SPINAL SURGERY METHODS USING A ROBOTIC INSTRUMENT SYSTEM

• US 20080195081A1
• Filed: 02/01/2008
• Published: 08/14/2008
• Est. Priority Date: 02/02/2007
• Status: Abandoned Application

• Current Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Moll, Frederic H.
• Application Number:
  US12/024,642
• Publication Number:
  US 20080195081A1
• Time in Patent Office: Days
• US Class Current: 604/510
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2061 using shape-sensors, e.g. fiber shape sensors with Bragg gratings
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/71 Manipulators operated by drive cable mechanisms
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61G 13/10 Parts, details or accessories surgical drape sheets A61B46/00
• CPC Class Codes: A61G 13/101 Clamping means for connecting accessories to the operating table supports as part of surgical instruments A61B90/50
• CPC Class Codes: A61G 7/0503 Holders, support devices for receptacles, e.g. for drainage or urine bags hanging-up devices for infusion A61M5/1414

Abstract

Methods of performing various minimally invasive spinal surgical applications with a flexible, robotically controlled catheter instrument are disclosed. In one embodiment, a surgical method comprises inserting a robotically controlled, flexible catheter instrument through the sacral hiatus and into the epidural space of the spine, and advancing the catheter instrument toward the lumbar spine, to an area of the spine to be treated. The catheter instrument is then used to perform a therapeutic procedure on the spine, such as (without limitation), the delivery of a spinal stabilization device, or performing a lumbar discectomy, laminectomy, forminotomy, kyphoplasty, or spineoplasty.

Claims

1. A method for performing a medical procedure on a patient'"'"'s spine, comprising:

inserting a robotically controlled, flexible catheter instrument through the sacral hiatus and into the epidural space of the spine;

robotically maneuvering a distal end portion of the catheter instrument toward the lumbar spine; and

performing a therapeutic procedure on the spine using said catheter instrument.

2. The method of claim 1, wherein the therapeutic procedure is a lumbar discectomy.

3. The method of claim 1, wherein performing the therapeutic procedure comprises:

puncturing a herniated disc using a needle coupled to the catheter instrument;

removing a part of the herniated disc using an end effector coupled to the catheter instrument; and

draining an area of the herniated disc using a suction port disposed on the catheter instrument.

4. The method of claim 1, wherein the therapeutic procedure comprises a laminectomy.

5. The method of claim 1, wherein performing the therapeutic procedure comprises removing a portion of the lamina of the spine using an end effector coupled to the catheter instrument to relieve pressure on the spinal cord of the spine.

6. The method of claim 5, wherein said end effector comprises a drill bit or a router bit.

7. The method of claim 1, wherein the therapeutic procedure comprises a forminotomy.

8. The method of claim 1, wherein performing the therapeutic procedure comprises removing material from the bones of the vertebrae that pass nerve bundles to the body from the spinal cord of the spine using an end effector coupled to the catheter instrument.

9. The method of claim 8, wherein the end effector comprises a drill bit or a router bit.

10. The method of claim 1, wherein the therapeutic procedure comprises the delivery of a spinal stabilization device.

11. The method of claim 1, wherein performing the therapeutic procedure comprises:

robotically maneuvering the distal end portion of the catheter instrument to an interstitial space between two spinous processes of the spine;

inserting a deflated spinal stabilization device carried by the catheter instrument into the interstitial space; and

inflating the spinal stabilization device.

12. The method of claim 1, wherein performing the therapeutic procedure comprises:

robotically maneuvering the distal end portion of the catheter instrument to an interstitial space between two spinous processes of the spine;

removing at least a part of an intervertebral disc using an end effector coupled to the catheter instrument;

inserting a deflated spinal stabilization device carried by the catheter instrument into the interstitial space; and

inflating the spinal stabilization device.

13. The method of claim 1, wherein the therapeutic procedure is a kyphoplasty procedure.

14. The method of claim 1, wherein performing the therapeutic procedure comprises:

drilling a hole into a damaged vertebra of the spine using an end effector coupled to the catheter instrument;

inserting a balloon carried by the catheter instrument through the hole and into an interior cavity of the vertebra;

inflating the balloon to displace damaged vertebral tissue located in the interior of the vertebra to thereby enlarge the cavity;

deflating and removing the balloon from the cavity; and

introducing a filling material into the cavity through the hole using the catheter instrument.

15. The method of claim 1, wherein the therapeutic procedure is a spineoplasty.

16. The method of claim 1, wherein performing a therapeutic procedure comprises:

drilling a hole into a damaged vertebra of the spine using a first end effector coupled to the catheter instrument;

creating a cavity in the damaged vertebra using a second end effector coupled to the catheter instrument;

inserting a porous retainer into the cavity using the catheter instrument; and

introducing bone graft material into the retainer via a working lumen of the catheter instrument.

17. A method for performing a medical procedure on a patient'"'"'s spine, comprising:

inserting two or more robotically controlled, flexible catheter instruments through the sacral hiatus and into the epidural space of the spine;

robotically maneuvering the two or more catheter instruments toward the lumbar spine; and

performing a therapeutic procedure on the spine using the two or more catheter instruments.

18. The method of claim 17, wherein respective one or more end effectors are coupled to respective distal end portions of each of the two or more catheter instruments.