ROBOTIC SYSTEM AND METHOD FOR SPINAL AND OTHER SURGERIES

• US 20140121676A1
• Filed: 04/02/2012
• Published: 05/01/2014
• Est. Priority Date: 04/01/2011
• Status: Active Grant

• Current Assignee: KB Medical SA (Globus Medical, Inc.)
• Original Assignee: Ecole polytechnique fãdãrale de lausanne epfl (Schweizerische Eidgenossenschaft)
• Inventors: Kostrzewski, Szymon, Berard, Philippe, Baur, Charles, Duff, John Michael, Sandu, Kishore
• Granted Patent: US 9,308,050 B2
• Time in Patent Office: Days
• US Class Current: 606/130
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/7082 for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws driving other bone screws A61B17/8875
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 2017/00694 with means correcting for movement of or for synchronisation with the body
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2057 Details of tracking cameras
• CPC Class Codes: A61B 2034/301 for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/302 specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2034/303 specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2034/305 Details of wrist mechanisms at distal ends of robotic arms
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 5/1127 : using markers
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/50 : Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61B 90/57 : Accessory clamps
• CPC Class Codes: A61B 90/90 : Identification means for patients or instruments, e.g. tags
• CPC Class Codes: Y10S 901/03 : Teaching system
• CPC Class Codes: Y10S 901/09 : Closed loop, sensor feedback controls arm movement

Abstract

The present invention relates to a method, such as a surgical method for assisting a surgeon for placing screws in the spine using a robot attached to a passive structure. The present invention also related to a method, such as a surgical method for assisting a surgeon for removing volumes in the body of a patient using a robot attached to a passive structure and to a device to carry out said methods.

The present invention further concerns a device suitable to carry out the methods according to the present invention.

Claims

1. A method for assisting a user for placing screws in the spine of a patient using a robot attached to a passive structure and holding a tool, wherein said method comprises the following steps:

after an marker of an tracking system is attached to a vertebrae the patient'"'"'s position is registered in that the transformation between the position of the vertebrae and of the attached marker and/or planning is found

the robot is positioned such that the planned screw trajectory is inside the robot'"'"'s workspace by moving the passive structure;

a navigation software assists the user in doing this task, whereby the user unblocks structure of the robot and manually moves the robot to a position indicated by the navigation software;

a target robot position, or at least a suitable robot position is determined;

in this case the user may block the passive structure such that it will be rigidly held in place;

when the screw trajectory is inside the robot'"'"'s workspace the robot starts to automatically follow it in real-time i.e. the vertebrae and the robot positions are measured and if one of them moves the robot will change the position of the tool to compensate;

the user can proceed with the desired surgical procedure.

3. The method of claim 1, wherein it comprises a haptic interaction of the surgeon with the device.

4. The method of claim 3, wherein the user feels repulsive/wall-like forces on the haptic device when the tool approaches the “

no-go”

zone.

9. The method of one of the preceding claims wherein the coupling between the haptic device movements and the robot movements is definable to allow the user to have small movements/high precision or big movements/high speed.

10. The method as defined in one of claims 1 wherein the automatic compensation of the patient'"'"'s movement is switched off and is done manually by the user.

11. The method as defined in one of the preceding claims, wherein the target position of the robot or at least a suitable robot position is determined as a semi-transparent phantom image (indicator) on a screen, and the phantom is in a first color at the beginning and changes to another color when the robot'"'"'s workspace contains the screw trajectory or when the robot'"'"'s workspace contains the volume to be removed.

12. A device to carry out the method as defined in one of the preceding claims, wherein said device comprises at least

a surgery planning software,

a robotic system, comprising an active robot and a passive structure for positioning the active robot and a controller,

a measurement system for real-time patient and robot position measurements and position tracking, and

a workstation with a navigation software controlling the device and for providing feedback to the user.

13. The device as defined in claim 12, wherein said workstation is a computer, such as a personal computer.

14. The device as defined in claim 12, wherein said computer contains the surgery planning software and monitors the measurement system.

15. The device as defined in one of claims 12, wherein the active robot covers a small volume and the passive structure covers a large volume.

2. A method for assisting a user for removing volumes in the body of a patient using a robot attached to a passive structure and holding a tool, wherein said method comprises the following steps:

after a marker of the tracking system is attached to the patient the patient position is registered in that the transformation between the position of the volumes and of the attached marker is found;

the robot is positioned such that the planned volume(s) to be removed is (are) inside the robot'"'"'s workspace by moving the passive structure;

a navigation software assists the user in doing this task, whereby the user unblocks the passive structure and manually moves the robot to the position indicated by the navigation software;

a target robot position, or at least suitable, robot position is determined;

in this case the user may block the passive structure such that the robot will be rigidly held in place;

when the volume(s) to be removed is (are) are in the robot'"'"'s workspace the robot starts to automatically compensate for the patient movements in real-time i.e. marker and the robot positions are measured and if one of them moves the robot will change the position of the tool to compensate;

the user can proceed with the standard surgical procedure whereby the navigation software controls the robot'"'"'s position so that the tool held by the robot (driller or shaver) does not violate the “

no-go”

zones defined during planning.

5. The method as defined in claim 2, wherein whereby the volumes to be removed (stay-in zones) and volumes that must be protected (no-go zones) are defined preoperatively or intra-operatively.

6. The method as defined in claim 2, wherein if the user wants to remove certain volumes he enters it with the tool and inside said volume the tool remains blocked inside until he explicitly wants to leave it (“

stay-in”

volume).

7. The method of claim 6, wherein when the tool stays inside the stay-in volume the user feels repulsive/wall-like forces that prevent him from leaving the volume.

8. The method of one of claims 2, wherein margins of interaction around the “

no-go” and

“

stay-in”

zones can be defined.