Systems and methods for performing minimally invasive surgery

Patent metadata

Field	Value
Publication number	US-12042243-B2
Application number	US-202017069482-A
Country	US
Kind code	B2
Filing date	Oct 13, 2020
Priority date	Jun 19, 2014
Publication date	Jul 23, 2024
Grant date	Jul 23, 2024

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 minimally invasive surgery, the system comprising:
a robotic arm with an end effector;
a first dilator to access a vertebrae of a patient through an incision of a patient, wherein the first dilator defines a working channel for accessing the vertebrae;
one or more subsequent dilators sized and shaped to slide over the first dilator and/or one or more of the one or more subsequent dilators, wherein: the one or more subsequent dilators comprise a last added dilator having a distal end adapted to be inserted through the incision of the patient to enlarge the incision, each of the one or more subsequent dilators are configured to be positioned over the preceding dilators and increase the size of the working channel, each dilator except the last added dilator being configured to be removed from the patient thereby leaving the last added dilator,
a dilator fixator adapted to be attached to the end effector, the last added dilator being configured to be attached to the dilator fixator; and
a manipulator configured to allow robotically-assisted or unassisted positioning and/or movement of the end effector by a user with at least four degrees of freedom thereby automatically adjusting an angle and/or position of the attached last added dilator with respect to the vertebrae and aligning an axis defined by the last added dilator with a desired trajectory during a surgical procedure without removal of the last added dilator from the patient tissue during the repositioning, the manipulator further programmed to be automatically repositioned in response to the user changing the desired trajectory during the surgical procedure.

2. The system of claim 1 , wherein each one or more subsequent dilators have a circumference larger than the circumference of the first dilator, and the one or more subsequent dilators increase the size of the working channel as each subsequent dilator is added.

3. The system of claim 1 , comprising: a surgical instrument guide configured to be placed inside of the attached dilator, wherein the surgical instrument guide is sized and shaped to fit at least partially inside the attached dilator along an axis defined by the dilator.

4. The system of claim 3 , wherein the end effector comprises the surgical instrument guide attached thereto, configured to hold and/or restrict movement of a surgical instrument therethrough.

5. The system of claim 4 , wherein the surgical instrument guide is at least one of a drill bit guide, tap guide, screwdriver guide, screw guide, awl guide, and implant guide.

6. The system of claim 5 , wherein the surgical instrument is at least one of a drill bit, tap, screwdriver, screw, implant, and awl, wherein the surgical instrument is configured to slide through the surgical instrument guide.

7. The system of claim 1 , wherein the attached dilator is the dilator with largest circumference.

8. The system of claim 1 , wherein the attached dilator is configured to hold and/or restrict movement of a surgical instrument therethrough.

9. The system of claim 1 , wherein the manipulator comprises: a processor; and a memory, the memory storing instructions that, when executed by the processor, cause the processor to: store a transformation between the actual patient anatomy and one or more medical images; determine an ideal implant trajectory; and provide, for display on a graphical user interface, the ideal implant trajectory for review by the surgeon, wherein (i) the surgeon may adapt the ideal implant trajectory if needed using hands-on planning, and (ii) the surgeon acknowledges the ideal implant trajectory or the adapted trajectory thereby causing the acknowledged trajectory to be stored as the desired trajectory.

10. The system of claim 1 , further comprising a tool guide tube adapted to be attached to the end effector at the same time as the last added dilator and sized to slidably guiding a surgical tool through the working channel formed by the last dilator.

Assignees

• KB Medical SA
• Globus Medical Inc

Inventors

• Kostrzewski Szymon
• Nussbaumer Billy
• Villard Jimmy

Classifications

• A61B2034/2068

  using pointers, e.g. pointers having reference marks for determining coordinates of body points · CPC title

• A61B34/30

  Surgical robots · CPC title

• A61B2034/107

  Visualisation of planned trajectories or target regions · CPC title

• A61B90/11

  with guides for needles or instruments, e.g. arcuate slides or ball joints · CPC title

• A61B2034/2055

  Optical tracking systems · CPC title