Systems and methods for performing minimally invasive surgery

Patent metadata

Field	Value
Publication number	US-10828120-B2
Application number	US-201514744624-A
Country	US
Kind code	B2
Filing date	Jun 19, 2015
Priority date	Jun 19, 2014
Publication date	Nov 10, 2020
Grant date	Nov 10, 2020

Abstract

Minimally invasive surgical techniques are used to obtain access to vertebrae while protecting soft tissues in the surrounding area. The dilators may be used to provide a working channel through which the operation is performed. Standard dilators may be used with a robotic surgical system to provide precise guidance of surgical tools. A dilator may be held by the robot and automatically repositioned when the surgeon adjusts a trajectory for performing the surgery. The dilator itself may be used as a surgical instrument guide along with dilator adaptors that adjust the diameter of a portion of the dilator to allow for different sized tools to be guided by the dilator. Alternatively, surgical instrument guides may also be held by the robotic arm such that tools are guided by a surgical instrument guide through the dilator to perform a medical procedure.

First claim

What is claimed is:

1. A robotic surgical system for performing surgery, the system comprising:
a robotic arm comprising a force and/or torque control end-effector, wherein the end-effector comprises a surgical tool holder attached to the robotic arm via a force sensor, wherein the surgical tool holder is sized and shaped to hold a surgical tool;
an actuator for controlled movement of the robotic arm and/or positioning of the surgical tool holder;
a navigation system for detection of (i) a surgical tool position of the surgical tool held by the robotic arm and (ii) a patient position, the navigation system comprising:
a patient navigation marker configured to be associated with a patient anatomy for identifying the patient position,
a robot navigation marker associated with the surgical tool for identifying the surgical tool position, and
a tracking camera;

a processor and a non-transitory computer readable medium storing instructions thereon, wherein the instructions, when executed, cause the processor to:
determine projected trajectories based on one or more patient medical images;
determine and preview a list of the projected trajectories;
preview by display on a graphical user interface, the projected trajectories on the one or more patient medical images without moving the end-effector, and wherein the preview includes a follow view that shows an animated image following the projected trajectories in a view perpendicular to a trajectory axis;
receive a selection of a desired trajectory from the list of projected trajectories;
assist a surgeon in bringing the surgical tool holder to the desired trajectory, wherein assisting the surgeon in bringing the surgical tool holder to the desired trajectory includes both of (i) and (ii):
(i) providing attractive haptic feedback to guide the surgeon to bring the surgical tool holder to the desired trajectory, and
(ii) providing resistive haptic feedback to resist movement of the surgical tool holder in directions away from the desired trajectory; and

after the surgical tool holder is brought to the desired trajectory, lock the surgical tool holder along the desired trajectory,
wherein the force sensor is configured to detect a collision based upon a force applied to the robotic arm and the robotic arm is configured to adjust movement of the surgical tool based upon detection of the collision to adapt the desired trajectory,
wherein prior to locking the surgical tool holder along the desired trajectory, detecting, via the force sensor, a collision between the surgical tool holder and an object.

2. The robotic surgical system of claim 1 , wherein the instructions, when executed by the processor, cause the processor to, prior to assisting a surgeon in bringing the surgical tool holder to the desired trajectory, detect, via a sensor, the presence of a hand on a handle of the robotic arm.

3. The robotic surgical system of claim 2 , wherein the handle extends at least in part from the robotic arm.

4. The robotic surgical system of claim 1 , wherein the instructions to determine the projected trajectories comprises instructions that, when executed by the processor, cause the processor to: receive, from a navigation pointer, identification of a point along the patient anatomy; and determine the projected trajectories based on the identified point along the patient anatomy.

5. The robotic surgical system of claim 1 , wherein receiving a selection of the desired trajectory from the projected trajectories comprises receiving a modified trajectory based at least in part on one of the projected trajectories, wherein the desired trajectory is the modified trajectory.

6. The robotic surgical system of claim 1 , wherein the instructions, when executed by the processor, cause the processor to, prior to receiving a selection of the desired trajectory from the projected trajectories, render and display a representation of the projected trajectories and at least one of the one or more medical images.

7. The robotic surgical system of claim 6 , wherein the determination of the projected trajectories and the rendering and display of the representation of the projected trajectories is updated as the position of the surgical tool holder is changed, thereby providing visual feedback to a user to assist the user in positioning the surgical tool holder at a desired position.

8. The robotic surgical system of claim 1 , wherein the instructions, when executed by the processor, cause the processor to measure movement of the patient position and move the surgical tool holder based on said measured movement.

9. The robotic surgical system of claim 1 , wherein the one or more medical images comprise one or more of an MRI, CT, fluoroscopy, CT (ISO-C-3D) or 3D fluoroscopy medical image.

10. The robotic surgical system of claim 1 , wherein the one or more medical images comprise at least one of a pre-operative or an intra-operative medical image.

11. The robotic surgical system of claim 1 , wherein three medical views are used to review the projected trajectories, the three medical views include sagittal, axial, and coronal views.

12. The robotic surgical system of claim 1 , wherein when the surgical tool holder is locked along the desired trajectory, the end effector is only allowed to move along the desired trajectory or rotate along the desired trajectory.

13. A robotic surgical system for performing surgery, the system comprising:
a robotic arm;
a force control end-effector attached to the robotic arm, the end-effector having a surgical tool holder attached to the robotic arm via a force sensor, wherein the surgical tool holder is sized and shaped to hold a surgical tool;
an actuator for controlled movement of the robotic arm and positioning of the surgical tool holder;
a navigation system for detection of (i) a position of the surgical tool held by the surgical tool holder and (ii) a patient position, the navigation system including:
a patient navigation marker configured to be associated with a patient anatomy for detecting the patient position,
a robot navigation marker associated with the surgical tool for identifying the surgical tool position, and
a tracking camera adapted to continuously view positions of the patient navigation marker and the robot navigation marker;

a processor and a non-transitory computer readable medium storing instructions thereon, wherein the instructions, when executed, cause the processor to:
determine projected trajectories based on one or more patient medical images;
display on a graphical user interface, as a preview, the projected trajectories on the one or more patient medical images without moving the end-effector, and wherein the preview includes a follow view that shows an animated image following the projected trajectories in a view perpendicular to a trajectory axis;
receive a selection of a desired trajectory from the list of projected trajectories;
assist a surgeon in bringing the surgical tool holder to the desired trajectory, wherein assisting the surgeon in bringing the surgical tool holder to the desired trajectory includes both of (i) and (ii):
(i) providing attractive haptic feedback to guide the surgeon to bring the surgical tool holder to the desired trajectory, and
(ii) providing resistive haptic feedback to resist movement of the surgical tool holder in directions away from the desired trajectory; and

after the surgical tool holder is brought to the desired trajectory, lock the surgical tool holder along the desired trajectory.

14. The robotic surgical system of claim 13 , wherein the force sensor is configured to detect a collision

Assignees

• KB Medical SA

Inventors

• Kostrzewski Szymon
• Nussbaumer Billy
• Villard Jimmy

Classifications

• A61B17/3421 Primary

  Cannulas · CPC title

• A61B34/30

  Surgical robots · CPC title

• A61B2017/3433

  with different outer diameters of the cannula · CPC title

• A61B2034/2055

  Optical tracking systems · CPC title

• A61M29/00 Primary

  Dilators with or without means for introducing media, e.g. remedies · CPC title