Apparatus and systems for precise guidance of surgical tools

• US 10,813,704 B2
• Filed: 09/22/2017
• Issued: 10/27/2020
• Est. Priority Date: 10/04/2013
• Status: Active Grant

• Current Assignee: KB Medical SA (Globus Medical, Inc.)
• Original Assignee: KB Medical SA (Globus Medical, Inc.)
• Inventors: Kostrzewski, Szymon, Chappuis, Olivier, Nussbaumer, Billy, Gehriger, Daniel, Berthelin, Roderik
• Primary Examiner(s): Templeton, Christopher L
• Application Number:
  US15/712,368
• Publication Number:
  US 20180008358A1
• Time in Patent Office: 1,131 Days
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 2034/102 Modelling of surgical devices, implants or prosthesis
• 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 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/066 for measuring torque
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• 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 34/30 Surgical robots
• 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 34/76 Manipulators having means for providing feel, e.g. force or tactile feedback
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

Described herein are systems, apparatus, and methods for precise placement and guidance of tools during a surgical procedure, particularly a spinal surgical procedure. The system features a portable robot arm with end effector for precise positioning of a surgical tool. The system requires only minimal training by surgeons/operators, is intuitive to use, and has a small footprint with significantly reduced obstruction of the operating table. The system works with existing, standard surgical tools, does not required increased surgical time or preparatory time, and safely provides the enhanced precision achievable by robotic-assisted systems.

Claims

1. A surgical system for performing a robotically assisted medical procedure on a patient, said system comprising:

a computing system;

a robot arm;

an end-effector attached to the robot arm, wherein the end-effector is configured to releasably hold a plurality of surgical instruments;

a control interface configured to receive commands and to control operation of the robot arm, wherein the control interface is in electronic communication with the computing system;

an actuator, in electronic communication with the control interface, configured to move the robot arm;

a patient marker adapted to be coupled to a bone of the patient; and

a tracking detector configured to capture a position of the surgical instrument held by the end-effector in relation to the patient based on the patient marker,

wherein the computing system is configured to perform a registration to spatially align the end-effector, the patient and a desired trajectory of the end-effector based on the patient marker, and to maintain the spatial alignment without performing re-registration of the end-effector position when the surgical instrument held by the end-effector is removed and replaced with a different one of the surgical instruments.

2. The system of claim 1 further comprising a display screen configured to display a position of the surgical instrument and graphically display a virtual representation of the patient derived from a 3-D scan of the patient.

3. The system of claim 1, further comprising:

a display screen configured to display a projected trajectory of the robot arm based on a position of the robot arm in relation to the patient.

4. The system of claim 3, wherein tracking detector is an infrared camera.

5. The system of claim 1, wherein the tracking detector is a camera.

6. The system of claim 1 further comprising at least one force sensor disposed between the end-effector and the robot arm.

7. The system of claim 1, wherein the robot arm is housed on a mobile cart.

8. The system of claim 7, further comprising a stabilization mechanism configured to increase stiffness of the mobile cart to ensure accuracy of the medical procedure.

9. The system of claim 1 further comprising a surgical drape positioned between the robot arm and the end-effector.

10. The system of claim 1, wherein the control interface controls the actuator to move the end-effector in a direction corresponding to a direction of an application of force sensed by a force sensor.

11. The system of claim 1, wherein the control interface moves the end-effector at a predetermined steady velocity.

12. The system of claim 1, further comprising a user-actuatable switch, wherein the computing system is configured to place the end-effector in a force control mode based on a status of the user-actuatable switch, whereby under the force control mode the computing system controls the actuator to move the end-effector in a direction corresponding to a direction of force applied to the end-effector.

13. The system of claim 12, wherein the computing system is configured to place the end-effector in an active holding position based on the status of the user-actuatable switch, whereby under the active holding position the computing system locks the actuator to prevent the end-effector from moving.

14. The system of claim 1, further comprising a display screen configured to display a projected trajectory of an implant based on a position of the end-effector in relation to the patient.

15. The system of claim 1 further comprising, a tracking marker attached to each of the plurality of surgical instruments for detection by the tracking detector, thereby allowing tracking of a position of the surgical instrument held by the end-effector.

16. The system of claim 1, further comprising:

a mobile cart housing on which the robot arm is housed;

a plurality of wheels attached to the mobile cart;

a locking mechanism to lock the wheels by electronic activation.

17. The system of claim 1, further comprising a tracking module configured to identify the surgical instruments by identifying markers attached to the surgical instruments from images received from the tracking detector.

18. A surgical system for performing a robotically assisted medical procedure on a patient, said system comprising:

a computing system;

a robot arm;

a plurality of surgical instruments;

an end-effector attached to the robot arm and adapted to releasably hold the plurality of surgical instruments;

an actuator configured to move the robot arm;

a control interface coupled to the computing system and the actuator, the control interface configured to receive commands from the computing system and to control operation of the robot arm via the actuator;

a patient marker adapted to be attached to a bone of the patient; and

a tracking detector configured to capture a position of the surgical instrument held by the end-effector in relation to the patient based on the patient marker, the tracking detector further configured to identify the plurality of surgical instruments;

wherein the computing system is configured to perform a registration to spatially align the end-effector relative to the patient based on the patient marker attached to the patient, and to maintain the spatial alignment without performing re-registration of the end-effector position when the surgical instrument held by the end-effector is removed and replaced with a different one of the surgical instruments.

19. The system of claim 18, wherein the computing system includes a tracking module configured to identify the different surgical instruments by identifying markers attached to the surgical instruments from images received from the tracking detector.

20. The system of claim 18, further comprising a user-actuatable switch, wherein the computing system is configured to place the end-effector in a force control mode based on a status of the user-actuatable switch, whereby under the force control mode the computing system controls the actuator to move the end-effector in a direction corresponding to a direction of force applied to the end-effector.