).
Retrieving
Device
Identification
Data for LMS
Database
4
The Serial Number of a Nav. Sys II – Cart is the serial number of the Cart. The Serial Number of a laptop based
system is the serial number of the laptop itself as found on the underside.
Page 23 of 104
4.7.3








License Generation (LMS)
Go to https://license.stryker.com
Login with username and password as provided by Operations.
Click License Manager
Click Edit Customers, verify customer is in database. If not present,
click Add New Customer to add your customer’s details.
Click Edit Devices, verify that the Navigation System is in the database.
If not present, device identification data must be obtained from the
Navigation System using the DIU. See 4.7.2.
To add a device click Edit Devices , click on link Add new Device and
select Browse button to pick your DIU file from your memory stick
stored with the DIU tool. Click the Upload button to upload the file to
the LMS. Pick the correct distribution center, customer ID and enter a
description as needed. Select Save Device Details for complete the task.
Click Get License
Based of what has been ordered select one package of the following
SpineMap™ 3D configuration packages:
SpineMap™ 3D Navigation
SpineMap™ 3D Planning
SpineMap™ 3D C-arm 3D Navigation
License
Generation
(LMS)
(REF 6002-650-000)
(REF 6002-651-000)
(REF 6002-650-010)
OrthoMap® 3D configuration packages:
OrthoMap® 3D Navigation
OrthoMap® 3D Planning
OrthoMap® 3D C-arm 3D Navigation






4.7.4






5
(REF 6005-650-000)
(REF 6005-651-000)
(REF 6005-650-010)
Select License Validity
Enter Order Number
Select Serial Number
Click Generate Licens.
Download license to USB stick.
Log off. 5
Installing the License
Click > adjacent to grayed out SpineMap™ 3D/OrthoMap® 3D
Click License Manager
Enter the license string:
o Click Browse, open the license file created in 4.7.3 “License
Generation (LMS)” and close the License Manager.
o Enter the string manually.
Click Accept to install the license.
The license is now installed and the SpineMap™ 3D/OrthoMap® 3D
Package can now be started.
Further Information on license generation can be found on the web application’s help page.
Installing the
License
Page 24 of 104
User Settings
4.8
User Settings
If required, each user of SpineMap™ 3D/OrthoMap® 3D can store his/her
own settings. To use this feature, each user must have his/her own user
name: To create new users, the “Add user assistants” must be used.
 Logon as user NavigationAdmin
Create New
User
 Execute Tools…Add User
 Enter Username: UserName (Note: use characters, numbers and
underscore “_“ only and must not be longer than 20 characters).
 Enter Password: Password. (Note: for the password only
characters, numbers and underscore “_” is allowed, length
should be between 5 and 14 characters).
 Confirm Password: Password
 Select Create
 File appman_user.def is opened automatically. Edit according to
Chapter 4.5 “Application Manager Setup”, file appman_user.def
 Enter user’s real world name in line username=
This name will be displayed on the application manager screen.
 Edit application list as described in Chapter 4.5 “Application
Manager Setup”.
 Add another user or leave the Add User assistant
 Set the user password to never expires according to Chapter 4.9
“User Password Management”.
Page 25 of 104
User Password Managements
4.9
User Password Management
To switch off the expiration of a user password, follow this procedure:
 Logon as NavigationAdmin

Press Shutdown…

Press Windows Desktop…

With right mouse button click My Computer 6 on the desktop and
open Manage. Go to Local Users and GroupsUsers

Open properties of the user and verify that the box Password never
expires is checked. If not, check box.
User Password
Management
or: StartSettingsControl PanelAdministrative ToolsComputer ManagementLocal Users and
GroupsUsers
6
Page 26 of 104
4.10


Click on Tools

Click Edit appman_system.def

Enter the hospital’s name under section ‘hospital_name’

Save file.


Start SpineMap™ 3D[OrthoMap® 3D] Navigation application
On the Home page open User settings … in the Administration
section.
Raise the “Stryker® Contact” tab and enter the appropriate contact
settings for the site. This contact will be shown if Get Support is
chosen from the Help section of the application’s Home page.

Hospital Name
Stryker® Contact
Information
Page 27 of 104
Image Import
4.11
Image Import


Click Shutdown …

Click Windows Desktop

Open the Windows Disk Administrator by right clicking
My ComputerManage and selection of Disk Management
Device Settings
Notify the numbers of the disks as indicated in the dark grey list of all
connected disk drives, here: Disk 0 (hard disk), Disk 1(Sony Mo). If
unsure which disk belongs to which physical drive you can right click
the disk and open the Properties dialog to check the Hardware
Vendor. Write down disk number and according physical drive type.

Adjust drive letters: MaxOptics/Sony M:

Close Computer Management dialog and click Back to Navigation
button.
Page 28 of 104
Image Import

To receive DICOM files via network first contact the Hospital’s
network administrator to integrate the Stryker® Navigation PC into
the network.

Login as user NavigationAdmin

Click “>” next to SpineMap™ 3D/OrthoMap® 3D

The DICOM receiver simple_storage.exe is called by
start_dicom_receiver.bat. The start_dicom_receiver.bat is started by
the AutoExNt service

Click ImportEdit start_dicom_receiver.bat

Set the DICOM_PORT number according to your actual
configuration.
The other configurable variables are set to useful default values during
installation, so there is no need to change them.
DICOM
Network
EXE_DIR must be set to the name of the directory where simple_storage.exe is located.
DICOM_DEST specifies the directory where the received images shall be stored. This
directory must be the same as STP_DATAIN (defined in SPINE3D[ONCOLOGY].bat),
because the DICOM import plug-in reads the images from STP_DATAIN.
Set LOG_NAME to the name of the log file.
Set LOG_SIZE to the max. size of the log file. (It is deleted and rewritten when it reaches this
limit.)

Click Shutdown…

Click Windows Desktop…

Ensure that the port is open in the firewall:
- Open the firewall: Start Menu\Programs\McAfee Desktop
Firewall\McAfee Desktop Firewall
- Right-click "Allow DICOM receiver - port 4711" and select
"duplicate".
- Right-click "Allow DICOM receiver - port 4711" and select
"properties".
- Change "4711" to the DICOM_PORT number specified above in
the "description" field and in "Local Service".
- Close the Firewall window.
Activate the AutoExNt service by right-clicking on the My Computer
icon. Select Manage, Services and Applications, Services. Right-click
on AutoexNT. Select Properties, General and change Startup type to
automatic. Confirm your changes with OK, shut down and restart the
system. After the system has rebooted, the receiver starts
automatically even if you are not logged in.


The application entity title of simple_storage is ‘DICOM_STORAGE’,
but it will accept any other name with 1 to 16 characters.

Notice: The file c:\winnt\system32\autoexnt.bat for the service to start
the DICOM receiver will be overwritten each time a new installation
of an image-based Stryker® Navigation package is made. Backup the
file if necessary and restore it after installation. Refer to the
Installation Instructions of the operating system for further details on
how to configure the data import via DICOM network.
Page 29 of 104
Image Import

Ensure to write protect media before inserting in drives for image
import.
Under certain circumstances (when starting the disk administrator)
WINDOWS will write some kind of signature to the media that will
make it unreadable by the import modules.

DICOM MOs:
Can be accessed directly by the corresponding drive letter.

Other MOs:
Make sure that the PHYSICALDRIVE server is started:
My ComputerManageServices and
Magneto
Optical Disk
(MO)
ApplicationsServicesPHYSICALDRIVE server
Due to the new DICOM plug-in a revalidation of established navigation
imaging protocols is mandatory after installation.
DICOM
Imaging
Protocol Check
Follow the functional testing instructions of the Installation Protocol. Make
sure to cover the customer’s scanners and revise established imaging
protocols.
Page 30 of 104
Backup/Restore
4.12
Backup/Restore


Click “>” next to SpineMap™ 3D/OrthoMap® 3D

Click Devices patient_backup_setup.def

Set the drive letter for the backup drive to the correct CD/DVD writer’s
drive letter 7 (e.g. E or F):
backup_drive=E
CDRW/DVD
Settings for
Patient
Backup
7 You can check for the appropriate drive letter in the Windows File Explorer or in the Windows Disk Management
dialog as shown in chapter 4.11.
Page 31 of 104
Additional Settings
4.13
Additional Settings
4.13.1
File appman_user.def
In order to adapt the appearance of the Application Manager to meet every single user’s specific
needs, e.g. to show the users name and a specific list of applications, the file appman_user.def of
each system user can be changed:


Click “Tools”  Edit appman_user.def of …  <User Name>
in order to edit the settings for the application manager for different
users.
Individual
Application
Manager
Settings
The following settings can be made:
Section
Entry
Description
[general]
use_system_username
User name from the current users
Windows profile is used.
Default: no
[general]
Username
Username to show on the Application
Manager's screen. Ignored if
“use_system_username” is set to “yes”.
Default: “” (No user name)
[main_group]
entryXX
Applications visible in Application
Manager. To make an application
invisible comment out 8 the line
“entryXX”.
For each user the applications displayed in the Application Manager can be customized. Add a ‘;’ at
the beginning of a line to hide an application of the corresponding entry.
Please note: if there is only one application configured in the [main_group] list this application is
started automatically when the “Navigation” user logs on. The application manager does not show
up in that case.
8
To comment out a line add a ‘;’ at the beginning of that line.
Page 32 of 104
Remote Planning Systems
5
Remote Planning System
5.1
The Remote Planning System comes with pre-installed software packages, the latest packages
available at the time of shipment. First, login as NavigationAdmin and check, if the software
package and version you want is already installed. If you see the package name “SpineMap™
3D/OrthoMap® 3D” or “SpineMap™ 3D/OrthoMap® 3D” grayed out in the Application
Manager you can activate the package by licensing – refer to Chapter 4.7 . Once licensed, start
the package and check the package version using the “About” button.
The Installation of the Remote Planning Software works according to the Installation of
SpineMap™ 3D/OrthoMap® 3D on Navigation System II with some minor differences
explained in the following paragraph.
Please refer to the previous chapter for:
 Installation of the operating system
 Software Installation
 Application Manager Setup
 License Installation
 User Settings
 User Password Management
 Application Settings
 Image Import
 Backup/Import
 Additional Settings
5.2
Put SpineMap™ 3D/OrthoMap® 3D into Service
Resulting planning data and patient backups from SpineMap™ 3D/OrthoMap® 3D must only
be used and restored with navigation systems running the same version of SpineMap™
3D/OrthoMap® 3D as well.
It is part of the installation procedure to verify whether the remote planning system is
compatible to the associated navigation system. The system must not be installed, handed over
to the hospital and released for patient treatment if the 2 systems are not compatible.
Page 33 of 104
GEYMS and Philips Hitachi formats
5.3
Import of images with GEYMS and Philips Hitachi formats
Login as Navigationadmin
Click on SpineMap 3D/OrthoMap 3DImportLegacy Import Enable
Send an E-mail to import_modules@stryker.com which describes the scanner type which was
connected.
Page 34 of 104
Setup without Ziehm and Siemens C-armss
5.4
Setup without Ziehm and Siemens C-arms
When no C-arm is licensed the Dicom receivers for the C-arms have to be disabled:
SpineMap™ 3D
Remove Read Only attribute of file
C:\Programs\Stryker_Leibinger\spine3d\system_settings\watchdog.def
Open file
OrthoMap® 3D
C:\Programs\Stryker_Leibinger\oncology\system_settings\watchdog.def
Open file
Go to section
[GENERIC]
Change the line
required = COORDENGINE DICOM_SIEMENS DICOM_ZIEHM3D
into
required = COORDENGINE
Comment the following sections by adding a semicolon to each line:
;[DICOM_SIEMENS]
;start_command = start_dicom_receiver_siemens.bat
;stop_command = kill_process.exe
;keywords = storescp.exe
;required =
;optional =
;init_time = 500
;init_restarts = 2
;restarts = -1
;WINDOW_TYPE = 1
;TITLE
= DICOM Siemens 3D
;[DICOM_ZIEHM3D]
;start_command = start_dicom_receiver_ziehm.bat
;required =
;optional =
Page 35 of 104
Setup without Ziehm and Siemens C-armss
;init_time = 500
;init_restarts = 2
;restarts = -1
;WINDOW_TYPE = 1
;TITLE
= DICOM Ziehm 3D
Save the file and exit the editor.
Set file attribute to Read Only
Page 36 of 104
5.5
SpineMap™ 3D
Open file
OrthoMap® 3D
Open file
Go to section
[GENERIC]
Change the line
into
required = COORDENGINE DICOM_SIEMENS
Comment the following section by adding a semicolon to each line:
;[DICOM_ZIEHM3D]
;start_command = start_dicom_receiver_ziehm.bat
;required =
;optional =
;init_time = 500
;init_restarts = 2
;restarts = -1
;WINDOW_TYPE = 1
;TITLE
= DICOM Ziehm 3D
Page 37 of 104
5.6
SpineMap™ 3D
Open file
OrthoMap® 3D
Open file
Go to section
[GENERIC]
Change the line
into
required = COORDENGINE DICOM_ZIEHM3D
Comment the following section by adding a semicolon to each line:
;[DICOM_SIEMENS]
;start_command = start_dicom_receiver_siemens.bat
;required =
;optional =
;init_time = 500
;init_restarts = 2
;restarts = -1
;WINDOW_TYPE = 1
;TITLE
= DICOM Siemens 3D
Page 38 of 104
Ziehm C-arm calibration
6
Calibrate C-arms
6.1
Ziehm Vision Vario 3D and Ziehm Vision FD Vario 3D calibration
6.1.1
Prerequisites
To calibrate a Ziehm C-arm the following equipment is required
1. Navigation System II.
2. Ziehm C-arm with intraoperative 3D imaging technology.
3. External USB keyboard for the C-arm.
4. 10Base-T Crossover Cable (REF 6004-400-100).
5. 3 Batteries.
6. Universal Tracker.
7. Scanned pointer (use OrthoGrip Pointer 6003-012-100)
8. C-arm Digitizer (use Short Pointer 6000-012-000 or Knee Pointer 6003-011-000)
9. Styrofoam/plastics block or X-ray translucent fixation for scanned pointer.
10. X-ray translucent table or tripod to position the Styrofoam/plastic block with the scanned
pointer in the isocenter.
11. Passwords and service commands:
a. Administrator password for the Stryker Navigation System
_______________________
b. Service mode password for the C-arm
_______________________
Procedural Steps
6.1.2
Step Device
Instructions
1.
C-arm &
Define the following configuration settings:
Navigation a. TCP/IP address of the Navigation System
System
___.___.___.___
b. TCP/IP address of the C-arm
___.___.___.___
Task
TCP/IP
Network
settings for
Navigation
System and
C-arm
c. Subnet mask of the TCP/IP connection
___.___.___.___
d. DICOM port number where the Navigation System
receives the images from the C-arm (default is 4721)
_______________________
2.
Navigation
System
a. Logon as NavigationAdmin
Login
b. Press Shutdown…
c. Press Windows Desktop…
Page 39 of 104
Step Device
3.
Navigation
System
Instructions
Check (or set) the TCP/IP address of the Navigation
System. This TCP/IP address must correspond to the
setting on the C-arm.
a. Press MyNetworkPlaces (with right mouse
button)Properties
Task
Setting the
TCP/IP
Address of
the
Computer
b. Select Loacal Area Connection (with right mouse
c. Select Internet Protocol (TCP/IP)
d. Select Properties
e. Select Use the following TCP/IP address
f. Enter the required TCP/IP address as supplied by the
hospital’s network administrator.
Attention: the C-arm uses 2 TCP/IP addresses. In the
standard configuration the client address of the Carm is used (e.g. 172.16.10.40) and the same address
with the last number plus 1 (e.g. 172.16.10.41). DO
NOT set the TCP/IP address of the Navigation
System to one of these 2 C-arm TCP/IP addresses.
g. Enter the required subnet mask as supplied by the
h. Enter the required default gateway as supplied by the
i. Click OK to save your changes.
4.
Navigation
System
d. Click StartProgramsMcAfee Desktop
FirewallMcAfee Desktop Firewall
e. Right-click in the white area and select AddNew
Rule…
Firewall
Settings
C-arm 3D
Installation
Tool
Application
Page 40 of 104
Step Device
> 4 Navigation
System
Instructions
Task
f. Set the filter for the TCP/IP protocol:
1. Set Description to Allow Ziehm C-arm
TCP/IP communication
2. Select Action to Permit
3. Select Address to Single
4. Set the TCP/IP address of the C-arm (same
as in #1).
5. Check the Active flag.
6. Click OK
Page 41 of 104
Step Device
> 4 Navigation
System
Instructions
g. Set filter for Ziehm DICOM port (default 4721)
1. Right-click in the white area and select
Task
AddNew Rule…
2. Set Description to Allow Ziehm DICOM
port.
4. Select Local Service to Single
5. Type in DICOM port number (default is
4721).
7. Click OK
h. Set filter for Ziehm C-arm PING
AddNew Rule…
2. Set Description to Allow Ziehm C-arm
PING
4. Select Protocol ICMP
5. Set Address to Single
as in #1)
7. Check the Active flag
8. Click OK
i. Click OK to save the rules.
j.
Exit Desktop Firewall.
Page 42 of 104
Step Device
Instructions
5.
Navigation a. Open file
System
C:\Programs\Stryker_Leibinger\spine3d\bin\
SpineMap™
spine3d.bat
3D
b. Set DICOM_PORT_ZIEHM_3D (default is 4721).
Application
c. Safe file and exit the editor.
6.
Navigation
System
OrthoMap®
3D
Application
a. Open file
7.
Navigation
System &
C-arm
Connect the C-arm and the Navigation System with the
Cross-over Network Cable.
8.
C-arm
Connect the USB keyboard to the C-arm.
9.
C-arm
Switch on the C-arm.
10.
C-arm
Type in service password ___________ and press Enter
to get into the service mode.
C:\Programs\Stryker_Leibinger\oncology\bin\oncol
ogy.bat
b. Set DICOM_PORT_ZIEHM _3D (default is 4721).
c. Safe file and exit the editor.
The C-arm gives acoustical feedback (beep tone).
11.
C-arm
Set the pointer tip diameter in file RoboC2.ini.
a. Type in service command qqqq and press Enter to
close the controller software of the C-arm.
Task
TCP/IP and
DICOM Port
Numbers for
SpineMap
3D
Application
TCP/IP and
DICOM Port
Mumbers for
OrthoMap®
3D
Application
C-arm
Service
Password
Set Pointer
Tip
Diameter
b. Open file C:\RoboC_V5_4\config\RoboC2.ini (with
notepad editor).
c. Set CASPOINTER to 1.
d. Safe file and exit the editor.
e. Click on shortcut to auto.bat icon on the C-arm
touch screen to restart C-arm software.
12.
C-arm
Type in service password ___________ and press Enter
to get into the service mode.
The C-arm gives acoustical feedback (beep tone).
Page 43 of 104
Step Device
13.
C-arm
Instructions
Click on Config.
14.
Click on Service Settings
Enter the Service Password _____________
Click on DICOM.
C-arm
Task
Page 44 of 104
Step Device
15.
C-arm
Instructions
Select ServersStoragenet_navigation=2
Task
16.
a. Set the DICOM Port (default is 4721).
DICOM port
Hostname
TCP/IP
Address
AE-Title of
the
Navigation
System
C-arm
b. Set the Hostname to STRYKER-IGS
c. Set the TCP/IP address to the TCP/IP address of the
Navigation System (same as in #1).
d. Set the AE-Title to StrykerReceiver
e. Select Class Modality CR
17.
Navigation
System and
C-arm
Test the DICOM and network connection between Carm and Navigation System
a. Start SpineMap™ 3D or OrthoMap® 3D application.
Test the
Network and
DICOM
Connection
b. Click on Test button on the C-arm DICOM settings
page.
c. Check if C-arm displays the message box
Verification successful
d. Click OK
e. Switch off the C-arm
f. Switch on the C-arm
g. Close SpineMap™3D or OrthoMap® 3D application.
Page 45 of 104
Step Device
18.
Navigation
System
Instructions
Start the C-arm 3D Installation Tool on the Navigation
System.
Task
Start
Calibration
SpineMap™ 3D: Start the C-arm 3D Installation Tool
from Application Manager entry SpineMap 3DRun
C-arm 3D Installation
or
OrthoMap® 3D: Start C-arm 3D Installation Tool from
Application Manager entry OrthoMap 3DRun C-arm
3D Installation
19.
20.
21.
22.
23.
Navigation
System
Navigation
System
Navigation
System
Navigation
System
C-arm
(C-arm calibration for Ziehm has only to be performed
either for SpineMap 3D or OrthoMap 3D.)
Click Start Installation.
Select the C-arm type Ziehm.
Switch on the Universal Tracker.
Switch on the scanned pointer and validate it.
Switch on the C-arm Digitizer and validate it.
Click on tab 3D.
Start new scan on the C-arm by clicking New Scan.
Page 46 of 104
Step Device
24.
C-arm
Instructions
Select the patient orientation (for calibration scans any
patient orientation can be selected).
Task
Select body region (extremities).
Page 47 of 104
Step Device
25.
C-arm
Instructions
a. Place the C-arm that the scanned pointer’s tip is in
the isocenter (with laser) in AP position.
Task
b. Place the Universal Tracker that it is close to the
scanned pointer tip (~5 cm).
c. Follow the instructions on the C-arm console.
Press AP button.
Page 48 of 104
Step Device
26.
C-arm
Instructions
Position the C-arm that the pointer tip is in the
isocenter when C-arm is in lateral position.
Task
Press LAT button on the screen.
27.
C-arm
Perform the collision check with the C-arm and put the
C-arm into lateral position.
28.
C-arm
Lock all brakes except for the horizontal carriage brake.
29.
C-arm
Press the With Navigation button on the C-arm.
30.
Navigation
System
Align the camera that the scanned pointer and the
Universal Tracker is visible and that the C-arm Digitizer
is visible when touching the registration points on the Carm.
Page 49 of 104
Step Device
C-arm
31.
Instructions
Start the registration procedure.
Task
DO NOT move the scanned pointer and the Universal
Tracker during registration and before scan has been
completed!
Align the Navigation System II-Camera and digitize the
3 markers points on the image intensifier with the Carm Digitizer.
Page 50 of 104
Step Device
32.
Navigation
System
Instructions
Send the digitized points to the C-arm by clicking on
Send Registration button (if an error message appears,
press the With Navigation button on the C-arm again).
The C-arm gives acoustical feedback when receiving the
points (6 beep tones). Navigation System confirms
successful transfer of the registration points.
Task
Transfer
Position
33.
Check the accuracy information on the C-arm and
confirm if distance is acceptable. If registration value is
higher than 0.5 mm the digitization of the points should
be repeated.
Registration
Check on Carm
C-arm
34.
C-arm
35.
C-arm
completed.
Unlock the orbital and the horizontal carriage break of
the C-arm.
Perform the 3D scan while pressing the left footswitch
until the scan has been finished.
Perform 3D
Scan
Page 51 of 104
Step Device
36.
Navigation
System
Instructions
Send the scanned pointer position to the C-arm (the
scanned pointer needs not be visible while its position is
sent) by clicking on Send Position button.
37.
C-arm
Set the cursor of the Multi Planar View of the C-arm on
the scanned pointer tip (use the zoom function to zoom
into the images for higher accuracy).
38.
C-arm
Type in service command nex2 and press Enter on the
C-arm.
39.
C-arm
a. Confirm Perform Calibration by clicking on Yes
b. Write down the calibration values.
Task
Perform Carm
Calibration
Save
Calibration
c. Click OK
40.
Navigation
System
Stop the transfer of the scanned pointer tip position by
clicking on Stop Sending button.
Page 52 of 104
Step Device
41.
Navigation
System
42.
C-arm
Instructions
Close the C-arm 3D Installation Tool.
Task
Set the pointer tip diameter plus the drape thickness in
file RoboC2.ini.
a. Type in service command qqqq and press Enter to
close the RoboC2 software on the C-arm.
b. Open file C:\RoboC_V5_4\config\RoboC2.ini
c. Set CASPOINTER value dependent on tip diameter
of the C-arm Digitizer and 2x of drape thickness.
(if pointer tip is 1mm and drape has a thickness of
0.045mm the value has to be set to 1mm +
2x0,045mm = 1,09mm).
d. Switch off the C-arm.
e. Switch on the C-arm.
43.
C-arm
44.
49.
Navigation
System
Navigation
System
Navigation
System
Navigation
System
Navigation
System
C-arm
50.
C-arm
51.
C-arm
52.
53.
C-arm
C-arm
Lock all brakes except for the horizontal carriage brake.
54.
C-arm
45.
46.
47.
48.
Put a drape over the image intensifier of the C-arm that
the registration points are covered.
Start the C-arm 3D Installation Tool.
Repeat
Procedure
Select the C-arm type Ziehm
Switch on the Universal Tracker.
Switch on the scanned pointer and validate it.
Switch on the C-arm Digitizer and validate it.
Click New Scan
Click New Scan Center
Follow the instructions on the C-arm console.
Place the C-arm that the scanned pointer’s tip is in
the isocenter (using laser of C-arm) in AP position.
e. Press the AP button.
a. Position the C-arm that the pointer tip is in the
b. Press LAT button on the screen.
a.
b.
c.
d.
Page 53 of 104
Step Device
55.
Navigation
System
Instructions
Confirm Registration button (if an error message
appears, press the Navigation button on the C-arm
again). The C-arm gives acoustical feedback when
receiving the points (6 beep tones). Navigation System
confirms successful transfer of the registration points.
Task
56.
higher than 0.5mm the digitization of the points should
be repeated.
Registration
Check on CArm
C-arm
57.
C-arm
58.
59.
C-arm
Navigation
System
60.
C-arm
61.
C-arm
completed!
the C-arm.
Perform a (2nd) 3D scan from the scanned pointer.
Send the scanned pointer position to the c-arm (the
scanned pointer needs not be visible while its position is
sent) by clicking on Send Position button.
Set the cursor of the Multi Planar View of the c-arm to
the scanned pointer tip (use the zoom function to zoom
into the images for higher accuracy).
Type in service command nex2 and press Enter on the
C-arm.
Compare Carm
Calibration
Page 54 of 104
Step Device
62.
C-arm
Instructions
DO NOT confirm Perform Calibration. Click on No.
Note down the calibration values for x, y, and z. The
values contain the distance between the scanned pointer
tip and the center of the scanned volume.
Task
Write down
difference
values
compared to
previous
calibration
Each value for x, y and z must not exceed the range of
±1.0mm.
63.
64.
65.
C-arm
C-arm
Navigation
System
If one of the values exceeds ±1.0mm calibration
procedure has to be repeated (From step 18 on).
Click OK.
Click button Stop Sending
Close the C-arm 3D Installation Tool.
Logoff from Navigation System.
Page 55 of 104
Ziehm C-arm scan procedure
6.1.3
Perform scan procedure
Step Device
Instructions
1.
Navigation Logon as Navigation
System
2.
Navigation a. Click on SpineMap™ 3D or OrthoMap® 3D and
System
start the application.
Item
Login
Start
Application
b. Click on Start C-arm 3D scan
c. Click on Ziehm C-arm
d. Click on Scan Intra-Operative
e. Switch on the Universal Tracker.
f. Switch on the C-arm Digitizer (Short Pointer) and
validate it.
3.
OR table
Mount the Universal Tracker onto a scan phantom and
place it on the OR table.
4.
C-arm
a. Switch on the C-arm.
Start C-arm
b. Connect the C-arm and the Navigation System with
a crossover network cable.
5.
OR Table
6.
Navigation
System
7.
C-arm
Place the scan phantom using the laser pointer of the Carm that it is located near to the isocenter of the C-arm.
Align the camera that the Universal Tracker is visible
and that the C-arm Digitizer is visible when touching
the registration points on the C-arm.
Start new scan on the C-arm by clicking New Scan
Page 56 of 104
Step Device
8.
C-arm
Instructions
Select the patient orientation
Item
Select body region (extremities).
Page 57 of 104
Step Device
9.
C-arm
Instructions
Place the C-arm that the scan phantom is in the
isocenter (with laser) in AP position and follow the
instructions on the C-arm console.
Item
Press AP button.
10.
C-arm
Position the C-arm that the scan phantom is in the
Press LAT button on the screen.
11.
C-arm
12.
13.
C-arm
C-arm
Lock all brakes except of the horizontal carriage brake.
Page 58 of 104
Step Device
14.
C-arm
Instructions
Start the registration procedure.
Item
DO NOT move the scan phantom during registration
and before scan has been completed!
15.
Navigation
System
Transfer Position button (if an error message appears,
press the With Navigation button on the C-arm again).
The C-arm gives acoustical feedback when receiving the
points (6 beep tones). Navigation System confirms
successful transfer of the registration points.
Transfer
Position
Page 59 of 104
Step Device
16.
C-arm
Instructions
higher than 0.5mm the digitization of the points should
be repeated.
Item
Registration
Check on Carm
Perform 3D
Scan
Landmark
Check
17.
C-arm
18.
C-arm
19.
Navigation
System
DO NOT move the scan phantom until the scan has
been completed.
the C-arm.
Perform the 3D scan while pressing the left footswitch
until the scan has been finished. After the scan the
images are transferred automatically to the Navigation
System (this can take ~1 minute).
The Navigation System shows the landmark
confirmation page after receiving the images.
20.
Navigation
System
a. Check the registration by performing a landmark
check.
b. The landmark check passes when accuracy is better
than 2 mm.
c. The C-arm calibration has to be repeated when
landmark check fails.
21.
Navigation
System
Exit the application and shut down the Navigation
System.
Page 60 of 104
Ziehm C-arm troubleshooting
6.2
Troubleshooting
Scan does not start when pressing left footswitch
If scan does not start when pressing the left footswitch, unlock orbital break and move C for
approximately 5 degrees in ORBITAL direction. DO NOT move the Universal Tracker. Then
press the left footswitch and perform the 3D scan.
Page 61 of 104
6.3
6.3.1
Prerequisites
To calibrate a Siemens C-arm the following equipment is required
1. Navigation System II
2. Siemens C-arm with intraoperative 3D imaging technology
3. 10Base-T Crossover Cable (REF 6004-400-100)
4. 3 Batteries
5. Universal Tracker
6. Pointer
7. C-arm Tracker 9”
8. C-arm Tracker Adapter 9” for Siemens C-arms or Universal Tracker Adapter for 9” Carms
9. Siemens Calibration Phantom for Stryker Navigation System
10. Stand for Siemens Calibration Phantom
a. Administrator password for Navigation System
_______________________
b. Administrator password for C-arm (known by Siemens service technician)
_______________________
Page 62 of 104
6.3.2
System Configuration
Step Device
Instructions
1.
C-arm &
Navigation a. TCP/IP address of the Navigation System
System
___.___.___.___
___.___.___.___
___.___.___.___
Task
These
settings
have to be
the same
for
Navigation
System and
C-arm
d. Hostname of the Navigation System (default is
STRYKER-IGS)
e. DICOM port number where the Navigation System
_______________________
2.
Navigation
System
Login
3.
Navigation
System
Setting the
TCP/IP
address of
the
Computer
b. Select Loacal Area connection (with right mouse
button) Properties
c. Select Internet Protocol (TCP/IP).
Page 63 of 104
Step Device
4.
Navigation
System
Instructions
Rule…
Task
Firewall
settings
C-arm 3D
Installation
Tool
Application
f. Set the filter for the C-arm’s TCP/IP address
1. Set Description to Allow Siemens C-arm3D
TCP/IP communication.
4. Set the TCP/IP address of the C-arm (same as
in #1).
6. Click OK
Page 64 of 104
Step Device
> 4. Navigation
System
Instructions
Task
g. Set the filter for the C-arm PING:
AddNew Rule…
PING
4. Set Protocol to ICMP
6. Set the TCP/IP address of the C-arm (same as
in #1).
8. Click OK
Page 65 of 104
Step Device
> 4. Navigation
System
Instructions
Task
h. Set filter for Siemens DICOM port (default 4722)
AddNew Rule…
2. Set Description to Allow Siemens DICOM
port 4722
4. Set Protocol to TCP/IP
5. Select Local Service to Single and type in the
port number (default is 4722).
7. Click OK
Page 66 of 104
Step Device
> 4. Navigation
System
Instructions
Task
j.
Exit Desktop Firewall
5.
System
SpineMap™
spine3d.bat
3D
b. Set DICOM_PORT_SIEMENS_3D (default is 4722).
Application
6.
Navigation
System
OrthoMap®
3D
Application
7.
Navigation
System &
C-arm
8.
C-arm
TCP/IP and
DICOM
Port
Numbers
for
SpineMap
™ 3D
Application
a. Open file
TCP/IP and
C:\Programs\Stryker_Leibinger\oncology\bin\oncolog DICOM
y.bat
Port
Numbers
b. Set DICOM_PORT_SIEMENS_3D (default is 4722)
for
OrthoMap
® 3D
Application
cross-over Network Cable
Page 67 of 104
Step Device
9.
C-arm
Instructions
Select ServiceLocal Service from the Options menu.
10.
C-arm
Enter the Service Password and click OK
11.
C-arm
Click on Configuration
Task
C-arm
Service
Mode
Page 68 of 104
Step Device
12.
C-arm
Instructions
a. Select System Options (on the right).
b. Select the system type and check the following lines:
Task
Attached to Network
DICOM Offline Devices
DICOM Networking
Image Import/Export
c. Click on Next
13.
C-arm
a. Click in theDICOM section on Network Nodes
Set TCP/IP
Address
and
Hostname
b. Enter the Host Name of the Navigation System.
c. Enter the TCP/IP address of the Navigation System. It
is the same TCP/IP address as set in step #1.
d. Click on Save
e. Click on “>”
Page 69 of 104
Step Device
14.
C-arm
15.
C-arm
16.
Navigation
System and
C-arm
17.
C-arm
Instructions
a. Enter the Logical Name NAV3D_StrykerNavigation
(Starting with NAV3D_ is madatory)
b. Enter the AE Title StrykerReceiver
(ensure that the all small and capital letters are typed
in correctly and that there are no additional blanks are
entered)
c. Enter the Port Number
This is the DICOM port number where the
Navigation System receives the images from the
Siemens C-arm.
d. Check that Port Number is set to the same value as the
DICOM_PORT_SIEMENS_3D in #5 and #6 (default
is 4722).
e. Set Storage on checked.
f. Click on Add
g. Click on Save
Check the order of all listed nodes in the Logical Name
selection box.
NAV3D_StrykerNavigation must be the first node listed.
If NAV3D_StrykerNavigation is not the first node listed
the images will not transfer properly. If other nodes are
already installed they need to be uninstalled, then
reinstalled later after the NAV3D_StrykerNavigation
node.
a. Start the SpineMap™ 3D/OrthoMap® 3D application
on the Navigation System.
b. Check the DICOM connection by clicking on the
VERIFICATION button.
a. Click on Finish
b. Click on Home
Task
Set Node
Settings
Check
Node
Settings
Verify
Node
Settings
Complete
Node
Settings
Never close any page by clicking on the cross
(except
of the home page). Otherwise setting may not be saved
reliably.
Page 70 of 104
Step Device
18.
C-arm
Instructions
Restart the C-arm software by clicking OK
6.3.3
C-arm Calibration
Step Device
Instructions
19.
C-arm
a. Mount the 3D-Adapter Siemens Iso-C (REF 6004400-020) to the image intensifier
b. C-arm Tracker 9" (REF 6004-007-005) to the adapter.
c. Make sure the Fluoroscopy Phantom is not attached
to the tracker.
C-arm
a. Switch on the C-arm
20.
b. Mount the Siemens Calibration Phantom
c. Attach the 3D Installation Adapter. (REF 6004-400210) to the Siemens Calibration Phantom.
d. Position the Siemens Calibration Phantom in the
isocenter of the C-arm using the laser pointer of the
C-arm.
e. Verify the correct positioning of the phantom with 2
orthogonal x-rays (one from AP and one from lateral
direction).
Task
Restart Carm
Software
Task
Mount Carm Tracker
and remove
Fluoroscopy
Phantom
Position
Siemens
Calibration
Phantom
Example X-ray image of a bad phantom position:
The phantom is not centered. The edge of the phantom is
here visible on the top and it is shifted to the left (see red
arrows).
Page 71 of 104
Step Device
> 20. C-arm
Instructions
Example X-ray image of a well aligned calibration
phantom:
21.
System.
Navigation
System
Task
from Application Manager entry SpineMap 3DRun C-
arm 3D Installation
OrthoMap® 3D: Start the C-arm 3D Installation Tool
from Application Manager entry OrthoMap -3DRun
Navigation
System
Navigation
System
NOTE: If both applications are used for Siemens 3D Carms, the calibration procedure has to be performed only
once. After calibration of e.g. SpineMap™ 3D the
calibration data can be copied and used for OrthoMap 3D
(and vice versa). See section 1.1.1.
Select the C-arm type Siemens
Click on Start Installation
a. Switch on the Universal Tracker
b. Mount it onto the Siemens Calibration Phantom
24.
Navigation
System
Switch on the C-arm Tracker (ensure that the
Fluoroscopy Phantom is removed)
25.
Navigation
System
Align the camera that the Universal Tracker and the Carm Tracker are visible when C-arm is in start position for
the calibration scan.
22.
23.
Page 72 of 104
Step
26.
Device
C-arm
Instructions
Select OptionsServiceLocal Service from the menu.
27.
C-arm
Enter the Service Password
28.
Task
Click on Main System
Page 73 of 104
Step
29.
Device
C-arm
Instructions
Select ARCADIS Orbic 3D
Task
Click NEXT
Click 3D Calibration - Stryker Navigation
30.
C-arm
Perform the following 8 calibration scans (4 start
Positions and 2 resolutions).
Step
1
2
3
4
check
5
6
7
8
Angulation, Orbital
Angulation =180 °
Orbital = +95°
Angulation = 180°
Orbital = -95°
Angulation = 180°
Orbital = +95°
Angulation = 180°
Orbital = -95°
Verify the positioning of the
Siemens Calibration Phantom.
Make sure it is still positioned
in the isocenter by making
orthogonal x-rays.
Angulation = 0°
Orbital = +95°
Angulation = 0°
Orbital = -95°
Angulation = 0°
Orbital = +95°
Angulation = 0°
Orbital = -95°
Mode
fast
fast
slow
slow
N/A
fast
fast
slow
slow
Page 74 of 104
Step
31.
Device
C-arm
Instructions
Task
Position the Siemens calibration phantom in the isocenter
from the C-arm, adjust it with fluoroscopy.
32.
C-arm
33.
Navigation
System
34.
C-arm
35.
C-arm
36.
Calibration
Phantom
C-arm
37.
If the contrast of the phantom is poor and the calibration
fails the scan quality can be increased by increasing
manually the mA values. Check the 2D images before
repeating the complete 3D calibration.
Move the C-arm into the position shown in the figure
(Angulation 180°-, Orbital +95°).
a. Align the camera that the C-arm tracker and the
Universal Tracker are visible.
Important: the trackers need to be visible only at
the beginning of the scans. It does not matter, if the
visibility gets lost during the scan.
b. Click on Go
a. Press the left footswitch and hold it pressed
(the first 4 calibration steps are performed)
b. When Success is displayed, move the C-arm into the
position displayed on the C-arm monitor.
Move the C-arm into the position shown in the figure
(angulation = 0°, orbital = ±95)
Position the Calibration Phantom into the isocenter of
the C-arm.
a. Align the camera that the C-arm Tracker and the
Important: the trackers need to be visible only at the
beginning of the scans. It does not matter, if the
Click on Go
Start
Calibration
Start
Calibration
Scan
Ensure that the C-arm is not swinging when starting the
scan.
Page 75 of 104
Step
38.
39.
Device
C-arm
Instructions
a. Press the left footswitch and hold it pressed
(the last 4 calibration steps are performed)
b. When Success is displayed, move the C-arm into the
position displayed on the C-arm monitor.
c. Click on Finish
d. Click on Home to complete the calibration
e. Close the Service Mode by clicking on
f. Close the C-arm 3D Installation Tool on the
Navigation System.
If an Error is displayed the following options have to be
checked:
a. Check the position of the Calibration Phantom.
b. Repeat the scan for the position the error was raised.
Select suitable angulation & orbital angle and scan
mode. Repeat the calibration scan for this position.
c. If recalibration is required, restart the C-arm and
repeat the calibration procedure.
d. If the contrast of the phantom is poor and the
calibration fails the scan quality can be increased by
increasing manually the mA values. Check the 2D
images before repeating the complete 3D calibration.
Task
Continue
Calibration
Scan
Error
during
Calibration
Page 76 of 104
Siemens ARCADIS® Orbic 3D scan
6.3.4
Perform a 3D scan with the Siemens ARCADIS® Orbic 3D
Step Device
Description
1.
C-arm
a. Connect the Navigation system and the ARCADIS®
Orbic 3D with the 10Base-T Crossover Cable (REF
6004-400-100).
Comment
Start 3D
Scan
b. Mount the 3D-Adapter Siemens Iso-C (REF 6004-400020) to the image intensifier.
c. Attach the C-arm Tracker 9" (REF 6004-007-005) to
the adapter.
2.
Navigation
System
d. Make sure the Fluoroscopy Phantom is not attached to
the C-arm Tracker.
a. Logon as Navigation
Start 3D
Scan
b. Start the SpineMap 3D or OrthoMap 3D application
from Application Manager
c. Click on Start C-arm 3D scan
d. Select C-arm type Siemens
e. Select Scan Intra-Operative
f. Switch on Universal Tracker and mount it onto the
scanned phantom.
g. Switch on C-arm Tracker.
h. Switch on Pointer and validate it.
3.
4.
C-arm
a. Switch on C-arm
b. Position the C-arm so that the phantom to be imaged
is in the isocenter of the C-arm.
c. Verify the correct positioning of the C-arm with 2
orthogonal x-rays (AP and lateral).
a. Select in menu PatientRegistration
b. Enter the required patient data.
c. Click on 3D scan button.
d. Select the body part to be scanned.
Page 77 of 104
Step Device
> 4.
Description
e. Select the patient’s position on the OR table by
clicking on the arrows.
Comment
f. Select the position of the C-arm relative to the patient
by clicking on one of the C-arm symbols.
Page 78 of 104
Step Device
5.
Description
a. Select the Scan protocol (Slow = 100 pictures, Fast =
50 pictures per scan).
b. Select StrykerNavigation as navigation system
c. Select 3D Navigation
d. Select Start 3D Scan
Comment
6.
a. Perform the collision check by following the
instruction on the C-arm monitor.
b. Lock all breaks of the C-arm.
Collision
check
C-arm
Page 79 of 104
Step Device
7.
Navigation
System
8.
C-arm &
Navigation
System
9.
C-arm &
Navigation
System
Description
a. Align the camera that the Universal Tracker and the
C-arm Tracker are visible.
NOTE: The trackers need to be visible only at the
beginning of the 3D scan. It does not matter, if the
b. Start the 3D scan with the left footswitch. Keep the
footswitch pressed until the 3D scan has finished.
a. The images will be transferred to the Navigation
System.
b. A visual landmark check has to be performed before
the images can be used for navigation. Follow the
instructions on the Navigation System.
c. The visual landmark check passes when accuracy is
better than 2 mm.
d. If the landmark check fails the calibration procedure
has to be repeated.
Perform the phantom scan for all other start positions and
resolution (slow/fast).
All in all 4 start positions and 2 resolutions i.e. 8 scans and
landmark checks have to be performed.
Comment
Perform
3D scan
Image
Transfer
and
Registratio
n Check
Perform
landmark
check for
all start
positions
and scan
resolutions
Page 80 of 104
6.4
6.4.1
Prerequisites
To calibrate a Siemens Iso-C C-arm the following equipment is required
1. Navigation System II
2. Siemens C-arm with intraoperative 3D imaging technology
3. 10Base-T Crossover Cable (REF 6004-400-100)
4. 3 Batteries
5. Universal Tracker
6. Pointer
7. C-arm Tracker 9”
8. C-arm Tracker Adapter 9” for Siemens C-arms or Universal Tracker Adapter for 9” Carms
9. Siemens Calibration Phantom for Stryker Navigation System
10. Stand for Siemens Calibration Phantom

Administrator password for Navigation System
_______________________

Administrator password for C-arm (known by Siemens service technician)
_______________________
Page 81 of 104
6.4.2
System Configuration
Step Device
Instructions
1.
C-arm &
Navigation
a. TCP/IP address of the Navigation System
System
___.___.___.___
___.___.___.___
Task
Settings for
Navigation
System and
C-arm
___.___.___.___
d. Hostname of the Navigation System (default is
STRYKER-IGS)
e. DICOM port number where the Navigation System
_______________________
2.
Navigation
System
Login
3.
Navigation
System
Setting the
TCP/IP
Address of
the
Computer
b. Select Loacal Area connection (with right mouse
button) Properties
c. Select Internet Protocol (TCP/IP).
Page 82 of 104
Step Device
4.
Navigation
System
Instructions
c. Press Windows Desktop….
Rule…
Task
Firewall
settings
C-arm 3D
Installation
Tool
Application
Page 83 of 104
Step Device
> 4. Navigation
System
Instructions
f. Set the filter for the C-arm’s TCP/IP address
Task
TCP/IP communication
as in #1).
12. Click OK
Page 84 of 104
Step Device
> 4. Navigation
System
Instructions
g. Set the filter for the C-arm PING:
Task
AddNew Rule…
PING
4. Set Protocol to ICMP
as in #1).
8. Click OK
Page 85 of 104
Step Device
> 4. Navigation
System
Instructions
h. Set filter for Siemens DICOM port (default 4722)
Task
AddNew Rule…
2. Set Description to Allow Siemens DICOM
port 4722
4. Set Protocol to TCP/IP
5. Select Local Service to Single and type in the
port number (default is 4722).
7. Click OK
j.
5.
Exit Desktop Firewall.
System
SpineMap™
spine3d.bat
3D
b. Set DICOM_PORT_SIEMENS_3D (default is 4722).
application
TCP/IP and
DICOM Port
Numbers for
SpineMap™
3D
Application
Page 86 of 104
Step Device
6.
Navigation
System
OrthoMap®
3D
application
Instructions
a. Open file
7.
Navigation
System &
C-arm
Cross-over Network Cable.
8.
C-arm
9.
C-arm
Press Crtl-D to switch to the 3D mode.
10.
C-arm
Select OptionsLocal Service from the menu
11.
C-arm
Enter the Service Password and click OK
C:\Programs\Stryker_Leibinger\oncology\bin\oncolo
gy.bat
b. Set DICOM_PORT_SIEMENS_3D (default is 4722)
Task
TCP/IP and
DICOM Port
Numbers for
OrthoMap®
3D
application
C-arm
Service
Mode
Page 87 of 104
Step Device
12.
C-arm
Instructions
Click on Configuration
13.
a. Select System Options (on the right).
b. Select the following settings:
C-arm
Task
Attached to Network
DICOM Offline Devices
DICOM Networking
Image Import/Export.
c. Click on Next
Page 88 of 104
Step Device
14.
C-arm
Instructions
a. Click in the DICOM section on Network Nodes.
Task
Set TCP/IP
Address and
Hostname
b. Enter the Host Name of the Navigation System.
c. Enter the TCP/IP address of the Navigation System.
It is the same TCP/IP address as set in step #1.
d. Click on Save
e. Click on “>”
15.
C-arm
Set Node
Settings
Attention: Default Node must be set to Set first node
a. In Logical Name select Define New
b. Enter the Logical Name N_StrykerNavigation
(Starting with N_ is madatory)
Page 89 of 104
Step Device
> 15 C-arm
16.
C-arm
17.
Navigation
System and
C-arm
18.
C-arm
Instructions
c. Enter the AE Title StrykerReceiver
(ensure that the all small and capital letters are typed
in correctly and that there are no additional blanks
entered)
d. Enter the Port Number.
It is the DICOM port number where the Navigation
System receives the images from the Siemens C-arm.
e. Check that Port Number is set to the same value as
the DICOM_PORT_SIEMENS_3D in #5 and #6
(default is 4722).
f. Set Storage on checked.
g. Click on Add
h. Click on Save
Check the order of all listed nodes in the Logical Name
selection box. N_StrykerNavigation must be the first
node listed. If N_StrykerNavigation is not the first node
listed the images will not transfer properly. If other
nodes are already installed they need to be uninstalled,
and then reinstalled later after the N_StrykerNavigation
node.
a. Start the SpineMap™ 3D/OrthoMap® 3D
application on the Navigation System.
b. Check the DICOM connection by clicking on the
VERIFICATION button.
Restart the C-arm software by clicking OK. The restart
can take approximately 5 min.
6.4.3
C-arm Calibration
Step Device
Instructions
1.
C-arm
a. Mount the 3D-Adapter Siemens Iso-C (REF 6004400-020) to the image intensifier.
b. C-arm Tracker 9" (REF 6004-007-005) to the
adapter.
c. Make sure the Fluoroscopy Phantom is not attached
to the tracker.
2.
C-arm
b. Mount the Siemens Calibration Phantom.
c. Attach the 3D Installation Adapter. (REF 6004-400210) to the Siemens Calibration Phantom.
d. Position the Siemens Calibration Phantom in the
isocenter of the C-arm using the laser pointer of the
C-arm.
e. Verify the correct positioning of the phantom with 2
orthogonal x-rays (one from AP and one from
lateral direction).
Task
Check Node
Settings
Verify Node
Settings
Restart Carm
Software
Task
Mount Carm Tracker
and remove
Fluoroscopy
Phantom
Position
Siemens
Calibration
Phantom
Page 90 of 104
Step
> 2.
Device
C-arm
Instructions
Example X-ray image of a bad phantom position:
Task
The phantom is not centered. The edge of the phantom
is here visible on the top and it is shifted to the left (see
the red arrows).
Example X-ray image of a well aligned calibration
phantom:
3.
Navigation
System
System.
from Application Manager entry SpineMap 3DRun
Start Carm
3D
Installtion
Tool
OrthoMap® 3D: Start the C-arm 3D Installation Tool
from Application Manager entry OrthoMap -3DRun
Page 91 of 104
Step
> 3.
Device
Navigation
System
4.
Navigation
System
Navigation
System
Instructions
Note: If both applications are used for Siemens 3D Carms the calibration procedure has to be performed only
once. After calibration of e.g. SpineMap™ 3D the
calibration data can be copied and used for OrthoMap®
3D (and vice versa). See section 1.1.1.
Select the C-arm type Siemens
Click on Start Installation
a. Switch on the Universal Tracker
b. Mount it onto the Siemens Calibration Phantom
6.
Navigation
System
Switch on the C-arm Tracker (ensure that the
Fluoroscopy Phantom is removed)
7.
Navigation
System
8.
C-arm
Align the camera that the Universal Tracker and the Carm Tracker are visible when C-arm is in start position
for the calibration scan.
Select ServiceLocal Service from the Options menu.
9.
C-arm
Enter the Service Password
5.
Task
Page 92 of 104
Step
10.
Device
Instructions
Click on Calibration Iso-C 3D
Task
Page 93 of 104
Step
11.
Device
C-arm
Instructions
Depending on the Iso-C version 2 different selections
are offered. DO NOT chose the wrong option, otherwise
all existing previous calibrations would be deleted:
Task
Select removable or not mounted when the following
screen appears.
Select No when the question Registration Unit Fix
Mounted? is asked.
Click on “>”.
12.
C-arm
Perform the following 8 calibration scans (4 start
Positions described by Angulation and Orbital and 2
resolutions with 50 and 100 pictures).
The scans have to be performed in the following order:
Page 94 of 104
Step Device
> 12. C-arm
Instructions
No. of
Step
1
2
3
4
check
5
6
7
8
Task
Angulation, Orbital
Angulation =0 °
Orbital = -95°
Angulation = 0°
Orbital = +95°
Angulation = 0°
Orbital = -95°
Angulation = 0°
Orbital = +95°
Verify the positioning of the Siemens
Calibration Phantom. Make sure it is
still positioned in the isocenter by
making orthogonal x-rays.
Angulation = 180°
Orbital = +95°
Angulation = 180°
Orbital = -95°
Angulation = 180°
Orbital = +95°
Angulation = 180°
Orbital = -95°
No. of
Pictures
50
50
100
100
N/A
50
50
100
100
Page 95 of 104
Step
13.
Device
C-arm
Instructions
Task
a. Select the parameters according to the table.
Start
b. Select StrykerNavigation
calibration
c. Move the C-arm into the selected position.
d. Select the number of pictures.
e. Position the Siemens calibration phantom in the
isocenter from the C-arm, adjust it with fluoroscopy.
If the contrast of the phantom is poor and the
14.
Navigation
System
a. Align the camera that the C-arm tracker and the
NOTE: The trackers need to be visible only at the
beginning of the scans. It does not matter, if the
b. Click on Go.
Page 96 of 104
Step
15.
Device
C-arm
Instructions
Press the left footswitch and hold it pressed until the
dialog box Calibration successful appears.
Task
Start
Calibration
Scan
Move the C-arm into the start position for the next
calibration scan.
16.
17.
C-arm
Repeat the procedure for all remaining steps (2 -8) to
complete all 8 calibration scans.
a. After completion of all calibration scans click on
Finish
b. Click on Home to complete the calibration.
c. Close the Service Mode by clicking on .
d. Close the C-arm 3D Installation Tool on the
Navigation System.
If an Error is displayed the following options have to be
checked:
Continue
Calibration
Scan
Error during
Calibration
a. Check the position of the Calibration Phantom.
b. Repeat the scan for the position the error was raised.
Select suitable angulation & orbital angle and scan
mode. Repeat the calibration scan for this position.
c. If recalibration is required, restart the C-arm and
repeat the calibration procedure.
d. If the contrast of the phantom is poor and the
Page 97 of 104
Siemens Siremobil Iso-C scan
6.4.4
Perform a 3D scan with the Siemens Iso-C 3D
Step Device
Instructions
1.
C-arm
a. Connect the Navigation system and the Siremobil
Iso-C with the 10Base-T Crossover Cable (REF
6004-400-100).
Task
Start 3D scan
b. Mount the 3D-Adapter Siemens Iso-C (REF 6004400-020) to the image intensifier.
c. Attach the C-arm Tracker 9" (REF 6004-007-005) to
the adapter.
2.
Navigation
System
d. Make sure the Fluoroscopy Phantom is not attached
to the C-arm Tracker.
a. Logon as Navigation
Start 3D scan
b. Start the SpineMap 3D or OrthoMap 3D application
from Application Manager
c. Click on Start C-arm 3D scan
d. Select C-arm type Siemens
e. Select Scan Intra-Operative
f. Switch on Universal Tracker and mount it onto the
scanned phantom.
g. Switch on C-arm Tracker.
h. Switch on Pointer and validate it.
3.
C-arm
b. Press Ctrl-D to switch to 3D mode.
c. Position the C-arm so that the phantom to be
imaged is in the isocenter of the C-arm.
4.
d. Verify the correct positioning of the C-arm with 2
orthogonal X-ray images (AP and lateral).
a. Select in menu PatientAcquisition ISO-C 3D
b. Select the body part to be scanned.
c. Select C-arm position.
Page 98 of 104
Step Device
5.
Instructions
a. Select the Scan protocol (Slow = 100 pictures, Fast =
50 pictures per scan).
b. Select StrykerNavigation as navigation system
c. Select 3D Navigation
d. Click on Start 3D Scan
Task
6.
a. Perform the collision check by following the
instruction on the C-arm monitor.
b. Lock all breaks of the C-arm.
Collision
Check
a. Align the camera that the Universal Tracker and the
C-arm Tracker are visible.
Perform 3D
Scan
7.
8.
Navigation
System
C-arm &
Navigation
System
b. NOTE: The trackers need to be visible only at the
beginning of the 3D scan. It does not matter, if the
c. Start the 3D scan with the left footswitch. Keep the
footswitch pressed until the 3D scan has finished.
a. Select in the menu PatientBrowser.
b. Select Local Database <Current patient
name>3D Images.
c. Select N_StrykerNavigation and press Send.
d. The images will be transferred to the Navigation
System.
e. A visual landmark check has to be performed before
the images can be used for navigation. Follow the
instructions on the Navigation System.
f. The visual landmark check passes when accuracy is
better than 2 mm.
g. If the landmark check fails the calibration procedure
has to be repeated.
Image
Transfer and
Registration
Check
Page 99 of 104
Step Device
9.
C-arm &
Navigation
System
Instructions
Perform the phantom scan for all other start positions
and resolution (slow/fast). All in all 4 start positions and
2 resolutions i.e. 8 scans and landmark checks have to be
performed.
Task
Perform
Landmark
Check for all
Start
Positions
and Scan
Resolutions
Page 100 of 104
Siemens C-arm calibration of SpineMap™ 3D and OrthoMap® 3D on the same
cart
6.4.5
C-arm calibration of SpineMap™ 3D and OrthoMap® 3D on the same
Navigation System
When a Siemens ARCADIS® Orbic or Siremobil Iso-C C-arm has to be used for SpineMap™
and OrthoMap® on the same Navigation System the following instructions have to be
performed:
1. Calibrate the C-arm for SpineMap™ as described in chapter 6.3 for the ARCADIS® Orbic
or chapter 6.4 for the Siremobil Iso-C.
2. Copy file
C:\Programs\Stryker_Leibinger\spine3d\system_settings\siemens_carm3D_calibration.dat
into directory
C:\Programs\Stryker_Leibinger\oncology\system_settings
CAUTION: DO NOT calibrate the Siemens C-arm twice when it should be used for
SpineMap™ and OrthoMap®. Each new calibration of the C-arm overwrites the previous one.
Therefore the calibration file siemens_carm3D_calibration.dat has to be copied as described
above.
Page 101 of 104
Siemens C-arm troubleshooting
6.4.6
Troubleshooting
Poor contrast of the Siemens calibration phantom
If the contrast of the phantom is poor and the calibration fails the scan quality can be
increased when the mA values are set manually to a higher value. Check the 2D images before
repeating the complete 3D calibration.
Page 102 of 104
Siemens C-arm troubleshooting
Page 103 of 104
Stryker Corporation or its divisions or other corporate affiliated entities
own, use or have applied for the following trademarks or service marks:
OrthoMap, SpineMap. All other trademarks are trademarks of their
respective owners or holders.
Always refer to the package insert, product label and/or user instructions
before using any Stryker product. Products may not be available in all
markets. Product availability is subject to the regulatory or medical
practices that govern individual markets.
Copyright © 2008 Stryker
Printed in Germany
Manufactured and Distributed by:
Stryker Leibinger GmbH & Co. KG
Bötzinger Straße 41
D-79111 Freiburg / Germany
t: +49 (0)761 4512-0
f: +49 (0)761 4512-120
Distributed by:
Stryker Navigation
4100 East Milham Avenue
Kalamazoo, MI 49001 USA
t: 1 269 323 7700
t: (for U.S. only) 800 253 3210

SpineMap 3D Installation Instructions

Transcription

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