System and method for interactive haptic positioning of a medical device

• US 7,747,311 B2
• Filed: 03/06/2003
• Issued: 06/29/2010
• Est. Priority Date: 03/06/2002
• Status: Active Grant

• Current Assignee: MAKO Surgical Corporation (Stryker Corporation)
• Original Assignee: MAKO Surgical Corporation (Stryker Corporation)
• Inventors: Quaid, Arthur E. III
• Primary Examiner(s): Casler; Brian
• Assistant Examiner(s): KISH, JAMES M
• Application Number:
  US10/384,194
• Publication Number:
  US 20040034283A1
• Time in Patent Office: 2,672 Days
• Field of Search: 901/9, 901 33- 35, 345156-158, 434/262, 600/407, 600/408, 600/424
• US Class Current: 600/424
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/1767 for the patella
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00128 related to intensity or progress of surgical action
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/00212 using remote controls
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2034/104 Modelling the effect of the tool, e.g. the effect of an implanted prosthesis or for predicting the effect of ablation or burring
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2068 using pointers, e.g. pointers having reference marks for determining coordinates of body points
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2090/031 torque limiting
• CPC Class Codes: A61B 2090/064 : for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/365 : augmented reality, i.e. correlating a live optical image with another image
• CPC Class Codes: A61B 2090/3945 : Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• 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 34/32 : operating autonomously
• CPC Class Codes: A61B 34/35 : for telesurgery
• CPC Class Codes: A61B 34/37 : Master-slave robots A61B34/35 takes precedence
• CPC Class Codes: A61B 34/70 : Manipulators specially adapted for use in surgery
• CPC Class Codes: A61B 34/74 : Manipulators with manual electric input means
• CPC Class Codes: A61B 34/76 : Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 34/77 : Manipulators with motion or force scaling
• CPC Class Codes: A61B 90/03 : Automatic limiting or abutting means, e.g. for safety
• CPC Class Codes: A61B 90/06 : Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: B25J 13/025 : comprising haptic means
• CPC Class Codes: B25J 9/0081 : with master teach-in means

Abstract

A combination of a haptic device and a computer-assisted medical system is used for interactive haptic positioning of a medical device coupled to the haptic device. A reconfigurable haptic object facilitates the positioning of the medical device and/or the haptic device. The haptic object may be modified in response to application of a force against the haptic object by a user of the haptic device pushing the haptic device against the haptic object. Preferably, the haptic object moves in the direction of the force applied by the haptic device. The medical device may be guided to a desired pose relative to a target area from its current position. The user may approach the target area from its current position and still be provided with haptic cues to enable the user to guide the medical device to the target area.

Claims

1. A surgical method comprising:

defining a virtual pathway to a target region of an anatomy of a patient on whom a surgical procedure is to be performed, defining the virtual pathway including defining a cutting surface that defines a surface of bone that is to be sculpted to receive an implant device;

storing the defined virtual pathway;

providing virtual pathway haptic feedback to a surgeon indicative of interaction between a surgical instrument attached to a haptic device and the stored virtual pathway;

providing protective haptic feedback to the surgeon indicative of interaction between the surgical instrument and a virtual boundary defining an anatomical structure of the patient to be avoided;

modifying said virtual pathway during the surgical procedure based at least in part on a current pose of the surgical instrument; and

dynamically enabling and disabling portions of the cutting surface to facilitate smoothly transitioning from one portion of the cutting surface to another portion of the cutting surface without leaving sharp edges.

2. The method of claim 1, wherein said modifying step comprises modifying said virtual pathway in response to a value of at least one scalar valued function of at least one haptic interaction wrench applied to said haptic device exceeding at least one threshold value.

3. The method of claim 1, wherein said modifying step comprises:

modifying said virtual pathway in response to the surgeon pushing said haptic device to push said surgical instrument against said virtual pathway during the surgical procedure and generating at least one haptic interaction wrench in response to said pushing of said surgical instrument against said virtual pathway.

4. The method of claim 3, wherein the modifying step further comprises:

modifying said virtual pathway in response to a value of at least one scalar valued function of said at least one haptic interaction wrench exceeding at least one threshold value.

5. The method of claim 4, wherein said at least one threshold value is user configurable.

6. The method of claim 3, further comprising:

determining whether a value of at least one scalar valued function of said at least one haptic interaction wrench exceeds at least one threshold value.

7. The method of claim 3, further comprising:

generating at least one haptic interaction wrench in response to said pushing of said haptic device to move the surgical instrument against said virtual pathway.

8. The method of claim 7, wherein the step of generating the at least one haptic interaction wrench further includes:

generating a force on the haptic device which resists the surgical instrument from crossing the virtual boundary.

9. The method of claim 1, further comprising:

providing at least one haptic cue based on said virtual pathway to guide the surgeon in setting said surgical instrument into a desired pose relative to said target region, the haptic cue conveying information or producing a preselected effect when the surgeon interacts with the haptic device.

10. The method of claim 1, further comprising:

providing at least one haptic cue based on said virtual pathway to guide the surgeon in moving said haptic device to move said surgical instrument toward said target region along a path defined at least in part by said virtual pathway.

11. The method of claim 1, further comprising:

guiding said surgeon in moving said haptic device to move said surgical instrument into a desired pose relative to said target region from said current pose in accordance with the virtual pathway haptic feedback and the protective haptic feedback.

12. The method of claim 11, wherein the virtual pathway haptic feedback includes:

at least one haptic interaction wrench which one of (1) attracts said surgical instrument toward the virtual pathway and (2) repels the surgical instrument from the virtual pathway to maintain said surgical instrument in said desired pose.

13. The method of claim 1, wherein the surgical procedure is a joint replacement and further comprising:

tracking and displaying the current pose of the surgical instrument on a display;

wherein the modifying step includes modifying the cutting surface in accordance with the current pose of the surgical instrument.

14. The method of claim 1, wherein the protective haptic feedback includes:

providing haptic constraints that prevent the surgeon from moving said surgical instrument past the virtual boundary.

15. The method of claim 14, further comprising:

determining at least one haptic interaction wrench to be applied to said haptic device to maintain said surgical instrument in said desired pose.

16. The method of claim 1, further comprising:

determining a next desired pose for said surgical instrument when the surgical instrument is in a desired pose relative to said target region.

17. The method of claim 1, further comprising:

modifying the cutting surface in accordance with the current pose of the surgical instrument relative to said target region.

18. A method for interactive haptic positioning of a haptic device coupled to a bone removal surgical instrument during an orthopedic surgical procedure on a bone of a patient, comprising:

defining a virtual cutting surface which defines a bone surface to be sculpted in a bone of said patient to receive an implant device;

displaying a diagnostic image of said bone with a depiction of the bone removal surgical instrument in a current pose;

generating at least one haptic interaction wrench based at least in part on the current pose of said bone removal surgical instrument relative to the virtual cutting surface as the bone removal surgical instrument removes bone adjacent the bone surface to be sculpted;

dynamically modifying said virtual cutting surface in response to said at least one haptic interaction wrench such that said virtual cutting surface is dynamically modified based on the current position of said bone removal surgical instrument relative to the virtual cutting surface to avoid abrupt transitions; and

guiding a user with haptic feedback in moving said bone removal surgical instrument along the dynamically modified virtual cutting surface to remove bone to form the sculpted bone surface without sharp edges.

19. The method of claim 18, further comprising:

providing at least one haptic cue to guide said user in moving said haptic device to move the bone removal surgical instrument along the bone to sculpt the bone surface defined by the virtual cutting surface.

20. The method of claim 19, wherein said dynamically modifiable virtual cutting surface provides a guidance of a cutting jig.

21. The method of claim 18, further comprising:

providing at least one haptic cue in response to a position of the bone removal surgical instrument relative to said virtual cutting surface to guide said user in moving said haptic device to move the bone removal surgical instrument into a desired pose relative to the virtual cutting surface.

22. The method of claim 18, further comprising:

determining whether a value of at least one scalar valued function of said at least one haptic interaction wrench exceeds at least one threshold value and modifying said virtual cutting surface in response to said value exceeding said at least one threshold value.

23. The method of claim 18, wherein the dynamic step includes:

dynamically modifying the virtual cutting surface in response to a user input from an non-haptic modality.

24. The method of claim 18, wherein said dynamic modifying step comprises:

modifying said virtual cutting surface in response to the user of said haptic device pushing said haptic device to push the bone removal surgical instrument against said virtual cutting surface.

25. A system for haptic positioning of a haptic device during a medical procedure, comprising:

a display which displays a diagnostic image of an anatomy of a patient containing a target region in which the medical procedure is to be performed;

a tracking system which tracks a pose of the haptic device and a bone cutting surgical instrument relative to the target region, the tracking system being connected with the display such that the display displays a current pose of the bone cutting surgical instrument on the image of the anatomy;

a processor programmed to;

define one or more virtual pathways that define cutting planes indicating a surface of a bone to be left after portions of bone are removed by the bone cutting surgical instrument,

control the display to display a visual representation of the virtual pathway on the displayed image of the anatomy, and

a haptic feedback system which provides haptic feedback to the haptic device indicative of (1) an interaction between the bone cutting surgical instrument and a region of anatomy of the patient to be avoided and (2) an indication of a relationship of the bone cutting surgical instrument to the virtual pathway.

26. The system of claim 25, wherein said processor is further programmed to:

control the haptic device to generate at least one haptic interaction wrench responsive to pushing the bone cutting surgical instrument against the virtual pathway; and

modify said virtual pathway in response to a value of at least one scalar valued function of said at least one haptic interaction wrench responsive to pushing the haptic device to push the bone cutting surgical instrument against the virtual pathway exceeding at least one threshold value, but not responsive to a haptic interaction wrench generated in response to pushing the haptic device to push the bone cutting surgical instrument against the anatomy of the patient.

27. The system of claim 25, wherein said processor is further programmed to:

control the haptic device to provide at least one haptic cue to guide a user in setting a desired pose of said bone cutting surgical instrument relative to said target region.

28. The system of claim 25, wherein said processor is further programmed to:

control the haptic device to provide at least one haptic cue based on said virtual pathway to guide a user in moving said haptic device to move said bone cutting surgical instrument toward said target region along a path defined at least in part by said virtual pathway.

29. The system of claim 25, wherein said processor is further programmed to:

control the haptic device to guide a user in moving said haptic device to move said bone cutting surgical instrument into a desired pose relative to said target region from said current pose.

30. The system of claim 29, wherein said processor is further programmed to:

determine at least one haptic interaction wrench to be applied to said haptic device to maintain said bone cutting surgical instrument in said desired pose.

31. The system of claim 25, wherein said processor is further programmed to:

dynamically modify the virtual pathway based on a current relationship between the bone cutting surgical instrument coupled to the haptic device and the virtual pathway defining the bone surface to be left.

32. The system of claim 25, wherein said virtual pathway is selected from the group consisting of a straight line and a curve.

33. The system of claim 25, wherein said at least one haptic cue guides a user in moving said haptic device to move said bone cutting surgical instrument into a desired pose from the current pose.

34. The system of claim 33, wherein said processor is further programmed to determine at least one haptic interaction wrench to be applied to said haptic device to maintain said bone cutting surgical instrument in said desired pose.

35. The system of claim 25, wherein the medical procedure is joint replacement surgery.