US20070016010A1

Movatterモバイル変換

Info

Publication number: US20070016010A1
Application number: US11/389,554
Authority: US
Inventors: Francis Creighton; Seth Burgett
Original assignee: Stereotaxis Inc
Current assignee: Stereotaxis Inc
Priority date: 2002-01-23
Filing date: 2006-03-24
Publication date: 2007-01-18
Also published as: US7019610B2; US20040030324A1

Abstract

A system for magnetically navigating a medical device in an operating region within the body of a patient. The system includes a magnet having a front field projecting from the front of the magnet sufficient to project a magnetic field into the operating region in the patient. The magnet is mounted for movement between a navigation position in which the magnet is located adjacent to the patient with the front of the magnetic generally facing the operating region, and an imaging position in which the magnet is spaced from the patient and the front generally faces away from the operating region.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

This is a continuation application of U.S. patent application Ser. No. 10/347,525, filed Jan. 17, 2003, which is a continuation-in-part of U.S. patent application Ser. No. 10/056,227, filed Jan. 23, 2002, the entire disclosures of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

This system relates to magnetic navigation of medical devices in the body, and in particular to a system for applying a magnetic field of selected direction to an operating region in a subject's body to orient a magnetically responsive medical device.

Magnetic navigation of medical devices has significantly improved to ability of medical professionals to control medical devices in the body. Early magnetic navigation techniques involved the use of superconducting magnets. While these techniques were, and remain, highly effective, advances in permanent magnetic materials and in the design of permanent magnets, have made it possible to use permanent magnets for magnetic navigation. While the magnetic fields created by superconducting magnets can be readily changing the currents in the superconducting electromagnetic coils, in order to change the magnetic field created by permanent magnets for navigation, it is generally necessary to change the position and/or orientation of the permanent. In order to accurately control the magnetic field applied by permanent magnets, it is necessary to accurately control the position and/or orientation of the permanent magnet.

SUMMARY OF THE INVENTION

The present invention relates to a magnetic navigation system, and in particular to a system including magnet units comprising a permanent magnet, and a support for controlling the position and orientation of a permanent magnet. The system is adapted for magnetically navigating a medical device in an operating region within the body of a patient. Generally, the system comprises a magnet having a front field projecting from the front of the magnet sufficient to project a magnetic field into the operating region in the patient. The magnet is mounted for movement between a navigation position in which the magnet is located adjacent to the patient with the front of the magnetic generally facing the operating region, and an imaging position in which the magnet is spaced from the patient and the front generally faces away from the operating region.

According to another aspect of the invention the system includes a magnet system comprising: a magnet and a support for mounting the magnet and changing the position and orientation of the magnet to change the direction of magnetic field applied to the operating region. The support is preferably capable of pivoting the magnet about a first axis that rotates about a second axis perpendicular to the first axis, and translating the magnet, preferably parallel to the second axis.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a magnetic surgery suite incorporating magnet assemblies in accordance with the principles of this invention;

FIG. 1A is a top plan view of the magnetic surgery suite;

FIG. 2 is an exploded front perspective view of one of the magnet assemblies (the other magnet assembly being a mirror image thereof), with the cover removed to show details of construction;

FIG. 3 is a front perspective view of the magnet assembly, with the cover removed;

FIG. 4 is a front perspective view of the magnet assembly, showing the lower cover;

FIG. 5 is a front perspective view of the magnet assembly, showing the upper cover;

FIG. 6 is a rear perspective view of the magnet assembly;

FIG. 7 is a front elevation view of the magnet assembly;

FIG. 8 is a further exploded front perspective view of the positioner system of the magnet assembly

FIG. 9 is a front elevation view of the positioner system of the magnet assembly;

FIG. 10 is a left side elevation view of the positioner system of the magnet assembly

FIG. 11 is a right side elevation view of the positioner system of the magnet assembly;

FIG. 12 is a rear elevation view of the positioner system;

FIG. 13 is a top plan view of the positioner system;

FIG. 14 is a bottom plan view of the positioner system;

FIG. 15 is a front elevation view of the phi drive mechanism of the magnet assembly;

FIG. 16 is a top plan view of the phi drive mechanism;

FIG. 17 is a left side elevation view of the phi drive mechanism;

FIG. 18 is a right side elevation view of the phi drive mechanism;

FIG. 19 is a front elevation view of the front plate of the phi drive mechanism;

FIG. 20 is a left side elevation view of the front plate of the phi drive mechanism;

FIG. 21 is a right side elevation view of the front plate of the phi drive mechanism;

FIG. 22 is a horizontal transverse view of the front plate of the phi drive mechanism, taken along the plane of line22-22 inFIG. 19;

FIG. 23 is an exploded perspective view of the phi drive mechanism;

FIG. 24 is a front elevation view of the theta drive mechanism of the magnet assembly;

FIG. 25 is a top plan view of the theta drive mechanism;

FIG. 26 is a left side elevation view of the theta drive mechanism;

FIG. 27 is a bottom plan view of the theta drive mechanism;

FIG. 28 is a front perspective view of the theta drive mechanism;

FIG. 29 is a front elevation view of theta drive motor;

FIG. 30 is a top plan view of the theta drive motor;

FIG. 31 is a bottom plan view of the theta drive motor;

FIG. 32 is a left side elevation view of the theta motor;

FIG. 33 is an exploded front perspective view of the theta motor;

FIG. 33 is an a top plan view of the z drive mechanism

FIG. 34 is an front elevation view of the z drive mechanism;

FIG. 35 is a left side elevation view of the z drive mechanism;

FIG. 36 is a right side elevation view of the z drive mechanism;

FIG. 37 is bottom plan elevation of the z drive mechanism;

FIG. 38 is an exploded perspective view of the z drive mechanism

FIG. 39 is a perspective view of the pedestal;

FIG. 40 is an exploded front perspective view of the pedestal showing the pivot assembly, the drive system assembly, and the locking system;

FIG. 41 is an exploded front perspective view of the pedestal with the pivot assembly, the drive system assembly, and the locking system assembly removed;

FIG. 42 is a bottom plan view of the pedestal;

FIG. 43 is a longitudinal cross sectional view of the pedestal taken along the plane of line43-43 inFIG. 42;

FIG. 44 is a side elevation view of the pedestal;

FIG. 45 is an exploded perspective view of the pivot assembly for pivotally mounting the pedestal;

FIG. 46 is a perspective view of the drive mechanism;

FIG. 47 is a perspective view of the drive assembly.

FIG. 48 is a side elevation view of the magnet.

FIG. 49 is a front elevation view of the magnet.

Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.

DETAILED DESCRIPTION OF THE INVENTION

A magnetic surgery suite incorporating magnet units in accordance with the principles of this invention is indicated generally as20 inFIG. 1. As shown inFIG. 1, thesuite20 comprises anoperating room22 and acontrol room24. Thecontrol room24 is preferably adjacent to theoperating room22, and has awindow26 from which the procedure taking place in theoperating room22 can be viewed. However, thecontrol room24 does not have to be adjacent to theoperating room22, and instead could be located remotely from the operating room, for example on a different floor, or in a different building, or even in a different city.

Theoperating room22 includes a patient support, such as apatient bed26, and a pair of

magnet units

28 and30, disposed on opposite sides of the patient bed to project a magnetic field into the operating region in a patient on the patient bed. The operating room also includes animaging system32, comprising a C-arm mounting at least onex-ray source34 and at least onex-ray receiver36, such as an amorphous silicon imaging plate.

Cabinets

38 and40 are provided for computer controllers and other electronics for operating the

magnet units

28 and30 and theimaging system32. A plurality of displays42 (six in this preferred embodiment) are mounted on an articulatingarm44 from the ceiling. Thedisplays42 display images from theimaging system32, and screens from the control system for operating the

magnet units

28 and30. A plurality ofcontrols46 are provided on thepatient bed26 for operating a user interface to control the

magnet units

28 and30, in conjunction with the screens displayed on thedisplays42.

Thecontrol room24 includes acabinet48 for a processor for operating the user interface for controlling the

magnet units

28 and30. A plurality of displays50 (two in this preferred embodiment) are provided for displaying images from theimaging system32, and screens from the user interface. A plurality ofcontrols52 are provided on thepatient bed26 for operating a user interface to control the

magnet units

28 and30, in conjunction with the screens on thedisplays52.

Each of the

magnet units

28 and30 projects a strong magnet field from its front face, so that together, the magnets provide a magnet field of sufficient strength to orient a magnetic medical device in an operating region in the patient on thepatient bed26. Because of the strength of the field projected by the

magnet units

28 and30, the units are preferably rotatably mounted to swing between an operative position in which the units face the patient support, and project a field into the operating region in the patient on the patient bed, and a stowed position, in which the magnet units do not face the patient bed.

As shown inFIG. 2, each of the

magnet units

28 and30 comprises amagnet100, a mechanism200 for moving the magnet to change the magnetic field applied by themagnet100 to the operating region in a patient, and a pedestal700, for supporting the mechanism200 andmagnet100. As described in more detail below themagnet100 is preferably a compound magnet designed so that relatively small translations and/or rotations result in significant changes in the magnetic field direction projected into an operating region in the patient. As described in more detail below, the mechanism200 is adapted to support and translate and/or rotate themagnet100 to change the direction of the field applied by the magnet to the operating region in the patient. Themagnet100 and themechanism300 are preferably designed so that they can project a magnetic field in any direction in the operating region in the patient, or at least so that when both

magnet units

28 and30 are positioned on opposite sides of the patient, the combined effect of the magnets from the units projects a magnetic field in any direction.

In this preferred embodiment, the mechanism preferably provides three movements of the magnet100: translation of the magnet toward and away from the patient (referred to herein as translation in the z-direction), rotation of the magnet about an axis parallel to the z-direction, referred to herein as rotation in the θ-direction, and pivoting of the magnet about an axis perpendicular to the θ-axis, referred to herein as pivoting in the φ direction. The movements of themagnet100 in the z direction, the θ-direction, and the φ direction permitted by themechanism300 are sufficient to create a magnetic field of suitable strength for magnetic navigation, in any direction in the operating region in the patient. Of course, additional or different translations and or rotations could be provided for the same or different magnet design. The strength of the field projected by the magnets is preferably at least 0.05, and more preferably at least 0.09.

Themagnet100 is preferably comprised of a plurality ofblock102 arranged and mounted on abacking plate104, for example with adhesive themagnet100 further includes acover106, preferably with a smooth, contoured finished surface enclosing the assembly ofblocks102. Each of the blocks is made of a permeable magnetic material, and has a size, shape, position and magnetization direction to optimize field properties (direction and strength) while accommodating manufacturing. Examples of suitable magnets are disclosed in magnets such as those disclosed in U.S. patent application Ser. No. 10/082,715, filed Feb. 25, 2002, U.S. patent application Ser. No. 10/056,227, filed Jan. 23, 2003, and/or U.S. patent application Ser. No. 09/546,840, filed Apr. 11, 2000, the disclosures of all of which are incorporated herein by reference.

Themagnet100 andmechanism300 are mounted onpedestal800. As indicated above, and described in more detail below, thepedestal800 is mounted for pivoting about apost802, and haswheels804 which allow the pedestal to pivot from a stowed position, in which themagnet100 generally faces away from the patient, to an operative position in which the magnet generally faces the patient.

Themagnet100 andmechanism300 are preferably enclosed is a cover200 to protect the mechanism from interference, to prevent persons from being injured or property from being damaged by the mechanism, to reduce patient anxiety, and to enhance the appearance of the unit. As shown inFIG. 3, this cover includes aframe202 slidably mounted around the base of themechanism300. As shown inFIG. 4, the cover also comprises afront base cap204, which is generally U-shaped and adapted to be secured on the front and sides of thepedestal800, atop base cap206, which is adapted to be secured over the top of the pedestal, around themechanism300, and arear base cap208, which is adapted to be secured on the back of the pedestal cap device. As shown inFIG. 5, the cover200 also comprises afront panel210, adapted for mounting on theframe202 over the front of themagnet100 andmechanism300, and left and

right side panels

212 and214 adapted for mounting on theframe202 over the sides of the magnet and mechanism. An invertedU-shaped frame216 is mounted on theframe202 over the back of themechanism300. Theframe216 mounts aconduit218 for enclosing power and control leads, and aback panel220 for covering the back of the mechanism. A coolingfan unit222 is mounted on theframe202, inside thepanel220 to circulate air inside the cover through louvered openings formed in thecover220.

As shown inFIG. 8, themechanism300 preferably comprises aφ pivot mechanism302, for pivoting themagnet100 in the φ direction; a θ-rotation mechanism402, for rotating themagnet100 in the θ-direction; and a z-drive mechanism602 for translating the magnet in the z-direction.

As shown inFIGS. 15-22, theφ pivot mechanism302 comprises afront plate304, adapted for mounting themagnet100. Thefront plate304 is pivotally mounted to aback plate306. Theback plate306 is adapted to be mounted on the θ-rotation mechanism402, and has two

parallel brackets

308 and310 projecting from its front face for mounting thefront plate304. Ahub312 on the back of thefront plate304 is pivotally mounted between the

brackets

308 and310, so that the front plate can pivot. In this preferred embodiment, thefront plate304, and thus themagnet100 mounted on the front plate can pivot plus and minus 40°, for a total range of motion of 80°. This range of motion is based upon the properties of themagnet100, which in this preferred embodiment provides a 180° change in field direction over a range of pivoting of 80°. With a different magnet, the range of pivoting could be made larger or smaller, as desired.

As best shown inFIG. 23, amotor brake314 is mounted onbracket308, amotor mounting adapter316 is mounted over the motor brake on thebracket308. Amotor318 is mounted on the mountingadapter316, to turndrive shaft320 havingkey322 thereon. Ahousing24 encloses themotor318. Thedrive shaft320 engages thefront plate304 so that rotation of the drive shaft caused bymotor318 causes the plate to pivot about the φ pivot mechanism.

A +φ limit switch324 is mounted on ablock326 on the front face ofplate306, and is adapted to engage astop328 on thefront plane304. Similarly, a −φ limit switch330 is mounted on ablock332 on the front face ofplate308, and is adapted to engage a stop334 on the front plate. Atheta sensor flag336, which is used by the theta position sensor as described below, is secured on theback plate306. Phi sensor flags338 are secured on the back offront plate304. Arotary encoder340 is mounted on anencoder mounting plate342, on thebracket310, and is driven by the key322 on thedrive shaft320.

Theθ rotation mechanism402 is shown inFIGS. 24-28. Theθ rotation mechanism402 comprises acarriage404, which is preferably made of aluminum or other strong, lightweight, non-magnetic material. As best shown inFIG. 28, thecarriage404 has a generallycylindrical opening406 therein in which the outer race of abearing408 is mounted. Front and

rear retaining hubs

410 and412 are secured together, sandwiching the inner race of thebearing408 between them. A retaining ring is mounted in thecarriage404 over thefront retaining hub414. Thephi pivot mechanism302 is mounted to thefront retaining hub410, for rotation around about the theta axis.

Aposition sensor416 is mounted in a recess in the front of thecarriage404, and is triggered by theflag338 on the phi pivot mechanism.

Acam tray420, mounting acam422, is also secured on the bottom of thecarriage404. A plurality ofstops424 are also mounted on the bottom of thecarriage404. A pair of C-shapedbrackets426 are mounted on the bottom of the carriage for engage and moving the cover as thetheta mechanism402 moves in the z direction, as described below. Aprecision gear428 is mounted on abracket430 on the bottom of the carriage. The precision gear is used in sensing the position in the z-direction as a back up to the position sensing built in to thez drive mechanism602.

The driver for theθ rotation mechanism402 is indicated generally as434 inFIGS. 29-33. Thedriver434 comprises aservo motor436, agear box438, areducer mounting plate440, and apinion442. Thepinion440 engages and drives agear442 secured to therear hub444, causing rotation in the theta direction.

As shown inFIGS. 35-38, thez drive mechanism602 comprisesbase plate604. Mountingplates606 are provided on the underside of base plate, on either side, for securing the base plate to thepedestal800.

Tracks

608 and610 are mounted on theplate604. Twocarriages612 are slidably mounted on each of the

tracks

608 and610, for slidably mounting thecarriage404 of thetheta drive mechanism402. Aservo motor614 is mounted on thebase plate604 with abracket616. Aflexible shaft coupling618, drive screw bearing620 connectball screw shaft622 to theservo motor614. The end of theball screw shaft622 is supported in drive screw bearing624. Abracket626 is mounted on theball screw shaft622 and is secured to the underside of thecarriage402, to move the carriage.

Stops628 are mounted on thebase plate604 adjacent one end.Stops630 are mounted on thebase plate604 adjacent the other end.

Limit switches

632 and634 are mounted on theplate604 withbrackets636 an638, respectively. Arotary encoder640 is mounted on thebase plate604, and has apinion642. Thepinion642 engages theprecision gear428 on the bottom of thecarriage404, and measures the position of the carriage relative to thebase plate604.Rails644 are mounted on the sides of thebase plate604 for slidably mounting the cover200.

As shown inFIG. 39, thepedestal800 comprises aframe808, with aplatform810 for mounting themechanism402. Thepedestal800 is pivotally mounted for rotation aboutpost402, which is secured to the floor of the operating room. Acollar812 secured to theframe808 surrounds, and rotates around thepost402. Adrive mechanism814 is mounted in theframe808, for driving thepedestal800 to rotate around thepost402. Alock mechanism816 is also mounted in theframe808, for securing the pedestal against movement.

As shown inFIGS. 40 and 45, thepost802 is surrounded by aweldment818. Astop tube820 is mounted over thepost802, providing

stops

822 and824 for limiting the rotational movement of the pedestal. Lower outer mountingplate826 and lowerinner mounting plate828, and upper outer mountingplate830 and upper inner mounting832 are secured above and belowblock834, mountingspherical bearing836. Limit switches838,840,842, and844 are mounted on the upper mounting ring and are tripped by movement relative tocam846 secured on the top of thepost802.

As shown inFIGS. 40 and 46, thedrive mechanism814 comprises amotor848 connected togear box850. A hand crank852 onshaft854 is also connected togear box850.

Sheaves

856 and858 andbelt860 connect thegear box850 to thedrives shaft862, which in turn drives drivewheel864. Thus the motor can operate the drive wheel, or in a situation where power is not available, hand crank852 an be used to operate the drive wheel, and pivot the pedestal aroundpost802.

As shown inFIGS. 40 and 47, thelock mechanism816 comprises anelectric motor870 which turns agear box872 to pull or pushrod874. The pulling or pushing of therod874 causes thelock member876 to pivot. Thelock member876 has atab878, which pivots into and engages a slot in the floor of the procedure room. A hand crank880 onshaft882 also turns thegear box872, to manually pull or pushrod874. An springbiased interlock bar884, interferes with the hand crank, and must be manipulated out of the way in order to manually operate thelock mechanism816.

Claims

1. A system for magnetically navigating a medical device in an operating region within the body of a patient, the system includes a magnet having a front field projecting from the front of the magnet sufficient to project a magnetic field into the operating region in the patient, the magnet is mounted for movement between a navigation position in which the magnet is located adjacent to the patient with the front of the magnetic generally facing the operating region, and an imaging position in which the magnet is spaced from the patient and the front generally faces away from the operating region.

2. A magnet system for applying a magnetic field of selected direction to an operating region inside a patient on a support, to control a magnetic medical object in the operating region, the magnet system comprising: a base, a magnet mounted on the base, the base being movable with respect to the support, to move the magnet from an active position in which the magnet is adjacent the patient, and an inactive position, in which the magnet is spaced from the patient.

3. A magnet applicator for applying a magnetic field of selected direction to an operating region within the body of a patient, the magnet applicator comprising a magnet; a support for mounting the magnet and changing the position and orientation of the magnet to change the direction of magnetic field applied to the operating region, the support capable of pivoting the magnet about a first axis that rotates about a second axis perpendicular to the first axis, and translating the magnet in two mutually perpendicular horizontal directions.

4. A magnet applicator for applying a magnetic field of selected direction to an operating region within the body of a patient, the magnet applicator comprising a base, a magnet having a front face and a plurality of other faces, a support on the base for mounting the magnet and changing the position and orientation of the magnet to change the direction of magnetic field applied to the operating region, the base being movable between an active position in which the magnet is oriented with the front face facing the patient, and an inactive position in which that magnet is oriented with the front face is not facing the patient.

5. A magnet applicator for applying a magnetic field of selected direction to an operating region within the body of a patient, the magnet applicator comprising a magnet; a support for mounting the magnet and changing the position and orientation of the magnet to change the direction of magnetic field applied to the operating region, the support mounting the magnet to pivot about a first axis, which is rotatable about a second axis perpendicular to the first axis; and translating the magnet in two mutually perpendicular horizontal directions.

6. The magnet applicator according toclaim 5 wherein the second axis is parallel to one of the mutually perpendicular horizontal directions.

7. (canceled)

8. (canceled)

9. (canceled)

10. A magnet system for applying a magnetic field of selected direction to an operating region inside a patient on a support, to control a magnetic medical object in the operating region, the magnet system comprising: first and second magnets mounted on opposite sides of the operating region, each of the magnets being movable relative to the operating region from an activ position in which the magnets apply a magnetic field to the operating region and an inactive position in which the magnets apply a magnetic field to the operating region.

11. The magnet system according toclaim 10 further comprising a pivotally mounted base, the pivoting of the base changing the position and/or orientation of the magnet relative to the operating region.

12. The magnet system according toclaim 10 wherein the magnets have a front face and at least one side face from which the magnetic field projected by the magnet is substantially less than the magnet field projected from the front face, in the active position the magnet being oriented with the front face base generally toward the operating region, and in the inactive position the magnet being oriented with the at least one side face oriented toward the operating region.

13. A magnet system for applying a magnetic field of selected direction to an operating region inside a patient on a support, to control a magnetic medical object in the operating region, the magnet system comprising: first and second magnets mounted on opposite sides of the operating region, each of the magnets being movable relative to the operating region from an active position in which the magnets apply a magnetic field sufficient to control a magnet element in the device but which interferes with the imaging of the operating region; and second position in which the magnets do not apply a magnetic field that interferes with the imaging of the operating region.

14. A magnet system for navigating a magnetic medical device in the operating region in a patient, the system comprising at least one magnet for applying a magnet field to the operating region in the patient, the magnet being mounted for movement between an active position in which the magnet is adjacent the patient to apply a magnetic field to the operating region, and an inactive position in which the magnet is spaced sufficiently from the operating region that it does not interfere with the x-ray imaging of the operating region.

15. A magnet system for navigating a magnetic medical device in the operating region in a patient, the system comprising at least one magnet for applying a magnet field to the operating region in the patient, the magnet being mounted for movement between an active position in which the magnet is adjacent the patient to apply a magnetic field to the operating region, and an inactive position in which the magnet is spaced sufficiently from the operating region that it do s not apply a magnetic field of greater than5 gauss to imaging equipment positioned to image the operating region.

16. The system according toclaim 15 interfere with the x-ray imaging of the operating region.

17. A magnet system for applying a magnetic field to an operating region in a patient, the system comprising at least one magnet mounted to move between an active position in which the magnet is adjacent the patient to project a controllable magnetic field into the operating region and an inactive position in which the magnetic field projected by the magnet into the operating region is less than about 5 gauss.

18. The magnet system according toclaim 17 wherein there are two magnets one on each side of the patient, and wherein the total magnetic field applied by the magnets in the inactive position is less than about 5 gauss.

19. A magnet system for applying a magnetic field to an operating region in a patient, the system comprising at least one magnet mounted to move between an active position in which the magnet is adjacent the patient to project a controllable magnetic field into the operating region and an inactive position in which the field projected by the magnet in the operating region does not interfere with imaging of the operating region.

20. The magnet system according toclaim 19 wherein there are two magnets one on each side of the patient, and wherein the total magnetic field applied by the magnets in the inactive position is less than about 5 gauss.

21. The magnet system according toclaim 19 wherein the magnet is mounted on a pivoting base, and wherein the magnet moves between the active and inactive positions by the pivoting of the base.

22. The magnet system according toclaim 19 wherein the magnet both pivots and translates relative to the operating region as the base pivots.

23. The magnet system according toclaim 19 wherein the base pivots about a pivotally mounding further has a roller that rolls on an accurate track as the base pivots.

24. The magnet system according toclaim 19 wherein a first face of the magnet faces the operating region when the magnet is in the active position, and a second face of the magnet faces the operating region in the inactive position.

25. The magnet system according toclaim 19 wherein the magnet has a preferred direction in which the magnet projects a relatively strong magnetic field and at least one non-preferred direction in which the magnet projects a relatively weak magnetic field, the preferred direction generally facing the operating region when the magnet is in its active position, and the a non-preferred direction generally facing the operating region when the magnet is in its inactive position.

26. A magnetic navigation system comprising:

a support;

a magnet assembly on either side of the support for applying a controllable magnetic field to an operating region in a patient on the support;

the magnet assembly comprising a magnet, and a support that moves the magnet to change the direction of the field applied by the magnet to the operating region, the support selectively pivoting the magnet about a first axis, rotating the magnet about a second axis perpendicular to the first axis, and translating the magnet in a first and second mutually perpendicular directions.

37. The magnet assembly according to claim36 wherein each magnet assembly further comprises a base for mounting the support, each base being movable to move the magnet from an operative position adjacent the patient support to an inoperative position.

38. The magnet assembly according to claim36 wherein the base pivots translating and/or rotating the magnet relative to the operating region.

39. The magnet assembly according to claim36 wherein the second axis and one of the first and second directions are generally parallel.

40. The magnet assembly according to claim36 wherein the second axis and one of the first and second directions extend in a direction toward the patient.

41. The magnet assembly according to claim36 wherein the second axis is in a direction generally toward the patient.

42. The magnet assembly according to claim36 in which the second axis is generally horizontal, oriented generally toward the patient, and wherein the first and second directions are in a generally horizontal plane, with the first direction extending generally toward the patient, and the second direction extending generally perpendicular thereto.

43. A magnetic navigation system for applying a magnetic field in a selected direction to control a medical object in an operating region in the patient, the system comprising a patient support for supporting a patient, first and second magnet assemblies on opposite sides of the patient support, each magnet assembly comprising at least one magnet for applying a magnetic field to an operating region between the magnet assemblies in a patient on the support, and a support for supporting the at least one magnet and moving the at least one magnet to change the direction of magnetic field applied by magnet assemblies to the operating region.

44. The magnetic assembly according toclaim 43 wherein the supports pivot the at least one magnet about a first axis that rotates about a second axis perpendicular to the first.

45. The magnetic assembly according toclaim 43 wherein the supports translate the at least one magnet in first direction toward and away from the operating region.

46. The magnetic assembly according toclaim 43 wherein the support translates the magnet perpendicular to the first direction.