Surgical systems

Abstract

The present application relates to a surgical system. The passive end effector of the surgical system includes a base, a first mechanism, and a second mechanism. The base is attached to an end effector connector of a robotic arm positioned by a surgical robot. The first mechanism extends between a rotatable connection to the base and a rotatable connection to a tool attachment mechanism. The second mechanism extends between a rotatable connection to the base and a rotatable connection to the tool attachment mechanism. The first mechanism and the second mechanism pivot about the rotatable connection to limit the movement of the tool attachment mechanism to a range of movement within a working plane. The tool attachment mechanism is configured to be connected to a surgical saw, which includes a saw blade for cutting.

Description

Technical Field

[0001] The present disclosure relates to medical devices and systems, and more particularly, to robotic systems and associated end effectors for controlling the cutting of a patient's anatomical structure, and related methods and devices. Background Art

[0002] There are many surgical interventions that require osteotomy, i.e., cutting of anatomical structures such as bones along a target plane. Total knee arthroplasty typically requires resection of the femoral epiphysis and tibial epiphysis to remove damaged bone and cartilage and install a knee prosthesis. The surgeon may use an oscillating surgical saw to make five or more cuts on the femur and one or more cuts on the tibia.

[0003] During orthopedic surgery involving the joint and knee, it is important to accurately align and stabilize the saw while cutting the desired location on the bone. The surgeon's limited visibility of the surgical site coupled with difficulty controlling the movement of the saw creates the risk of undesired portions of the bone or adjacent tissue being cut. Vibrations created by the saw while cutting can reduce the accuracy of the cut. During knee surgery, the accuracy of the bone cut (plane cut) can affect the accuracy with which an implant can be attached to the exposed bone.

[0004] During some knee surgeries, a clamp is screwed onto the bone to guide the surgeon's movement of the saw while cutting. Errors in clamp placement and the limited stability of the saw blade during cutting can limit the accuracy of the cut. In addition, contact between the saw blade and the clamp can generate debris that risks entering the patient's body. Summary of the invention

[0005] Some embodiments of the present disclosure relate to a passive end effector of a surgical system. The passive end effector includes a base, a first mechanism, and a second mechanism. The base is configured to be attached to an end effector connector of a robotic arm positioned by a surgical robot. The first mechanism extends between a rotatable connection to the base and a rotatable connection to a tool attachment mechanism. The second mechanism extends between a rotatable connection to the base and a rotatable connection to the tool attachment mechanism. The first mechanism and the second mechanism pivot about the rotatable connection to limit the movement of the tool attachment mechanism to a range of movement within a working plane. The tool attachment mechanism is configured to be connected to a surgical saw, which includes a saw blade for cutting.

[0006] In some additional embodiments, the surgical system further comprises a tracking system configured to determine the pose of the anatomical structure to be cut by the saw blade and to determine the pose of the saw blade. The surgical robot comprises a robot base, at least one motor, and at least one controller. The robot arm is connected to the robot base and is configured to position the passive end effector. The at least one motor is operatively connected to move the robot arm relative to the robot base. The at least one controller is connected to the at least one motor and is configured to determine the pose of the target plane based on a surgical plan defining the position where the anatomical structure is to be cut and based on the pose of the anatomical structure. The at least one controller is further configured to generate manipulation information based on a comparison of the pose of the target plane with the pose of the surgical saw, and wherein the manipulation information indicates where the passive end effector needs to be moved to position the working plane of the passive end effector so that the cutting plane of the saw blade is aligned with the target plane.

[0007] In a first embodiment of the passive end effector, the first mechanism includes a first link segment and a second link segment, wherein the first link segment extends between a rotatable connection to a first position on the base and a rotatable connection to an end of the second link segment. The second mechanism includes a third link segment and a fourth link segment, wherein the third link segment extends between a rotatable connection to a second position on the base and a rotatable connection to an end of the fourth link segment, and wherein the first position and the second position on the base are spaced apart on opposite sides of the axis of rotation of the base when rotated by the robot arm. The tool attachment mechanism includes a fifth link segment, which extends between rotatable connections to distal ends of the second and fourth link segments away from the base.

[0008] In a second embodiment of the passive end effector, the first mechanism comprises a first link segment and a second link segment, wherein the first link segment extends between a rotatable connection to a first position on the base and a rotatable connection to an end of the second link segment. The second mechanism comprises a third link segment and a fourth link segment, wherein the third link segment extends between a rotatable connection to a second position on the base and a rotatable connection to an end of the fourth link segment, wherein the first position and the second position on the base are spaced apart on opposite sides of an axis of rotation of the base when rotated by the robot arm. The distal ends of the second link segment and the fourth link segment away from the base are rotatably connected to each other and to the tool attachment mechanism.

[0009] In a third embodiment of the passive end effector, the base includes a first elongated base segment and a second elongated base segment, which extend from spaced locations on opposite sides of the base's axis of rotation when rotated by the robotic arm, and when attached to the passive end effector, the first elongated base segment and the second elongated base segment extend in a direction away from the end effector coupling of the robotic arm. The first mechanism includes a first link segment, a second link segment, a third link segment, and a fourth link segment, wherein the first link segment and the second link segment extend parallel to each other between rotatable connections to spaced locations on the first elongated base segment and spaced locations on the third link segment. The end of the third link segment is rotatably connected to the end of the fourth link segment. The second mechanism includes a fifth link segment, a sixth link segment, and a seventh link segment, wherein the fifth link segment and the sixth link segment extend parallel to each other between rotatable connections to spaced locations on the second elongated base segment and spaced locations on the seventh link segment. The tool attachment mechanism includes an eighth link segment extending between rotatable connections to distal ends of the fourth link segment and the seventh link segment away from the base.

[0010] In a fourth embodiment of the passive end effector, the first mechanism includes a first link segment. The second mechanism includes a second link segment. The tool attachment mechanism includes a third, fourth, fifth, sixth, and seventh link segments. The first link segment and the second link segment extend between rotatable connections to a first position and a second position on the base, respectively, to a rotatable connection at an opposite end of the third link segment. When rotated by the robot arm, the first position and the second position on the base are spaced apart on opposite sides of the axis of rotation of the base. The fourth link segment extends from the third link segment in a direction toward the base. The fifth link segment and the sixth link segment extend parallel to each other between rotatable connections to spaced apart positions on the fourth link segment and spaced apart positions on the seventh link segment. The seventh link segment includes a rotatable connector configured to be connected to the surgical saw.

[0011] In a fifth embodiment of the passive end effector, the first mechanism includes a first link segment. The second mechanism includes a second link segment. The tool attachment mechanism includes a third, fourth, fifth, sixth, and seventh link segments. The first link segment and the second link segment extend between rotatable connections to a first position and a second position on the base, respectively, to a rotatable connection at an opposite end of the third link segment. When rotated by the robot arm, the first position and the second position on the base are spaced apart on opposite sides of the axis of rotation of the base. The fourth link segment extends from the third link segment in a direction away from the base. The fifth link segment and the sixth link segment extend parallel to each other between rotatable connections to spaced apart positions on the fourth link segment and spaced apart positions on the seventh link segment. The seventh link segment includes a rotatable connector configured to be connected to the surgical saw.

[0012] In a sixth embodiment of the passive end effector, the first mechanism includes a first link segment and a second link segment, wherein the first link segment extends between a rotatable connection to the base and a rotatable connection to an end of the second link segment. The second mechanism includes a third link segment. The tool attachment mechanism includes a fourth link segment, wherein the second and third link segments extend away from the base and are parallel to each other between rotatable connections to spaced-apart locations on the first link segment and spaced-apart locations on the fourth link segment. The fourth link segment includes an attachment member extending in a direction away from the base to a rotatable connector configured to be connected to the surgical saw. The attachment member extends from a location on the fourth link segment that is closer to the third link segment than to the second link segment.

[0013] In a seventh embodiment of the passive end effector, the first mechanism includes a first link segment and the second mechanism includes a second link segment. The tool attachment mechanism includes a third link segment. The first link segment and the second link segment extend between rotatable connections to a first position and a second position on the base, respectively, to rotatable connections at opposite ends of the third link segment. When rotated by the robotic arm, the first position and the second position on the base are spaced apart on opposite sides of the axis of rotation of the base. The third link segment includes an attachment member extending in a direction away from the base to a rotatable connector configured to be connected to the surgical saw. The attachment member extends from a position on the third link segment that is closer to the first link segment than to the second link segment.

[0014] Some other embodiments of the present disclosure relate to a surgical system, the surgical system comprising a tracking system, a surgical robot and a passive end effector. The tracking system is configured to determine the posture of an anatomical structure to be cut by a saw blade and determine the posture of the saw blade. The surgical robot comprises a robot base, a robot arm connected to the robot base and at least one motor operatively connected to move the robot arm relative to the robot base. The passive end effector comprises a base, a first mechanism and a second mechanism. The base is configured to be attached to an end effector connector of the robot arm. The first mechanism, the first mechanism extends between a rotatable connection to the base and a rotatable connection to a tool attachment mechanism. The second mechanism extends between a rotatable connection to the base and a rotatable connection to the tool attachment mechanism. The first mechanism and the second mechanism pivot about the rotatable connection, which can be configured to limit the movement of the tool attachment mechanism to a range of movement within a working plane. The tool attachment mechanism is configured to be connected to the surgical saw including a saw blade configured for cutting. The first mechanism and the second mechanism can constrain the cutting plane of the saw blade to be parallel to the working plane. The surgical robot further includes at least one controller, which is connected to the at least one motor and is configured to determine the posture of the target plane based on a surgical plan that defines the location where the anatomical structure is to be cut and based on the posture of the anatomical structure, and generate manipulation information based on a comparison of the posture of the target plane with the posture of the surgical saw. The manipulation information indicates where the passive end effector needs to move so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at a distance from the anatomical structure to be cut, and the distance is within the movement range of the tool attachment mechanism of the passive end effector.

[0015] After reviewing the following figures and detailed description, other surgical systems, passive end effectors, and corresponding methods and computer program products according to the embodiments will be apparent to those skilled in the art. All such surgical systems, passive end effectors, and corresponding methods and computer program products are intended to be included in this specification, within the scope of the present disclosure, and protected by the appended claims. In addition, all embodiments disclosed herein are intended to be implemented alone or in combination in any manner and / or combination. BRIEF DESCRIPTION OF THE DRAWINGS

[0016] The accompanying drawings illustrate certain non-limiting embodiments of the inventive concept, and are included to provide a further understanding of the present disclosure, and are incorporated in and constitute a part of this application. In the drawings:

[0017] Figure 1 An embodiment of a surgical system according to some embodiments of the present disclosure is presented;

[0018] Figure 2 Some embodiments of the present disclosure are shown Figure 1 A surgical robotic component of a surgical system;

[0019] Figure 3 Some embodiments of the present disclosure are shown Figure 1 A camera tracking system component of a surgical system;

[0020] Figure 4 An embodiment of a passive end effector attachable to a robotic arm and configured in accordance with some embodiments of the present disclosure is presented;

[0021] Figure 5 Medical operations were demonstrated in which surgical robots and camera systems were positioned around the patient;

[0022] Figure 6 An embodiment of an end effector coupler of a robotic arm configured to be connected to a passive end effector according to some embodiments of the present disclosure is presented;

[0023] Figure 7 Shown Figure 6 An embodiment of a cross-sectional view of an end effector coupling;

[0024] Figure 8 A block diagram showing components of a surgical system according to some embodiments of the present disclosure is shown;

[0025] Fig. 9 A block diagram of a surgical system computer platform including a surgical planning computer, which may be separate from and operatively connected to, or at least partially integrated with, a surgical robot, is shown according to some embodiments of the present disclosure;

[0026] Fig.10 An embodiment of a C-arm imaging device according to some embodiments of the present disclosure is presented, which may be used in conjunction with a surgical robot and a passive end effector;

[0027] Fig.11 An embodiment of an O-arm imaging device according to some embodiments of the present disclosure is presented, which may be used in conjunction with a surgical robot and a passive end effector; and

[0028] Figure 12-19

[0046] Alternative embodiments of passive end effectors configured in accordance with some embodiments of the present disclosure are presented.

[0029] Fig. 20 is a screenshot showing the progress of bone cutting during surgery. DETAILED DESCRIPTION

[0030] The inventive concept will now be described more fully below with reference to the accompanying drawings, in which examples of embodiments of the inventive concept are shown. The inventive concept can be implemented in many different forms and should not be construed as being limited to the embodiments listed herein. Rather, these embodiments are provided to make the disclosure more complete and complete, and to fully convey the scope of each inventive concept to those skilled in the art. It should also be noted that these embodiments are not mutually exclusive. A component in one embodiment may be defaulted to being present in or used in another embodiment.

[0031] Various embodiments disclosed herein relate to improvements in the operation of a surgical system when performing a surgical intervention requiring osteotomy. A passive end effector is disclosed that can be connected to a robotic arm positioned by a surgical robot. The passive end effector has a paired mechanism that limits the movement of a tool attachment mechanism within a certain range of movement. The tool attachment can be connected to a surgical saw for cutting, such as a sagittal saw with an oscillating saw blade. The mechanism can be configured to limit the cutting plane of the saw blade to be parallel to a working plane. The surgical robot can determine the pose of the target plane based on a surgical plan that defines the location where the anatomical structure is to be cut and based on the pose of the anatomical structure, and can generate manipulation information based on a comparison of the pose of the target plane with the pose of the surgical saw. The manipulation information indicates where the passive end effector needs to move so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at a distance from the anatomical structure to be cut, the distance being within the range of movement of the tool attachment mechanism of the passive end effector.

[0032] These and other related embodiments can operate to improve the accuracy of saw blade guidance compared to other robotic and manual (e.g., clamp) solutions for surgery. The mechanism of the passive end effector can allow the surgeon to focus on interpreting the direct force feedback when cutting bones using a surgical saw guided by the passive end effector. The mechanism can be a planar mechanism, for example, a terminal joint with 1 degree of freedom that is configured to constrain the cutting plane to align with a target plane. The surgeon can also more accurately detect and control the speed of bone removal based on audio and / or visual notification feedback provided by the surgical robot.

[0033] These embodiments can provide guidance during joint surgery with high precision, high rigidity, sufficient working space and direct force feedback, and in particular during knee surgery. As will be explained in detail below, the tracking system can be used to accurately align the cutting plane with the target plane to cut the bone. When the surgeon moves the saw blade along the cutting plane and directly senses the force feedback of the saw blade cutting the bone, high-precision cutting can be achieved by limiting the planar mechanism that keeps the cutting plane aligned with the target plane. In addition, these embodiments can be quickly adopted into surgical practice through limited changes in existing recognized surgical workflows.

[0034] Figure 1 An embodiment of a surgical system 2 according to some embodiments of the present disclosure is shown. Before performing an orthopedic surgical procedure, one may use, for example, Fig.10 C-arm imaging device 104 or Fig.11 A three-dimensional ("3D") image scan of the planned surgical area of ​​the patient is taken from an O-arm imaging device 106, or from another medical imaging device such as a computed tomography (CT) image or MRI. The scan can be taken preoperatively (e.g., a few weeks before surgery, most commonly) or intraoperatively. However, any known 3D or 2D image scan can be used in accordance with various embodiments of the surgical system 2. The image scan is sent to a computer platform in communication with the surgical system 2, such as Fig. 9 The surgical system computer platform 900 includes a surgical robot 800 (e.g., Figure 1 The surgeon views the surgical planning computer 910 ( Fig. 9 ) to generate a surgical plan defining a target plane in which the patient's anatomical structure is cut. The plane is a function of the patient's anatomical structure constraints, the selected implant, and its size. In some embodiments, the surgical plan defining the target plane is planned on the 3D image scan displayed on the display device.

[0035] Figure 1The surgical system 2 can assist the surgeon during a medical procedure by, for example, holding tools, aligning tools, using tools, guiding tools, and / or positioning tools for use. In some embodiments, the surgical system 2 includes a surgical robot 4 and a camera tracking system 6. The two systems can be mechanically coupled together by any different mechanisms. Suitable mechanisms may include, but are not limited to, mechanical latches, tethers, clamps or supports, or magnetic surfaces or magnetized surfaces. The ability to mechanically couple the surgical robot 4 and the camera tracking system 6 can allow the surgical system 2 to be manipulated and moved as a single unit, and allow the surgical system 2 to have a small footprint in an area, allowing easier movement through narrow passages and around turns, and allowing storage within a smaller area.

[0036] An orthopedic surgery may begin with the surgical system 2 being moved from a medical storage room to a medical procedure room. The surgical system 2 may be maneuvered through doorways, halls, and elevators to reach the medical procedure room. Within the medical procedure room, the surgical system 2 may be physically divided into two separate and distinct systems (the surgical robot 4 and the camera tracking system 6). The surgical robot 4 may be positioned adjacent to the patient in any suitable location to appropriately assist the medical staff. The camera tracking system 6 may be positioned at the bottom of the patient, at the patient's shoulder, or at any other location suitable for tracking the current posture and posture movement of the surgical robot 4 and the patient's trajectory portion. The surgical robot 4 and the camera tracking system 6 may be powered by an onboard power supply and / or plugged into an external wall outlet.

[0037] The surgical robot 4 may be used to assist the surgeon by holding and / or using tools during a medical procedure. In order to properly utilize and hold the tools, the surgical robot 4 may rely on a number of motors, computers, and / or actuators to function properly. Figure 1 As shown, the robot body 8 can serve as a structure in which multiple motors, computers, and / or actuators can be secured within the surgical robot 4. The robot body 8 can also provide support for the robotic telescopic support arm 16. In some embodiments, the robot body 8 can be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, fiberglass, or heavy plastics. The size of the robot body 8 can provide a stable platform to support attached components, and can accommodate, conceal, and protect multiple motors, computers, and / or actuators that can operate the attached components.

[0038] The robot base 10 can act as a lower support for the surgical robot 4. In some embodiments, the robot base 10 can support the robot body 8 and can attach the robot body 8 to a plurality of driven wheels 12. This attachment to the wheels can allow the robot body 8 to move effectively in space. The robot base 10 can run along the length and width of the robot body 8. The robot base 10 can be about two inches to about 10 inches high. The robot base 10 can be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, fiberglass, or heavy plastics or resins. The robot base 10 can cover, protect, and support the driven wheels 12.

[0039] In some embodiments, Figure 1 As shown, at least one driven wheel 12 can be attached to the robot base 10. The driven wheel 12 can be attached to the robot base 10 at any position. Each individual driven wheel 12 can rotate around a vertical axis in any direction. The motor can be placed above, within or adjacent to the driven wheel 12. The motor can allow the surgical system 2 to be manipulated to any position and stabilize and / or level the surgical system 2. The rod located within or adjacent to the driven wheel 12 can be pressed into the surface by the motor. The rod not shown can be made of any suitable metal to lift the surgical system 2. Suitable metals can be but are not limited to stainless steel, aluminum or titanium. Additionally, the rod can include a buffer (not shown) at the side end of the contact surface, which can prevent the rod from sliding and / or produce a suitable contact surface. The material can be any suitable material that acts as a buffer. Suitable materials can be but are not limited to plastic, neoprene, rubber or textured metal. The rod can lift the driven wheel 10, which can lift the surgical system 2 to any height required to level or otherwise fix the surgical system 2 relative to the patient's orientation. The weight of the surgical system 2 is supported by the small contact area of ​​the rod on each wheel, preventing the surgical system 2 from moving during the medical procedure. This rigid positioning can prevent objects and / or people from accidentally moving the surgical system 2.

[0040] The robot track 14 can be used to facilitate moving the surgical system 2. The robot track 14 provides a person with the ability to move the surgical system 2 without grasping the robot body 8. Figure 1 As shown, the length of the robot track 14 can be the same length as the robot body 8, shorter than the robot body 8, and / or longer than the robot body 8. The robot track 14 can be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, fiberglass, or heavy plastics. The robot track 14 can further provide protection to the robot body 8, thereby preventing objects and / or medical personnel from contacting, hitting, or bumping into the robot body 8.

[0041] The robot body 8 may provide support for a selectively compliant articulated robotic arm, hereinafter referred to as a "SCARA". Due to the repeatability and compactness of the robotic arm, the use of the SCARA 24 within the surgical system 2 may be advantageous. The compactness of the SCARA may provide additional space within a medical procedure, which may allow a medical professional to perform a medical procedure without excessive clutter and restricted areas. The SCARA 24 may include a robotic telescopic support 16, a robotic support arm 18, and / or a robotic arm 20. The robotic telescopic support 16 may be disposed along the robot body 8. As shown in FIG. Figure 1 As shown, the robotic telescopic support 16 can provide support for the SCARA 24 and the display 34. In some embodiments, the robotic telescopic support 16 can extend and retract in a vertical direction. The robotic telescopic support 16 can be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium or stainless steel, carbon fiber, fiberglass, or heavy plastics. The body of the robotic telescopic support 16 can be of any width and / or height to support the stress and weight placed on it.

[0042] In some embodiments, the medical staff can move the SCARA 24 by commands submitted by the medical staff. The commands can be derived from input received on the display 34 and / or the tablet computer. The commands can come from the pressing of a switch and / or the pressing of multiple switches. Figure 4 and 5 As best shown, the activation assembly 60 may include a switch and / or multiple switches. The activation assembly 60 may be operable to transmit a movement command to the SCARA 24, thereby allowing an operator to manually manipulate the SCARA 24. When the switch or multiple switches are pressed, the medical personnel has the ability to easily move the SCARA 24. Additionally, when the SCARA 24 does not receive a command to move, the SCARA 24 may be locked in place to prevent accidental movement by medical personnel and / or other objects. By being locked in place, the SCARA 24 provides a stable platform on which to operate, such as Figure 4 and 4 The passive end effector 1100 and attached surgical saw 1140 are shown ready for use in a medical procedure.

[0043] The robotic support arm 18 may be mounted on the robotic telescopic support 16 by a variety of mechanisms. Figure 1 and 2, the robot support arm 18 rotates in any direction relative to the robot telescopic support 16. The robot support arm 18 can rotate three hundred and sixty degrees around the robot telescopic support 16. The robot arm 20 can be connected to the robot support arm 18 in any suitable position. The robot arm 20 can be attached to the robot support arm 16 by various mechanisms. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball joints, press fits, welds, adhesives, screws, rivets, clamps, latches, and / or any combination thereof. The robot arm 20 can rotate in any direction relative to the robot support arm 18. In an embodiment, the robot arm 20 can rotate three hundred and sixty degrees relative to the robot support arm 18. This free rotation can allow the operator to position the robot arm 20 as planned.

[0044] Figure 4 and 5 The passive end effector 1100 in the embodiment of the present invention can be attached to the robot arm 20 at any suitable position. As will be explained in further detail below, the passive end effector 1100 includes a base, a first mechanism, and a second mechanism. The base is configured to be attached to the end effector connector 22 of the robot arm 20 positioned by the surgical robot 4. Various mechanisms may include but are not limited to latches, clamps, nuts and bolts, ball and socket fits, press fits, welds, adhesives, screws, rivets, and / or any combination thereof, by which the base can be attached to the end effector connector 22. The first mechanism extends between a rotatable connection to the base and a rotatable connection to a tool attachment mechanism. The second mechanism extends between a rotatable connection to the base and a rotatable connection to the tool attachment mechanism. The first mechanism and the second mechanism pivot about the rotatable connection and can be configured to limit the movement of the tool attachment mechanism to a range of movement within a working plane. The rotatable connection can be a pivot joint allowing 1 degree of freedom (DOF) of movement, a universal joint allowing 2 DOF of movement, or a ball joint allowing 3 DOF of movement. The tool attachment mechanism is configured to be connected to a surgical saw 1140 having a saw blade. The surgical saw 1140 can be configured to swing the saw blade for cutting. The first mechanism and the second mechanism can be configured to constrain the cutting plane of the saw blade to be parallel to the working plane. When the passive end effector is to be configured to constrain the movement of the saw blade to the cutting plane, the pivot joint can be preferably used to connect the planar mechanism.

[0045] The tool attachment mechanism can be connected to the surgical saw 1140 by various mechanisms, which may include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. In some embodiments, the dynamic reference array 52 is attached to the passive end effector 1100, for example, to the tool attachment mechanism, and / or to the surgical saw 1140. The dynamic reference array (also referred to herein as a "DRA") is a rigid body that can be placed on the patient, surgical robot, passive end effector, and / or surgical saw during a navigated surgical procedure. The camera tracking system 6 or other 3D positioning system is configured to track the pose (e.g., position and rotational orientation) of the tracking markers of the DRA in real time. The tracking markers include a fiducial, such as the illustrated arrangement of a sphere. Such tracking of the 3D coordinates of the tracking markers can allow the surgical system 2 to determine the position of the DRA 52 relative to the surgical saw 1140. Figure 5 The posture in any space of the target anatomical structure of the patient 50.

[0046] like Figure 1 As shown, the light indicator 28 can be positioned at the top of the SCARA 24. The light indicator 28 can be lit as any type of light to indicate the "condition" in which the surgical system 2 is currently operating. For example, green illumination can indicate that all systems are normal. Lighting red can indicate that the surgical system 2 is not operating normally. Pulsating light can mean that the surgical system 2 is performing a function. The combination of light and pulsation can produce an almost infinite number of combinations in which the current operating condition, status or other operating indication is conveyed. In some embodiments, the light can be generated by an LED bulb that can form a ring around the light indicator 28. The light indicator 28 can include a completely permeable material that allows light to pass through the entirety of the light indicator 28.

[0047] The light indicator 28 may be attached to the lower display support 30. Figure 2 As shown, the lower display support 30 can allow the operator to manipulate the display 34 to any suitable position. The lower display support 30 can be attached to the light indicator 28 by any suitable mechanism. In an embodiment, the lower display support 30 can rotate around the light indicator 28. In an embodiment, the lower display support 30 can be rigidly attached to the light indicator 28. The light indicator 28 can then rotate three hundred and sixty degrees around the robot support arm 18. The lower display support 30 can be any suitable length, and a suitable length can be about eight inches to about thirty-four inches. The lower display support 30 can serve as a base for the upper display support 32.

[0048] The upper display support 32 may be attached to the lower display support 30 by any suitable mechanism. The upper display support 32 may be any suitable length, and a suitable length may be from about eight inches to about thirty-four inches. Figure 1 As illustrated, the upper display support 32 can allow the display 34 to rotate three hundred and sixty degrees relative to the upper display support 32. Likewise, the upper display support 32 can rotate three hundred and sixty degrees relative to the lower display support 30.

[0049] Display 34 may be any device supported by upper display support 32. In an embodiment, Figure 2 As shown, display 34 can produce color and / or black and white images. The width of display 34 can be about eight inches to about thirty inches wide. The height of display 34 can be about six inches to about twenty-two inches high. The depth of display 34 can be about half an inch to about four inches.

[0050] In embodiments, the tablet computer may be used in conjunction with and / or without the display 34. In embodiments, a table may be placed on the upper display support 32 in place of the display 34 and may be removed from the upper display support 32 during a medical procedure. Additionally, the tablet computer may communicate with the display 34. The tablet computer may be connected to the surgical robot 4 via any suitable wireless and / or wired connection. In some embodiments, the tablet computer may be capable of programming and / or controlling the surgical system 2 during a medical procedure. When the tablet computer is used to control the surgical system 2, all input and output commands may be replicated on the display 34. Using a tablet computer may allow an operator to manipulate the surgical robot 4 without having to move around the patient 50 and / or the surgical robot 4.

[0051] like Figure 5 As shown, the camera tracking system 6 works in conjunction with the surgical robot 4 via a wired or wireless communication network. Figure 1 and 5 , the camera tracking system 6 can include some components similar to the surgical robot 4. For example, the camera body 36 can provide the functionality found in the robot body 8. The robot body 8 can provide a structure on which the camera 46 is mounted. The structure within the robot body 8 can also provide support for the electronics, communication devices, and power supply used to operate the camera tracking system 6. The camera body 36 can be made of the same materials as the robot body 8. The camera tracking system 6 can communicate directly with the tablet computer and / or display 34 via a wireless and / or wired network to enable the tablet computer and / or display 34 to control the functions of the camera tracking system 6.

[0052] The camera body 36 is supported by a camera base 38. The camera base 38 may be used as the robot base 10. Figure 1 In the embodiment of the present invention, the camera base 38 can be wider than the robot base 10. The width of the camera base 38 can allow the camera tracking system 6 to be connected to the surgical robot 4. Figure 1 As shown, the width of the camera mount 38 can be large enough to fit outside of the robotic base 10. The additional width of the camera mount 38 can allow the surgical system 2 to provide additional maneuverability and support for the surgical system 2 when the camera tracking system 6 is connected to the surgical robot 4.

[0053] As with the robotic base 10, a plurality of driven wheels 12 may be attached to the camera base 38. Similar to the operation of the robotic base 10 and driven wheels 12, the driven wheels 12 may allow the camera tracking system 6 to be stabilized and leveled or set in a fixed orientation relative to the patient 50. Such stabilization may prevent the camera tracking system 6 from moving during a medical procedure and may prevent the camera 46 from losing focus. Figure 5 The tracking of one or more DRAs 52 connected to the anatomical structure 54 and / or the tool 58 within the designated area 56 shown. This stability and maintenance of tracking enhances the ability of the surgical robot 4 to operate effectively with the camera tracking system 6. Additionally, the wide camera base 38 can provide additional support for the camera tracking system 6. Specifically, as Figure 5 As shown, the wide camera base 38 can prevent the camera tracking system 6 from tipping over when the camera 46 is placed on the patient. Without the wide camera base 38, the extended camera 46 may unbalance the camera tracking system 6, which may cause the camera tracking system 6 to tip over.

[0054] The camera telescopic support 40 can support a camera 46. In an embodiment, the telescopic support 40 can move the camera 46 higher or lower in a vertical direction. The telescopic support 40 can be made of any suitable material in which the camera 46 is supported. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, fiberglass, or heavy plastic. The camera handle 48 can be attached to the camera telescopic support 40 at any suitable location. The camera handle 48 can be any suitable handle configuration. Suitable configurations can be, but are not limited to, bars, circles, triangles, squares, and / or any combination thereof. Figure 1 As shown, the camera handle 48 may be triangular shaped, allowing the operator to move the camera tracking system 6 to a planned position prior to a medical procedure. In an embodiment, the camera handle 48 may be used to lower and raise the camera telescopic support 40. The camera handle 48 may perform raising and lowering of the camera telescopic support 40 by pressing a button, a switch, a lever, and / or any combination thereof.

[0055] The lower camera support arm 42 may be attached to the camera telescoping support 40 at any suitable location, in embodiments such as Figure 1 As shown, the lower camera support arm 42 can rotate three hundred and sixty degrees around the telescopic support 40. This free rotation can allow the operator to position the camera 46 in any suitable position. The lower camera support arm 42 can be made of any suitable material in which the camera 46 is supported. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, fiberglass, or heavy plastics. The cross-section of the lower camera support arm 42 can be any suitable shape. Suitable cross-sectional shapes can be, but are not limited to, circular, square, rectangular, hexagonal, octagonal, or I-beam. The length and width of the cross-section can be about one to ten inches. The length of the lower camera support arm can be about four inches to about thirty-six inches. The lower camera support arm 42 can be connected to the telescopic support 40 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball joints, press fits, welds, adhesives, screws, rivets, clamps, latches, and / or any combination thereof. The lower camera support arm 42 can be used to provide support for the camera 46. The camera 46 may be attached to the lower camera support arm 42 by any suitable mechanism. Suitable mechanisms may be, but are not limited to, nuts and bolts, ball joints, press fits, welds, adhesives, screws, rivets, and / or any combination thereof. The camera 46 may pivot in any direction at the attachment area between the camera 46 and the lower camera support arm 42. In an embodiment, the curved track 44 may be disposed on the lower camera support arm 42.

[0056] The curved track 44 may be placed at any suitable location on the lower camera support arm 42. Figure 3 As shown, the curved track 44 can be attached to the lower camera support arm 42 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball joints, press fits, welds, adhesives, screws, rivets, clamps, latches, and / or any combination thereof. The curved track 44 can be of any suitable shape, and suitable shapes can be crescent-shaped, circular, flat, oval, and / or any combination thereof. In an embodiment, the curved track 44 can be of any suitable length. A suitable length can be about one foot to about six feet. The camera 46 can be movably positioned along the curved track 44. The camera 46 can be attached to the curved track 44 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, rollers, brackets, supports, motors, and / or any combination thereof. Motors and rollers not shown can be used to move the camera 46 along the curved track 44. As shown in FIG. Figure 3As shown, during a medical procedure, if an object blocks the camera 46 from viewing one or more DRAs 52, the motor can use rollers to move the camera 46 along the curved track 44. This motorized movement can allow the camera 46 to move to a new position that is no longer blocked by the object without moving the camera tracking system 6. When the camera 46 is blocked from viewing the DRA 52, the camera tracking system 6 can send a stop signal to the surgical robot 4, the display 34, and / or the tablet. The stop signal can stop the SCARA 24 from moving until the camera 46 reacquires the DRA 52. This stop can prevent the SCARA 24 and / or the end effector coupling 22 from moving and / or using medical tools without being tracked by the surgical system 2.

[0057] like Figure 6 As shown, the end effector coupling 22 is configured to connect various types of passive end effectors to the surgical robot 4. The end effector coupling 22 may include a saddle joint 62, an activation assembly 60, a force sensor 64 ( Figure 7 ) and connector 66. The saddle joint 62 can attach the end effector coupler 22 to the SCARA 24. The saddle joint 62 can be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum or stainless steel, carbon fiber, fiberglass or heavy plastics. The saddle joint 62 can be made of a single piece of metal, which can provide additional strength and durability for the end effector. The saddle joint 62 can be attached to the SCARA 24 via an attachment point 68. There can be multiple attachment points 68 arranged around the saddle joint 62. The attachment point 68 can be sunken, flushed and / or arranged on the saddle joint 62. In some instances, screws, nuts and bolts and / or any combination thereof can pass through the attachment point 68 and fix the saddle joint 62 to the SCARA 24. The nuts and bolts can connect the saddle joint 62 to a motor (not shown) within the SCARA 24. The motor can move the saddle joint 62 in any direction. The motor may further prevent the saddle joint 62 from moving due to accidental collision and / or accidental contact by actively servoing in the current position or passively by applying a spring-actuated brake.

[0058] The end effector coupling 22 may include a load cell 64 interposed between the saddle joint 62 and the connected passive end effector. Figure 7 As shown, the load cell 64 may be attached to the saddle joint 62 by any suitable mechanism. Suitable mechanisms may be, but are not limited to, screws, nuts and bolts, threads, press fits, and / or any combination thereof.

[0059] Figure 8 800 is a block diagram showing components of a surgical system 800 according to some embodiments of the present disclosure. Figure 7 and8 , the load cell 64 can be any suitable instrument for detecting and measuring force. In some examples, the load cell 64 can be a six-axis load cell, a three-axis load cell, or a single-axis load cell. The load cell 64 can be used to track the force applied to the end effector coupling 22. In some embodiments, the load cell 64 can communicate with multiple motors 850, 851, 852, 853, and / or 854. When the load cell 64 senses a force, information about the amount of force applied can be distributed from the switch array and / or multiple switch arrays to the controller 846. The controller 846 can obtain the force information from the load cell 64 and process it with a switch algorithm. The controller 846 uses the switch algorithm to control the motor driver 842. The motor driver 842 controls the operation of one or more motors. The motor driver 842 can direct a specific motor to generate an equal amount of force, such as measured by the load cell 64 through the motor. In some embodiments, as indicated by the controller 846, the generated force can come from multiple motors, such as 850-854. Additionally, the motor driver 842 may receive input from a controller 846. The controller 846 may receive information about the direction of the force sensed by the load cell 64 from the load cell 64. The controller 846 may process the information using a motion controller algorithm. The algorithm may be used to provide information to a specific motor driver 842. In order to replicate the direction of the force, the controller 846 may activate and / or deactivate certain motor drivers 842. The controller 846 may control one or more motors, such as one or more of 850-854, to induce movement of the passive end effector 1100 in the direction of the force sensed by the load cell 64. This force-controlled movement may allow the operator to move the SCARA 24 and the passive end effector 1100 effortlessly and / or with very little resistance. The movement of the passive end effector 1100 may be performed to position the passive end effector 1100 in any suitable posture (i.e., position and angular orientation relative to a defined three-dimensional (3D) orthogonal reference axis) for use by medical personnel.

[0060] The connector 66 is configured to be connected to the base of the passive end effector 1100 and to the force sensor 64. The connector 66 may include an attachment point 68, a sensor button 70, a tool guide 72, and / or a tool connector 74. Figure 6 and 8As best shown, there can be multiple attachment points 68. Attachment points 68 can connect connector 66 to load cell 64. Attachment points 68 can be sunk, flush, and / or seated on connector 66. Attachment points 68 and 76 can be used to attach connector 66 to load cell 64 and / or passive end effector 1100. In some examples, attachment points 68 and 76 can include screws, nuts and bolts, press fits, magnetic attachments, and / or any combination thereof.

[0061] like Figure 6 As shown, the sensor button 70 can be positioned around the center of the connector 66. When the passive end effector 1100 is connected to the SCARA 24, the sensor button 70 can be pressed. Pressing the sensor button 70 can alert the surgical robot 4, and in turn, the medical staff, that the passive end effector 1100 has been attached to the SCARA 24. Figure 6 As shown, the guide 72 can be used to facilitate proper attachment of the passive end effector 1100 to the SCARA 24. The guide 72 can be sunken, flushed, and / or placed on the connector 66. In some instances, there can be multiple guides 72, and can have any suitable pattern and can be oriented in any suitable direction. The guide 72 can be any suitable shape to facilitate attaching the passive end effector 1100 to the SCARA 24. Suitable shapes can be, but are not limited to, circular, flat, square, polyhedron, and / or any combination thereof. Additionally, the guide 72 can be cut with a bevel, a straight line, and / or any combination thereof.

[0062] The connector 66 may have an attachment point 74. Figure 6 As shown, the attachment point 74 can form a protrusion and / or multiple protrusions. The attachment point 74 can provide a surface for the connector 66 on which the passive end effector 1100 can be clamped. In some embodiments, the attachment point 74 is arranged around any surface of the connector 66 and is oriented in any suitable manner relative to the connector 66.

[0063] like Figure 6 and 7As best shown, the activation assembly 60 can surround the connector 66. In some embodiments, the activation assembly 60 can take the form of a bracelet that is wrapped around the connector 66. In some embodiments, the activation assembly 60 can be located in any suitable area within the surgical system 2. In some instances, the activation assembly 60 can be located on any portion of the SCARA 24, any portion of the end effector coupling 22, can be worn by medical personnel (and wirelessly communicate), and / or any combination thereof. The activation assembly 60 can be made of any suitable material. Suitable materials can be, but are not limited to, neoprene, plastic, rubber, gel, carbon fiber, fabric, and / or any combination thereof. The activation assembly 60 can include a primary button 78 and a secondary button 80. The primary button 78 and the secondary button 80 can surround the entirety of the connector 66.

[0064] The primary button 78 may be a single ridge, such as Figure 6 As shown, it can wrap around the connector 66. In some examples, the main button 78 can be disposed on the activation assembly 60 along the end farthest from the saddle joint 62. The main button 78 can be disposed on the main activation switch 82, such as Figure 7 As best shown. The master activation switch 82 can be positioned between the connector 66 and the activation assembly 60. In some instances, there can be multiple master activation switches 82, which can be positioned adjacent to and below the master button 78 along the entire length of the master button 78. Pressing the master button 78 on the master activation switch 82 can allow the operator to move the SCARA 24 and the end effector coupling 22. As described above, once positioned in the appropriate position, the SCARA 24 and the end effector coupling 22 may not move until the operator programs the surgical robot 4 to move the SCARA 24 and the end effector coupling 22, or uses the master button 78 and the master activation switch 82 to move. In some instances, at least two non-adjacent master activation switches 82 may need to be pressed before the SCARA 24 and the end effector coupling 22 will respond to an operator command. Pressing at least two master activation switches 82 can prevent accidental movement of the SCARA 24 and the end effector coupling 22 during a medical procedure.

[0065] Activated by the main button 78 and the main activation switch 82, the load cell 64 can measure the magnitude and / or direction of the force applied by the operator, i.e., the medical personnel, on the end effector coupling 22. This information can be transferred to the motor within the SCARA 24, which can be used to move the SCARA 24 and the end effector coupling 22. Information about the magnitude and direction of the force measured by the load cell 64 can cause the motor to move the SCARA 24 and the end effector coupling 22 in the same direction as sensed by the load cell 64. This force-controlled movement can allow the operator to easily move the SCARA 24 and the end effector coupling 22, and because the motor moves the SCARA 24 and the end effector coupling 22 at the same time as the operator moves the SCARA 24 and the end effector coupling 22, a large amount of effort is not required.

[0066] like Figure 6 As shown, the secondary button 80 can be disposed at the end of the activation assembly 60 closest to the saddle joint 62. In some examples, the secondary button 80 can include a plurality of ridges. The plurality of ridges can be disposed adjacent to each other and can surround the connector 66. Additionally, the secondary button 80 can be disposed on a secondary activation switch 84. Figure 7 As shown, the secondary activation switch 84 can be disposed between the secondary button 80 and the connector 66. In some examples, the operator can use the secondary button 80 as a "selection" device. During a medical operation, the surgical robot 4 can notify the medical staff of certain conditions through the display 34 and / or the light indicator 28. The surgical robot 4 can prompt the medical staff to select functions, modes, and / or evaluate the conditions of the surgical system 2. Pressing the secondary button 80 once on the secondary activation switch 84 can activate certain functions, modes, and / or confirm information transmitted to the medical staff through the display 34 and / or the light indicator 28. In addition, pressing the secondary button 80 multiple times in rapid succession on the secondary activation switch 84 can activate additional functions, modes, and / or select information transmitted to the medical staff through the display 34 and / or the light indicator 28. In some examples, at least two non-adjacent secondary activation switches 84 can be pressed before the secondary button 80 can function normally. This requirement can prevent the medical staff from accidentally bumping when activating the assembly 60, resulting in unintended use of the secondary button 80. The primary button 78 and the secondary button 80 may use the software architecture 86 to transmit the medical staff's commands to the surgical system 2 .

[0067] Figure 8A block diagram of components of a surgical system 800 configured according to some embodiments of the present disclosure is shown, and it may correspond to the surgical system 2 above. The surgical system 800 includes a platform subsystem 802, a computer subsystem 820, a motion control subsystem 840, and a tracking subsystem 830. The platform subsystem 802 includes a battery 806, a power distribution module 804, a connector panel 808, and a charging station 810. The computer subsystem 820 includes a computer 822, a display 824, and a speaker 826. The motion control subsystem 840 includes a drive circuit 842, motors 850, 851, 852, 853, 854, stabilizers 855, 856, 857, 858, an end effector connector 844, and a controller 846. The tracking subsystem 830 includes a position sensor 832 and a camera converter 834. The surgical system 800 may also include a removable foot pedal 880 and a removable tablet computer 890.

[0068] Input power is supplied to the surgical system 800 through a power supply, which can be provided to a power distribution module 804. The power distribution module 804 receives the input power and is configured to generate different power supply voltages, which are provided to other modules, components and subsystems of the surgical system 800. The power distribution module 804 can be configured to provide different voltage supplies to the connector panel 808, which can be provided to other components such as the computer 822, the display 824, the speaker 826, the driver 842, to power the motors 850-854 and the end effector coupling 844, and to the camera converter 834 and other components for the surgical system 800. The power distribution module 804 can also be connected to a battery 806, which acts as a temporary power source in the event that the power distribution module 804 is not receiving power from the input power supply. At other times, the power distribution module 804 can be used to charge the battery 806.

[0069] The connector panel 808 can be used to connect different devices and components to the surgical system 800 and / or related components and modules. The connector panel 808 can contain one or more ports for receiving wires or connectors from different components. For example, the connector panel 808 can have a ground port for grounding the surgical system 800 to other equipment, a port for connecting a foot pedal 880, a port for connecting a tracking subsystem 830, which can include a position sensor 832, a camera converter 834, and a marker tracking camera 870. The connector panel 808 can also include other ports to allow USB, Ethernet, HDMI communication with other components (such as the computer 822).

[0070] The control panel 816 may provide various buttons or indicators for controlling the operation of the surgical system 800 and / or providing information from the surgical system 800 for the operator to observe. For example, the control panel 816 may include buttons for opening or closing the surgical system 800, raising or lowering the vertical column 16, and raising or lowering the stabilizer 855-858, which may be designed to engage the casters 12 to lock the surgical system 800 without physically moving. Other buttons may stop the surgical system 800 in the event of an emergency, which may remove all motor power and apply mechanical brakes to stop all motion from occurring. The control panel 816 may also have indicators for notifying the operator of certain system conditions (such as a line power indicator or the charge status of the battery 806).

[0071] The computer 822 of the computer subsystem 820 contains an operating system and software for operating designated functions of the surgical system 800. The computer 822 can receive and process information from other components (e.g., the tracking subsystem 830, the platform subsystem 802, and / or the motion control subsystem 840) in order to display information to the operator. Further, the computer subsystem 820 can provide output to the operator through a speaker 826. The speaker can be part of the surgical robot, part of the head mounted display assembly, or within another component of the surgical system 2. The display 824 can correspond to Figure 1 and 2 The display 34 shown in , or may be a head mounted display that projects images onto a see-through display screen that forms an augmented reality (AR) image overlaid on real world objects visible through the see-through display screen.

[0072] The tracking subsystem 830 may include a position sensor 832 and a camera converter 834. The tracking subsystem 830 may correspond to Figure 3 The camera tracking system 6 of FIG. 6A is provided with a marker tracking camera 870 that operates in conjunction with the position sensor 832 to determine the pose of the DRA 52. Such tracking may be performed in a manner consistent with the present disclosure and may include the use of infrared or visible light techniques, such as LEDs or reflective markers, to track the position of active or passive elements of the DRA 52, respectively. The position, orientation, and location of structures, such as the DRA 52, having these types of markers are provided to the computer 822 and may be displayed to an operator on the display 824. For example, as shown in FIG. Figure 4 and 5 As shown, a surgical saw 1240 having a DRA 52 or connected to an end effector coupling 22 having the DRA 52 tracked in this manner (which may be referred to as a navigation space) may be shown to the operator relative to a three-dimensional image of the patient's anatomy.

[0073] The motion control subsystem 840 can be configured to physically move the vertical column 16, the upper arm 18, the lower arm 20, or rotate the end effector coupling 22. The physical movement can be performed by using one or more motors 850-854. For example, the motor 850 can be configured to vertically raise or lower the vertical column 16. Figure 2 As shown, the motor 851 can be configured to move the upper arm 18 laterally about the junction with the vertical column 16. Figure 2 As shown, motor 852 may be configured to move lower arm 20 laterally about a joint with upper arm 18. Motors 853 and 854 may be configured to move end effector coupling 22 to provide translational movement along and rotational movement about three-dimensional axes. Fig. 9 The surgical planning computer 910 shown can provide control inputs to a controller 846 that directs the movement of the end effector coupling 22 to position the passive end effector coupled thereto in a planned pose (i.e., position and angular orientation relative to defined 3D orthogonal reference axes) relative to the anatomical structure to be cut during the surgical procedure. The motion control subsystem 840 can be configured to measure the position of the passive end effector structure using an integrated position sensor (e.g., an encoder). In one embodiment of the described embodiment, the position sensor is directly connected to at least one joint of the passive end effector structure, but can also be located at another location in the structure and the joint position is remotely measured via an interconnection of a timing belt, wires, or any other synchronous transmission interconnection.

[0074] Fig. 9 A block diagram of a surgical system computer platform 900 is shown, according to some embodiments of the present disclosure, comprising a surgical planning computer 910, which may be separate from and operatively connected to, or at least partially integrated with, a surgical robot 800. Alternatively, at least a portion of the operations disclosed herein for the surgical planning computer 910 may be performed by a component of the surgical robot 800, such as by a computer subsystem 820.

[0075] refer to Fig. 9 The surgical planning computer 910 includes a display 912, at least one processor circuit 914 (also referred to as a processor for brevity), at least one memory circuit 916 (also referred to as a memory for brevity) containing computer readable program code 918, and at least one network interface 920 (also referred to as a network interface for brevity). The network interface 920 can be configured to connect to a computer program program. Fig.10 The C-arm imaging device 104, Fig.11The O-arm imaging device 106, another medical imaging device, an image database 950 of medical images, components of the surgical robot 800 and / or other electronic devices.

[0076] When the surgical planning computer 910 is at least partially integrated within the surgical robot 800, the display 912 may correspond to Figure 2 The display 34 and / or Figure 8 The tablet computer 890 and / or head mounted display, the network interface 920 may correspond to Figure 8 The platform network interface 812, and the processor 914 may correspond to Figure 8 Computer 822.

[0077] The processor 914 may include one or more data processing circuits, such as general and / or special purpose processors, such as microprocessors and / or digital signal processors. The processor 914 is configured to execute computer readable program code 918 in the memory 916 to perform operations, which may include some or all of the operations described herein as being performed by a surgical planning computer.

[0078] Processor 914 is operable to display images of bones on display device 912, the images being received from one of imaging devices 104 and 106 and / or from image database 950 via network interface 920. Processor 914 receives operator definition of locations where anatomical structures (i.e., one or more bones) shown in one or more images are to be cut, such as by the operator touch-selecting locations on display 912 for planned surgical cuts, or using a mouse-based cursor to define locations for planned surgical cuts.

[0079] The surgical planning computer 910 is capable of performing anatomical measurements useful for knee surgery, similar to measurements of various angles to determine the center of the hip, the center of the angle, natural landmarks (e.g., the transepicondylar line, the whitesides line, the posterior condylar line, etc.). Some measurements can be automatic, while others involve human input or assistance. The surgical planning computer 910 allows the operator to select the correct implant for the patient, including the selection of size and alignment. The surgical planning computer 910 is capable of automatic or semi-automatic (involving human input) segmentation (image processing) of CT images or other medical images. The patient's surgical plan can be stored in a cloud-based server for retrieval by the surgical robot 800. During the surgical procedure, the surgeon will select which cut to make (e.g., posterior femur, proximal tibia, etc.) using a computer screen (e.g., a touch screen) or augmented reality interaction, such as a head-mounted display. The surgical robot 4 can automatically move the surgical saw to the planned position so that the target plane of the planned cut is optimally placed within the workspace of the passive end effector interconnecting the surgical saw and the robotic arm 20 .

[0080] In some embodiments, the surgical system computer platform 900 can use two DRAs to track the patient's anatomical position: one on the patient's tibia and one on the patient's femur. The platform 900 can use standard navigation instruments for registration and inspection (e.g., a pointer similar to the pointer used in the Globus Excelsius GPS system for spinal surgery). Tracking markers that allow detection of DRA movement with reference to the tracked anatomical structure can also be used.

[0081] The important difficulty of knee surgery is how to plan the position of the implant in the knee, and many surgeons strive to complete this plan on a computer screen, which is a 2D representation of a 3D anatomy on a computer screen. Platform 900 can solve this problem by using an augmented reality (AR) head-mounted display to produce an implant cover around the actual patient's knee. For example, the surgeon can operatively display a virtual handle to grab the implant and move it to the desired posture, and adjust the planned implant placement. Afterwards, during surgery, platform 900 can provide navigation through the AR head-mounted display to show the surgeon what is not directly visible. In addition, the progress of bone removal, such as depth or cutting, can be displayed in real time. Other features that can be displayed by AR can include but are not limited to gaps or ligament balance along the range of joint motion, contact lines on the implant along the range of joint motion, ligament tension and / or laxity covered by color or other graphics, etc.

[0082] In some embodiments, the surgical planning computer 910 can allow planning for the use of standard implants, such as posterior-stabilized implants and cruciate-retaining implants, cemented and uncemented implants, and revision systems for surgical procedures associated with, for example, total or partial knee and / or hip replacements and / or trauma.

[0083] The processor 912 can graphically display one or more cutting planes on the display 912 that intersect the displayed anatomical structure at the location selected by the operator for cutting the anatomical structure. The processor 912 also determines one or more sets of angular orientations and positions at which the end effector coupling 22 must be positioned so that the cutting plane of the surgical saw will be aligned with the target plane to perform the operator-defined cut, and stores the sets of angular orientations and positions as data in the surgical planning data structure. The processor 912 uses the known range of motion of the tool attachment mechanism of the passive end effector to determine where the end effector coupling 22 attached to the robotic arm 20 needs to be positioned.

[0084] The computer subsystem 820 of the surgical robot 800 receives data from the surgical plan data structure and receives information from the camera tracking system 6, which indicates the current posture of the anatomical structure to be cut and the current posture of the passive end effector and / or the surgical saw tracked by the DRA. The computer subsystem 820 determines the posture of the target plane based on the surgical plan that defines the position where the anatomical structure is to be cut and based on the posture of the anatomical structure. The computer subsystem 820 generates manipulation information based on a comparison of the posture of the target plane and the posture of the surgical saw. The manipulation information indicates where the passive end effector needs to move so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at a certain distance from the anatomical structure to be cut, and the distance is within the movement range of the tool attachment mechanism of the passive end effector.

[0085] As explained above, the surgical robot includes a robot base, a robot arm connected to the robot base, and at least one motor operatively connected to move the robot arm relative to the robot base. The surgical robot also includes at least one controller, such as a computer subsystem 820 and a motion control subsystem 840, which is connected to at least one motor and is configured to perform operations.

[0086] As follows, Figure 12-19Explained in further detail, the passive end effector includes a base, a first mechanism, and a second mechanism configured to be attached to an activation assembly of a robotic arm. The first mechanism extends between a rotatable connection to the base and a rotatable connection to a tool attachment mechanism. The second mechanism extends between a rotatable connection to the base and a rotatable connection to the tool attachment mechanism. The first mechanism and the second mechanism pivot about the rotatable connection, which can be configured to limit the movement of the tool attachment mechanism to a range of movement within a working plane. The rotatable connection can be a pivot joint that allows 1 degree of freedom (DOF) movement, a universal joint that allows 2 DOF movement, or a ball joint that allows 3 DOF movement. The tool attachment mechanism is configured to be connected to the surgical saw including a saw blade for cutting. The first mechanism and the second mechanism can be configured to limit the cutting plane of the saw blade to be parallel to the working plane.

[0087] In some embodiments, the operations performed by at least one controller of the surgical robot further include controlling movement of the at least one motor based on the manipulation information to reposition the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at the distance from the anatomical structure to be cut that is within the range of movement of the tool attachment mechanism of the passive end effector. The manipulation information may be displayed to guide an operator in moving the surgical saw and / or may be used by at least one controller to automatically move the surgical saw.

[0088] In one embodiment, the operation performed by the at least one controller of the surgical robot further includes providing the manipulation information to a display device for display to guide the operator to move the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at the distance from the anatomical structure to be cut, the distance being within the range of movement of the tool attachment mechanism of the passive end effector. The display device may correspond to display 824 ( Figure 8 ), Figure 1 display 34 and / or a head mounted display.

[0089] For example, manipulation information can be displayed on a head-mounted display that projects an image onto a perspective display screen that forms an augmented reality image overlaid on real-world objects visible through the perspective display screen. The operation can display a graphical representation of a target plane having a pose overlaid on the bone and the relative orientation therebetween corresponding to a surgical plan of how the bone is planned to be cut. The operation can alternatively or additionally display a graphical representation of a saw blade cutting plane so that the operator can more easily align the cutting plane with the planned target plane for cutting the bone. Thus, the operator can visually observe and perform movements to align the cutting plane of the saw blade with the target plane so that the saw blade is positioned at the planned pose relative to the bone and within the range of motion of the tool attachment mechanism of the passive end effector.

[0090] The automated imaging system may be used in conjunction with the surgical planning computer 910 and / or the surgical system 2 to acquire preoperative, intraoperative, postoperative, and / or real-time image data of a patient. Fig.10 and 11 An example automatic imaging system is shown. In some embodiments, the automatic imaging system is a C-arm 104 ( Fig.10 ) imaging device or 106( Fig.11 (Medtronic Navigation, Inc., with a place of business in Louisville, Colo., USA, owns Copyright) may wish to x-ray a patient from many different positions without the need for frequent manual repositioning of the patient, as may be required in an x-ray system. C-arm 104 x-ray diagnostic equipment can solve the problem of frequent manual repositioning and is well known in the medical field for surgical and other interventional procedures. Fig.10 As shown, the C-arm includes an elongated C-shaped member terminating in a "C" shaped opposite distal end 112. The c-shaped member is attached to an x-ray source 114 and an image receptor 116. The space within the C-arm 104 of the arm provides space for the physician to care for the patient substantially uninterrupted by the x-ray support structure.

[0091] The C-arm is mounted so that the arm can be rotationally moved in two degrees of freedom (i.e., about two perpendicular axes in a spherical motion). The C-arm is slidably mounted to the x-ray support structure, which allows the C-arm to orbitally rotate about its center of curvature, which can allow for selective vertical and / or horizontal orientation of the x-ray source 114 and image receptor 116. The C-arm can also be rotatable laterally (i.e., in a perpendicular direction relative to the direction of orbital motion to enable selective adjustment of the position of the x-ray source 114 and image receptor 116 relative to the width and length of the patient). The spherical rotation aspect of the C-arm device allows the physician to x-ray the patient at an optimal angle determined relative to the specific anatomy being imaged.

[0092] Fig.11 Shown in 106 includes a gantry housing 124, which can enclose an image capture portion that is not shown. The image capture portion includes an x-ray source portion and / or an x-ray emitting portion and an x-ray receiving portion and / or an image receiving portion, which can be positioned approximately one hundred and eighty degrees from each other and mounted on a rotor (not shown) relative to the track of the image capture portion. The image capture portion can be operatively rotated three hundred and sixty degrees during image acquisition. The image capture portion can rotate about a center point or axis, thereby allowing image data of the patient to be acquired from multiple directions or in multiple planes.

[0093] With stand housing 124 A radiation source 106 having a central opening for positioning around an object to be imaged, rotatable about the interior of a gantry housing 124, can be adapted to project radiation from a plurality of different projection angles. A detector system is adapted to detect radiation at each projection angle, thereby acquiring an image of the object from a plurality of projection planes in a quasi-simultaneous manner. The gantry can be attached to the support structure in a cantilevered manner. A support structure, such as a wheeled mobile cart with wheels. The positioning unit preferably translates and / or tilts the gantry to a planned position and orientation under the control of a computerized motion control system. The gantry may include a source and a detector disposed relative to each other on the gantry. The source and the detector may be fixed to a motorized rotor that can rotate the source and the detector in combination with each other around the interior of the gantry. The source can be pulsed in multiple positions and orientations in a partial and / or full three hundred and sixty degree rotation for multi-planar imaging of a target object located inside the gantry. The gantry may further include a track and bearing system for guiding the rotor as it rotates, the track and bearing system can carry the source and the detector. Both and / or one of the surgical system 106 and the C-arm 104 may be used as an automated imaging system to scan the patient and send the information to the surgical system 2 .

[0094] Images captured by the automated imaging system may be displayed on a display device of the surgical planning computer 910 , the surgical robot 800 , and / or another component of the surgical system 2 .

[0095] Now in Figure 12-19 Various embodiments of a passive end effector configured for use in a surgical system are described in the context of.

[0096] As will be explained in further detail below, Figure 12-19 The various passive end effectors shown each include a base, a first planar mechanism, and a second planar mechanism. The base is configured to be attached to a robotic arm (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5 The end effector coupler 22 in the embodiment of the present invention. Various clamping mechanisms can be used to securely attach the base to the end effector coupler to remove play and ensure suitable stiffness. The irreversible clamping mechanism that can be used to attach the base to the end effector coupler can include, but is not limited to, a toggle mechanism or one or more irreversible locking screws. The first mechanism extends between a rotatable connection to the two bases and a rotatable connection to a tool attachment mechanism. The second mechanism extends between a rotatable connection to the base and a rotatable connection to the tool attachment mechanism. The first mechanism and the second mechanism pivot around the rotatable connection. The rotatable connection can be a pivot joint that allows 1 degree of freedom (DOF) of movement, a universal joint that allows 2 DOF of movement, or a spherical joint that allows 3 DOF of movement. When a pivot joint is used, the first mechanism and the second mechanism can be configured to limit the movement of the tool attachment mechanism to a range of movement within a working plane. The tool attachment mechanism is configured to be connected to a surgical saw having a saw blade that is configured to swing for cutting. The first mechanism and the second mechanism can be configured to constrain the cutting plane of the saw blade to be parallel to the working plane, for example, by a pivot joint with 1 DOF motion. The tool attachment mechanism can be connected to the surgical saw by various mechanisms, which can include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA can be connected to the tool attachment mechanism or the surgical saw to enable tracking of the tool by the camera tracking system 6 ( Figure 3 ) tracks the saw blade’s posture.

[0097] As explained above, a surgical system (e.g., Figure 1 and Figure 2 The surgical system 2 in the invention includes a surgical robot (e.g., Figure 1 and Figure 2surgical robots 4) and tracking systems (e.g., Figure 1 and Figure 3 The camera tracking system 6 in the robot is configured to determine the posture of the anatomical structure to be cut by the saw blade and to determine the posture of the saw blade. The surgical robot includes a robot base, a robot arm rotatably connected to the robot base and configured to position a passive end effector. At least one motor is operatively connected to move the robot arm relative to the robot base. At least one controller is connected to the at least one motor and is configured to perform operations, the operations including determining the posture of a target plane based on a surgical plan defining the position where the anatomical structure is to be cut and based on the posture of the anatomical structure, wherein the surgical plan can be determined by Fig. 9 The surgical plan computer 910 is generated based on input from an operator (e.g., a surgeon or other surgical personnel). The operation further includes generating manipulation information based on a comparison of the pose of the target plane and the pose of the surgical saw. The manipulation information indicates where the passive end effector needs to be moved to position the working plane of the passive end effector so that the cutting plane of the saw blade is aligned with the target plane.

[0098] In some additional embodiments, the operations performed by at least one controller further include controlling the movement of the at least one motor based on the manipulation information to reposition the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at a certain distance from the anatomical structure to be cut, and the distance is within the movement range of the tool attachment mechanism of the passive end effector.

[0099] The operation may include providing the manipulation information to a display device for display, thereby guiding the operator to move the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and so that the saw blade is positioned at a certain distance from the anatomical structure to be cut, and the distance is within the movement range of the tool attachment mechanism of the passive end effector.

[0100] As explained above, some surgical systems may include a head-mounted display device that can be worn by a surgeon, a practicing nurse, and / or other person assisting with the surgical procedure. The surgical system may display information that allows the wearer to more accurately position the passive end effector and / or confirm that it has been accurately positioned with the saw blade aligned with the target plane for cutting the planned location on the anatomical structure. The operation of providing manipulation information to the display device may include configuring the manipulation information for display on the head-mounted display device, the head-mounted display device having a perspective display screen that displays the manipulation information as an overlay on the anatomical structure to be cut to guide the operator to move the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at the distance from the anatomical structure within the range of motion of the tool attachment mechanism of the passive end effector.

[0101] The operation of configuring the manipulation information for display on the head mounted display device can include generating a graphical representation of a target plane, which is displayed as an overlay anchored to and aligned with the anatomical structure to be cut, and generating another graphical representation of a cutting plane of the saw blade, which is displayed as an overlay anchored to and aligned with the saw blade. The wearer can thereby move the surgical saw to provide a visually observed alignment between the graphically presented target plane and the graphically presented cutting plane.

[0102] The operation for configuring the manipulation information for display on the head mounted display device may include generating a graphical representation of the depth of cut produced by the saw blade as a graphical representation of the anatomical structure being cut. Thus, the wearer may use the graphical representation of the depth of cut to better monitor how the saw blade cuts through the bone even though direct observation of the cutting is obstructed by tissue or other structures.

[0103] The tracking system can be configured to determine the posture of the anatomical structure to be cut by the saw blade based on determining the posture of tracking markers such as DRAs attached to the anatomical structure, and can be configured to determine the posture of the surgical saw based on determining the posture of tracking markers connected to at least one of the surgical saw and the passive end effector. The tracking system can be configured to determine the posture of the surgical saw based on a rotational position sensor, which is configured to measure the rotational position of the first mechanism and the second mechanism during the movement of the tool attachment mechanism in the working plane. As explained above, the position sensor can be directly connected to at least one joint of the passive end effector structure, but can also be positioned at another location in the structure and the joint position can be remotely measured through a timing belt, wires or any other interconnection of synchronous transmission interconnections. Additionally, the posture of the saw blade can be determined based on tracking markers attached to the structure base, position sensors in the passive structure, and a kinematic model of the structure.

[0104] The various passive end effectors disclosed herein can be sterilizable or non-sterile (covered by a sterile drape) passive 3 DOF (degrees of freedom) mechanical structures that allow mechanical guidance of a surgical saw such as a sagittal saw along two translations in a plane parallel to the saw blade (defining the cutting plane) and one rotation (instrument orientation) perpendicular to this cutting plane. During surgery, the surgical robot 4 automatically moves the end effector connector 22 and the passive end effector and surgical saw attached thereto into a position close to the knee or other anatomical structure so that all bone to be cut is within the working space of the passive end effector. This position depends on the cut to be made and the surgical plan as well as the implant structure. The passive end effector can have 3 DOF to guide the sagittal saw on a cutting plane that provides such as Fig.12 Shown are two translations (in the X and Y directions) and one rotation (about the Z axis).

[0105] When the surgical robot 4 reaches the planned position, it maintains that position (via brakes or active motor control) and does not move during a particular bone cut. The passive end effector allows the blade of the surgical saw to move along the planned target plane. This planar cutting is particularly useful for traditional total knee arthroplasty in which all bone cuts are planar. In partial knee arthroplasty, there is a special type of implant called an "on-lay" that can be combined with the sawed bone surface. Various passive end effectors have mechanical structures that can ensure guidance accuracy during cutting, have higher accuracy than traditional clamps, and provide sufficient working space range to cut all planned bones, and at the same time provide sufficient lateral stiffness (corresponding to locked DOF), although in addition to the forces applied by the surgeon and the bone reaction forces, there may be a lot of vibration originating from the surgical saw.

[0106] At the same time, it is preferred to measure the passive end effector position because it enables the surgical robot 4 to inform the surgeon how much bone has been removed (procedure advancement). One way to provide real-time information about bone removal is to have the surgical robot 4 measure the position of the saw blade with respect to the bone passing, as the saw blade can only pass through positions where the bone has been cut. In order to measure the saw blade position, a DRA can be mounted to the surgical saw and / or the passive end effector. This enables the saw position to be measured directly or indirectly in 3D space. An alternative method to measure the saw blade position is to integrate a position (rotational or translational) sensor (e.g., encoder, resolver) into the position information of the passive end effector so that the position of the saw blade is calculated using a mathematical model of the defined relationship between the position of the passive end effector geometry and the saw blade.

[0107] In one embodiment, a conventional sagittal saw mechanism can be used with the surgical system computer platform 900 with little or no changes. Potential changes would involve adjusting the external shield to allow the surgical saw to be easily attached to the passive end effector, but would not necessarily involve changes to the internal structure. The passive end effector can be configured to connect to a conventional sagittal saw provided by, for example, the DeSoutter company.

[0108] When the surgical robot 4 positions the passive end effector, in order to prevent the saw from being affected by unexpected passive end effector movement, for example, to prevent the surgical saw from falling onto a patient due to gravity, the passive end effector may include a locking mechanism that moves between an engagement operation and a disengagement operation. When engaged, the locking mechanism prevents movement of the saw blade relative to the robot end effector connector, directly by locking the degrees of freedom (DOF) of the surgical saw, or indirectly by braking or locking specific joints of the passive end effector. When disengaged, the first mechanism and the second mechanism of the passive end effector can move relative to the base without interference from the locking mechanism. The locking mechanism can also be used when the surgeon is holding the surgical saw and controlling the movement of the surgical robot 4 by applying forces and torques to the surgical saw. The surgical robot 4 uses a locking mechanism integrated in the distal end of the robotic arm 22. Figure 6 and 7 The load cell 64 is used to measure the applied force and torque, and generate responsive force and torque on the robotic arm 22, so that the surgeon can more easily move the passive end effector forward and backward, left and right, and apply rotation about various axes.

[0109] Fig.12 A first embodiment of a passive end effector is shown. Fig.12 , the passive end effector 1200 includes a base 1202 configured to be attached to a robotic arm positioned by a surgical robot (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5 The passive end effector 1200 further includes a first mechanism and a second mechanism extending between a rotatable connection to the base 1202 and a rotatable connection to the tool attachment mechanism. The rotatable connection may be a pivot joint allowing 1 degree of freedom (DOF) motion, a universal joint allowing 2 DOF motion, or a ball joint allowing 3 DOF motion. The first mechanism and the second mechanism form a parallel framework that positions the surgical saw rotation axis in the cutting plane.

[0110] The first and second link segments 1210a and 1220a form a first planar mechanism, and the third and fourth link segments 1210b and 1220b form a second planar mechanism. The first link segment 1210a extends between a rotatable connection to a first position on the base 1202 and a rotatable connection to the end of the second link segment 1220a. The third link segment 1210b extends between a rotatable connection to a second position on the base 1202 and a rotatable connection to the end of the fourth link segment 1220b. When rotated by the robot arm, the first and second positions on the base 1202 are spaced apart on opposite sides of the rotation axis of the base. The tool attachment mechanism is formed by the fifth link segment, which extends between rotatable connections to the distal ends of the second and fourth link segments 1220a and 1220b relative to the base 1202. The first and second mechanisms (the first and second link segments 1210a-1220a and the third and fourth link segments 1210b-1220b) pivot about their rotatable connections to limit the movement of the tool attachment mechanism 1230 to a range of movement within the working plane. The tool attachment mechanism 1230 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first and second mechanisms (the first and second link segments 1210a-1220a and the third and fourth link segments 1210b-1220b) can be configured to limit the cutting plane of the saw blade 1242 to be parallel to the working plane, for example, by a pivot joint with 1 DOF motion. The tool attachment mechanism 1230 may be connected to the surgical saw 1240 by various mechanisms, which may include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA 52 may be connected to the tool attachment mechanism 1230 or the surgical saw 1240 to enable tracking of the surgical saw 1240 by the camera tracking system 6 ( Figure 3 ) tracks the posture of saw blade 1242.

[0111] The passive end effector 1200 provides passive guidance for the surgical saw 1240 to constrain the saw blade 1242 to a defined cutting plane and reduce its mobility to three degrees of freedom (DOF): two translations Tx and Ty in planes parallel to the cutting plane of the saw blade 1242; and one rotation Rz about an axis perpendicular to the cutting plane.

[0112] In some embodiments, the tracking system is configured to determine the posture of the saw blade 1242 based on the rotational position sensors of the rotary joints of at least some of the link segments of the passive end effector 1200. The rotational position sensors are configured to measure the rotational position of the engaged link segments during movement of the tool attachment mechanism within the work plane. For example, the rotational position sensor can be configured to measure the rotation of the first link segment 1210a relative to the base 1202, another rotational position sensor can be configured to measure the rotation of the second link segment 1220a relative to the first link segment 1210a, and another rotational position sensor can be configured to measure the rotation of the tool attachment mechanism 1230 relative to the second link segment 1220a. The surgical saw 1240 can be connected to have a fixed orientation relative to the tool attachment mechanism 1230. The serial kinematic chain of the passive end effector 1200 connecting the saw blade 1242 and the robot arm 22 has serial link segments and pivot joints, which provides the desired maneuverability for the surgical saw 1240. The position of the tip of the saw blade 1242 in the plane defined by the passive kinematic chain can be completely determined by the joint angles sensed by the rotational position sensors and the structural geometry of the interconnected link segments. Therefore, by measuring the relative angles between each connected link segment, such as along one or more interconnection paths between the base 1202 and the surgical saw 1240, the position of the tip of the saw blade 1242 in the cutting space can be calculated using the proposed forward kinematic model. When the position and orientation of the distal end of the robotic arm 22 relative to the position and orientation of the bone is known, the position and orientation of the saw blade 1242 relative to the bone can be calculated and displayed to the surgeon as feedback.

[0113] Example types of rotary position sensors that may be used with the passive end effectors herein may include, but are not limited to: potentiometers; optical; capacitive; rotary variable differential transformer (RVDT); linear variable differential transformer (LVDT); Hall effect; and encoders.

[0114] Potentiometer based sensors are passive electronic components. Potentiometers work by changing the position of a sliding contact across a uniform resistor. In a potentiometer, the entire input voltage is applied across the entire length of the resistor, and the output voltage is the voltage drop between the fixed contact and the sliding contact. In order to receive an absolute position, the position needs to be calibrated. The measuring range of a potentiometer may be less than 360°.

[0115] An optical encoder may contain a rotating disk, a light source, and a light detector (photo sensor). The disk mounted on a rotating shaft has a pattern of opaque and transparent sectors encoded on the disk. As the disk rotates, these patterns interrupt the light emitted to the photo detector, resulting in a digital signal or pulse signal output. With the signal encoded on the disk, both absolute and relative measurements as well as multi-turn measurements are possible.

[0116] Capacitive encoders detect changes in capacitance using a high frequency reference signal. This is accomplished with three main parts: a fixed transmitter, a rotor, and a fixed receiver. Capacitive encoders are also available in a two-part configuration with a rotor and a combined transmitter / receiver. The rotor can be etched with a sinusoidal pattern, and as it rotates, this pattern modulates the transmitter's high frequency signal in a predictable way. Encoders can be multi-turn, but absolute measurement is difficult to achieve. Calibration is required at start-up.

[0117] RVDT and LVDT sensors operate with the core of the transformer in the null position, the output voltages of the two primary and secondary windings are equal in magnitude, however opposite in direction. The total output at the null position is always zero. Angular displacement relative to the null position induces a total differential output voltage. Therefore, the total angular displacement is proportional to the linear differential output voltage. The differential output voltage increases in the clockwise direction and decreases in the counterclockwise direction. This encoder functions in absolute measurement and may not be compatible with multi-turn measurement. Calibration is required during assembly.

[0118] In a Hall effect sensor, an electric current is applied along a thin metal strip. In the presence of a magnetic field, the electrons in the metal strip are deflected towards one edge, generating a voltage gradient on the short side of the strip (i.e. perpendicular to the feed current). In its simplest form, the sensor operates as an analog transducer, returning a voltage directly. In the presence of a known magnetic field, its distance from the Hall plate can be determined. Using a sensor array, the relative position of the magnet can be derived. By combining multiple sensor elements with a patterned magnet plate, absolute and relative positions can be detected similar to optical encoders.

[0119] The encoder sensor works in a similar manner to a rotary variable transformer sensor, brushless resolver, or synchronous machine. The stator receives DC power and generates a low-power AC electromagnetic field between the stator and the rotor. This electromagnetic field is modified by the rotor according to its angle. The stator senses the generated electromagnetic field and outputs the angle of rotation as an analog or digital signal. Unlike resolvers, encoders use laminated circuits instead of wound wire reels. This technology allows the encoder to be compact, low mass, low inertia, and high accuracy without the need for high-precision mounting. A signal (Z) is emitted to count one complete rotation. Multi-turn sensing and absolute sensing are possible.

[0120] Fig.13 A second embodiment of a passive end effector is shown. Fig.13 , the passive end effector 1300 includes a base 1302 configured to be attached to a robotic arm positioned by a surgical robot (e.g., Figure 1 and 2The end effector coupling (e.g., Figure 4 and 5 The passive end effector 1300 further includes a first mechanism and a second mechanism extending between a rotatable connection to the base 1302 and a rotatable connection to the tool attachment mechanism. The rotatable connection may be a pivot joint allowing 1 DOF movement, a universal joint allowing 2 DOF movement, or a spherical joint allowing 3 DOF movement. The first and second link segments 1310a and 1320a form a first planar mechanism, and the third and fourth link segments 1310b and 1320b form a second planar mechanism. The first link segment 1310a extends between a rotatable connection to a first position on the base 1302 and a rotatable connection to the end of the second link segment 1320a. The third link segment 1310b extends between a rotatable connection to a second position on the base 1302 and a rotatable connection to the end of the fourth link segment 1320b. When rotated by the robot arm, the first position and the second position on the base 1302 are spaced apart on opposite sides of the rotation axis of the base. The distal ends of the second link segment 1320a and the fourth link segment 1320b away from the base 1302 are rotatably connected to each other and to the tool attachment mechanism 1330. The first mechanism and the second mechanism (the first link segment and the second link segment 1310a-1320a and the third link segment and the fourth link segment 1310b-1320b) can be configured to rotate about their rotatable connection, for example, by a pivot joint with 1 DOF motion, to limit the movement of the tool attachment mechanism 1330 to a range of movement within the working plane. The tool attachment mechanism 1330 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first and second mechanisms (the first and second link segments 1310a-1320a and the third and fourth link segments 1310b-1320b) constrain the cutting plane of the saw blade 1242 to be parallel to the working plane. The tool attachment mechanism 1330 may be connected to the surgical saw 1240 by various mechanisms, which may include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA may be connected to the tool attachment mechanism 1330 or the surgical saw 1240 to enable the camera tracking system 6 ( Figure 3 ) tracks the posture of saw blade 1242.

[0121] Fig.14 A third embodiment of a passive end effector is shown. Fig.14, the passive end effector 1400 includes a base 1402 configured to be attached to a robotic arm positioned by a surgical robot (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5 The passive end effector 1400 further includes a first mechanism and a second mechanism extending between a rotatable connection to the elongated base segments 1404a and 1404b and a rotatable connection to the tool attachment mechanism. The one or more rotatable connections disclosed for this embodiment may be a pivot joint allowing 1 DOF motion, a universal joint allowing 2 DOF motion, or a ball joint allowing 3 DOF motion.

[0122] The first mechanism includes a first link segment 1411a, a second link segment 1410a, a third link segment 1420a, and a fourth link segment 1430a. The first and second link segments 1411a and 1410a extend parallel to each other between rotatable connections to spaced locations on the first elongated base segment 1404a and spaced locations on the third link segment 1420a. The end of the third link segment 1420a is rotatably connected to the end 1430a of the fourth link segment.

[0123] The second mechanism includes a fifth link segment 1411b, a sixth link segment 1410b, and a seventh link segment 1420b. The fifth and sixth link segments 1411b and 1410b extend parallel to each other between rotatable connections to spaced locations on the second elongated base segment 1404b and spaced locations on the seventh link segment 1420b. The tool attachment mechanism includes an eighth link segment 1440 extending 1402 between rotatable connections of the fourth and seventh link segments 1430a and 1420b away from the distal end of the base. In further embodiments, the eighth link segment 1440 of the tool attachment mechanism includes an attachment member 1442 extending in a direction away from the base 1402 to a rotatable connector configured to be connected to the surgical saw 1240. The attachment member 1442 extends from a location on the eighth link segment 1440 that is closer to the fourth link segment 1430a than to the seventh link segment 1420b.

[0124] The first mechanism and the second mechanism (the group of link segments 1411a, 1410a, 1420a, 1430a and the group of link segments 1411b, 1410b, 1420b) can be configured to pivot about their rotatable connections to limit the movement of the tool attachment mechanism 1440 to a range of movement within a working plane. The tool attachment mechanism 1440 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first mechanism and the second mechanism can be configured to limit the cutting plane of the saw blade 1242 to be parallel to the working plane, for example, by a pivot joint with 1 DOF motion. The tool attachment mechanism 1440 can be connected to the surgical saw 1240 by various mechanisms, which can include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA can be connected to a tool attachment mechanism 1440, such as to an attachment member 1442 or a surgical saw 1240 to enable tracking of the surgical saw 1240 by a camera tracking system 6 ( Figure 3 ) tracks the posture of saw blade 1242.

[0125] Fig.14 The passive end effector 1400 has a parallel architecture that enables the surgical saw to be positioned about the rotation axis in the cutting plane. Synchronous and / or differential motion of the lateral parallelograms allows the surgical saw rotation axis to be positioned in the cutting plane.

[0126] Fig.15 A fourth embodiment of a passive end effector is shown. The passive end effector 1500 includes a base 1502 configured to be attached to a robotic arm (e.g., Figure 1 and 2The end effector coupling (e.g., Figure 4 and 5 22 in the end effector connector). The base 1502 may include a first slender base segment and a second slender base segment, which extend from spaced-apart positions on opposite sides of the rotation axis of the base 1502 when rotated by the robotic arm. The first slender base segment and the second slender base segment extend away from each other. The passive end effector 1500 further includes a first mechanism and a second mechanism, which extend between a rotatable connection to the base 1502 and a rotatable connection to the tool attachment mechanism. One or more rotatable connections disclosed for this embodiment may be a pivot joint allowing 1 DOF movement, a universal joint allowing 2 degrees of freedom movement, or a ball joint allowing 3 degrees of freedom movement.

[0127] The first mechanism includes a first link segment 1510a. The second mechanism includes a second segment 1510b. The tool attachment mechanism includes a third link segment 1520, a fourth link segment 1530, a fifth link segment 1540a, a sixth link segment 1540b, and a seventh link segment 1550. The first and second link segments 1510a and 1510b extend between rotatable connections with first and second locations on the base 1502, respectively, such as rotatable connections with first and second elongated base segments extending away from the base 1502, and rotatable connections with opposite ends of the third link segment 1520. When rotated by the robot arm, the first and second locations on the base 1502 are spaced apart on opposite sides of the rotation axis of the base. The fourth link segment 1530 extends from the third link segment 1520 in a direction toward the base 1502. The fifth and sixth link segments 1540a and 1540b extend parallel to each other between rotatable connections to spaced locations on the fourth link segment 1530 and spaced locations on the seventh link segment 1550. The seventh link segment 1550 is configured with a rotatable connector configured to connect to the surgical saw 1240.

[0128] The first to sixth link segments 1510a-b, 1520, 1530, and 1540a-b can be configured to pivot about their rotatable connections to limit the movement of the seventh link segment 1550 to a range of movement within the working plane. The seventh link segment 1550 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first to sixth link segments 1510a-b, 1520, 1530, and 1540a-b can be configured to limit the cutting plane of the saw blade 1242 to be parallel to the working plane, for example, by a pivot joint with 1 DOF motion. The seventh link segment 1550 can be connected to the surgical saw 1240 by various mechanisms, which can include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA can be connected to the seventh linkage segment 1550 or the surgical saw 1240 to enable the camera tracking system 6 ( Figure 3 ) tracks the posture of saw blade 1242.

[0129] Fig.16 A fifth embodiment of a passive end effector is shown. The passive end effector 1600 includes a base 1602 configured to be attached to a robotic arm (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5 The passive end effector 1600 further includes a first mechanism and a second mechanism extending between a rotatable connection to the base 1502 and a rotatable connection to the tool attachment mechanism. The first mechanism includes a first link segment 1610a. The second mechanism includes a second segment 1610b. The tool attachment mechanism includes a third link segment 1620, a fourth link segment 1630, a fifth link segment 1640a, a sixth link segment 1640b, and a seventh link segment 1650. The one or more rotatable connections disclosed for this embodiment can be a pivot joint allowing 1 DOF movement, a universal joint allowing 2 DOF movement, or a ball joint allowing 3 DOF movement.

[0130] The first and second link segments 1610a and 1610b extend between rotatable connections to first and second locations on the base 1602, respectively, to a rotatable connection 1620 at an opposite end of the third link segment. The first and second locations on the base 1602 are spaced apart on opposite sides of the axis of rotation of the base 1602 when rotated by the robotic arm. The fourth link segment 1630 extends 1602 from the third link segment 1620 in a direction away from the base. The fifth and sixth link segments 1640a and 1640b extend 1650 parallel to each other between rotatable connections to spaced apart locations on the fourth link segment 1630 and spaced apart locations on the seventh link segment. The seventh link segment 1650 is configured with a rotatable connector configured to connect to the surgical saw 1240.

[0131] The first to sixth link segments 1610a-b, 1620, 1630, and 1640a-b can be configured to pivot about their rotatable connections to limit the movement of the seventh link segment 1650 to a range of movement within the working plane. The seventh link segment 1650 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first to sixth link segments 1610a-b, 1620, 1630, and 1640a-b can be configured to pivot while limiting the cutting plane of the saw blade 1242 to be parallel to the working plane. The seventh link segment 1650 can be connected to the surgical saw 1240 by various mechanisms, which can include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA can be connected to the seventh link segment 1650 or the surgical saw 1240 to enable tracking of the surgical saw 1240 by the camera tracking system 6( Figure 3 ) tracks the posture of saw blade 1242.

[0132] The passive end effector 1600 provides two perpendicular translational movements for positioning the surgical saw axis of rotation in the cutting plane, and two of the translations are implemented by parallelograms.

[0133] Fig.17 A sixth embodiment of a passive end effector is shown. The passive end effector 1700 includes a base 1702 configured to be attached to a robotic arm (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5The passive end effector 1700 further includes a first mechanism and a second mechanism extending between a rotatable connection to the base 1702 and a rotatable connection to the tool attachment mechanism. One or more rotatable connections disclosed for this embodiment may be a pivot joint allowing 1 DOF movement, a universal joint allowing 2 DOF movement, or a spherical joint allowing 3 DOF movement. The first mechanism and the second mechanism are connected to provide translation along the radius of the parallelogram. The first mechanism includes a first link segment and a second link segment 1710 and 1720b. The first link segment 1710 extends between a rotatable connection to the base 1702 and a rotatable connection to the end of the second link segment 1720b. The second mechanism includes a third link segment 1720a. The tool attachment mechanism includes a fourth link segment 1730. The second and third link segments 1720b and 1720a extend away from the base 1702 and extend parallel to each other between rotatable connections to spaced locations on the first link segment 1710 and spaced locations on the fourth link segment 1730. The fourth link segment 1730 includes an attachment member 1732 that extends in a direction away from the base to a rotatable connector that is configured to connect to the surgical saw 1240. The attachment member 1732 extends from a location on the fourth link segment 1730 that is closer to the third link segment 1720a than the second link segment 1720b.

[0134] The first to third link segments 1710, 1720b, 1720a can be configured to pivot about their rotatable connections to limit the movement of the fourth link segment 1730 to a range of movement within a working plane. The fourth link segment 1730 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first to third link segments 1710, 1720b, 1720a can be configured to limit the cutting plane of the saw blade 1242 to be parallel to the working plane. The fourth link segment 1730, for example, its attachment member 1732 can be connected to the surgical saw 1240 by various mechanisms, which can include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA can be connected to the fourth link segment 1730, for example, to the attachment member 1732 or the surgical saw 1240 to enable tracking by the camera tracking system 6 ( Figure 3 ) tracks the posture of saw blade 1242.

[0135] Fig.18 A seventh embodiment of a passive end effector is shown. The passive end effector 1800 includes a base 1802 configured to be attached to a robotic arm (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5 The passive end effector 1800 further includes a first mechanism and a second mechanism extending between a rotatable connection to the base 1802 and a rotatable connection to the tool attachment mechanism. The one or more rotatable connections disclosed for this embodiment may be a pivot joint allowing 1 DOF motion, a universal joint allowing 2 DOF motion, or a ball joint allowing 3 DOF motion. The first mechanism includes a first link segment 1810a. The second mechanism includes a second link segment 1810b. The tool attachment mechanism includes a third link segment 1820. The first and second link segments 1810a and 1810b extend between rotatable connections to the first and second positions on the base 1802, respectively, to the rotatable connection 1820 at opposite ends of the third link segment. When rotated by the robot arm, the first and second positions on the base 1802 are spaced apart on opposite sides of the rotation axis of the base 1802. The third link segment 1820 includes an attachment member 1822 that extends in a direction away from the base 1802 to a rotatable connector that is configured to be connected to the surgical saw 1240. The attachment member 1822 extends from a location on the third link segment 1820 that is closer to the first link segment 1810a than to the second link segment 1810b. The one or more rotatable connections disclosed for this embodiment can be a pivot joint that allows 1 DOF of motion, a universal joint that allows 2 degrees of freedom of motion, or a ball joint that allows 3 degrees of freedom of motion.

[0136] The first and second link segments 1810a and 1810b can be configured to pivot about their rotatable connections between the base 1802 and the third link segment 1820 to limit the movement of the attachment member 1822 to a range of movement within the working plane. In some other embodiments, one or more rotatable connections can be a universal joint that allows 2 DOF movement or a ball joint that allows 3 DOF movement so that the movement is not limited to the working plane. The tool attachment mechanism 1822 is configured to be connected to a surgical saw 1240 having a saw blade 1242 configured to swing for cutting. The first and second link segments 1810a and 1810b pivot while limiting the cutting plane of the saw blade 1242 to be parallel to the working plane. The attachment member 1822 can be connected to the surgical saw 1240 by various mechanisms, which can include but are not limited to screws, nuts and bolts, clamps, latches, tethers, press fits, or magnets. The DRA can be connected to the third link segment 1820, for example to the attachment member 1822 or the surgical saw 1240 to enable the camera tracking system 6 ( Figure 3 ) tracks the posture of saw blade 1242.

[0137] Fig.19 An eighth embodiment of a passive end effector is shown. The passive end effector 1900 includes a base 1902 configured to be attached to a robotic arm (e.g., Figure 1 and 2 The end effector coupling (e.g., Figure 4 and 5 The passive end effector 1900 further includes a first link segment 1910 and a second link segment 1920. The first link segment 1910 extends between a rotatable connection to the base 1902 and a rotatable connection to one end of the second link segment 1920. The other end of the second link segment 1920 is rotatably connected to the tool attachment mechanism. The rotation axes q1, q2 and q3 are parallel to each other to provide a planar cutting plane for the blade 1242. Therefore, the 3 DOF motion of the saw 1240 includes an x-direction Tx, a y-direction Ty, and a rotational direction around the z-axis Rz. The one or more rotatable connections disclosed for this embodiment can be a pivot joint allowing 1 DOF motion, a universal joint allowing 2 degrees of freedom motion, or a spherical joint allowing 3 degrees of freedom motion.

[0138] Tracking markers 52 attached to the end effector base 1902 and saw 1240, as well as tracking markers on bones (e.g., tibia and femur), can be used to accurately and continuously monitor the real-time position of the blade 1242 and the blade tip relative to the patient's bone being cut. Although not explicitly shown in other figures, in all embodiments, tracking markers can be attached to the saw 1240 and all end effectors 1902 to track the position of the blade relative to the patient's bone being cut. Although not shown, encoders can be positioned in each of the link segments 1910 and 1920, alternatively or in addition to the tracking markers, to always accurately determine where the saw blade tip is.

[0139] Example Surgical Procedures

[0140] Example surgical procedures using the surgical robot 4 in an operating room (OR) may include:

[0141] Optional step: Preoperative planning of surgical procedures based on medical images.

[0142] 1. The surgical robot 4 system is outside the operating room (OR). The nurse brings the system to the OR when the patient is prepared for surgery.

[0143] 2. The nurse powers on the robot and deploys the robot arm. The nurse verifies the accuracy of the robot system and tracking system.

[0144] 3. In the case of a sterilized passive end effector, the scrub nurse places a sterile drape on the robotic arm and mounts the passive end effector with the sagittal saw on the robotic arm. The scrub nurse locks the passive end effector with the locking mechanism. The scrub nurse attaches the DRA to the passive structure via the drape (if necessary). For a non-sterile passive end effector, the drape is placed after attaching the passive end effector to the robotic arm, the DRA is attached to the passive end effector with the drape in between, and the sterilized saw is attached to the passive end effector with the drape in between.

[0145] 4. The surgeon attaches navigation markers to one or more bones of the patient, such as the tibia and femur. The bones are registered to the camera tracking system 6 using, for example, the Horn algorithm, surface matching, or other algorithms. Soft tissue balance assessment can be performed, whereby the system allows the surgeon to assess the balance of soft tissues in the operating room, for example, by tracking the relative movement of the femur and tibia when the surgeon applies forces (e.g., varus / valgus stress) in different directions. Soft tissue balance information can be used to change the surgical plan (e.g., moving implant components, changing implant types, etc.).

[0146] 5. When the surgeon is ready to cut the bone, the scrub nurse brings the surgical robot 4 to the operating table close to the knee joint to be operated on and stabilizes the surgical robot 4 on the floor. The system can operate to guide the nurse to find the position of the robot 4 so that all cutting planes are within the robot and passive structure workspace.

[0147] 6. The surgeon selects different parameters on the screen of the surgical robot 4 to make the first cut according to the surgical plan (bone to be cut, desired cutting plan, etc.).

[0148] 7. The surgical robot 4 automatically moves the robot arm 22 to reposition the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane, and the saw blade is positioned at a certain distance from the anatomical structure to be cut, and the distance is within the moving range of the tool attachment mechanism of the passive end effector.

[0149] 8. The surgeon unlocks the passive end effector.

[0150] 9. The surgeon performs a cut that is limited to the cutting plane provided by the passive end effector. The surgical robot 4 can provide a real-time display of the tracked position of the saw blade relative to the bone so that the surgeon can monitor the progress of the bone removal. In one manner, the tracking subsystem processes the position of the saw relative to the bone in real time based on camera images and various tracking markers attached to the saw, robot arm, end effector, femur and tibia. The surgeon can then use the locking mechanism to lock the passive end effector when the cut is completed.

[0151] 10. The surgeon selects the next cut to be performed on the screen and proceeds as before.

[0152] 11. The surgeon may perform a trial implant placement and intermediate soft tissue balance assessment and based on this change the implant plan and associated cuts.

[0153] 12. After all cuts are completed, the nurse removes the surgical robot 4 from the operating table and detaches the passive end effector from the robot arm.

[0154] 13. The surgeon places the implant and completes the procedure.

[0155] In step 9 above, it may be difficult for the doctor to visually confirm the progress of the cutting due to the tissues and ligaments around the bone and the debris generated by the cutting and other surgical instruments near the bone. Even if visual confirmation is acceptable, there are certain areas of the bone that the doctor cannot see, such as the back of the bone being cut.

[0156] Advantageously, a robotic system embodiment of the present invention provides a method for the surgeon to confirm the progress of the bone being cut in multiple dimensions. The camera tracking system 6 and the tracking markers attached to the end effector base (1100, 1202, 1302, 1402, 1502, 1602, 1702, 1802, 1902), the robotic arm 20 and the saw (1140, 1240) allow the tracking subsystem 830 and the computer subsystem 820 to calculate the precise position of the saw blade relative to the bone in real time, so that the surgeon can monitor the progress of the bone removal.

[0157] Fig. 20 is a screenshot showing the progress of bone cutting during surgery. Fig. 20 Subsystems 830 and 820 are shown displaying three images: a side view, an AP view, and a top view. In each image, the real-time position of the saw blade 1242 relative to the bone (e.g., tibia 2000) is displayed on the display 34. The side view and the top view are particularly useful to the doctor because they show the position of the saw blade, which is not easy to see. At the top of the display, the computer subsystems 830, 820 display the number of cutting programs and the program currently running. For example, as shown in the screenshot, the doctor may have programmed 6 plane cuts, and the current cutting program is the first one. In addition, because the subsystems 830 and 820 can track the position where the blade may have traveled with tracking marks, it can determine how much of the bone cutting (area cut) of a particular cutting program has been completed, and the percentage of progress is displayed in the display 34. The bone image itself is preferably derived from an actual image of the patient's body to obtain an accurate representation. The bone image is enhanced by the subsystem 820 with contours showing the cortical bone 2004 and the cancellous bone 2002. This is important for doctors to understand because the resistance to cutting differs greatly between the two types of bones.

[0158] If an augmented reality (AR) head mounted display is used, the computer subsystem 820 can generate the same contour lines showing the cortical bone and cancellous bone, and continuously superimpose them on the actual leg when the doctor moves his / her head. The area that has been cut can be covered on the actual bone with a shadow. In addition, the implant to be inserted into the cutting area can also be covered on the bone to show the doctor that the cutting is correctly performed along the plane of the implant. This is all possible because subsystems 830 and 820 can track the position of the blade and its movement history relative to the bone with tracking markers and camera subsystems.

[0159] Additional limitations and embodiments:

[0160] In the above description of each embodiment of the inventive concept, it should be understood that the terms used herein are only for the purpose of describing specific embodiments, and are not intended to limit the inventive concept. Unless otherwise specified, all terms used herein (including technical terms and scientific and technological terms) have the same meanings commonly understood by those skilled in the art to which the inventive concept belongs. It should be further understood that the terms as defined in the commonly used dictionary should be interpreted as having the meaning consistent with its meaning in the context of this specification and in the relevant field, and are clearly defined in this article, and will not be interpreted in an idealized or overly formal sense.

[0161] When an element is referred to as being "connected to" or "coupled to" "in response to" another element or a variation thereof, it may be directly connected to, coupled to or in response to another element, or there may be an intermediate element. In contrast, when an element is referred to as being "directly connected to", "directly coupled to", "directly in response to" another element or a variation thereof, there is no intermediate element. Throughout the text, the same number refers to the same element. In addition, "connection", "connection", "response" or its variations as used herein may include wireless connection, connection or response. Unless the context clearly indicates otherwise, as used herein, the singular forms "a, an" and "the" are intended to include plural forms. For the sake of brevity and / or clarity, well-known functions or configurations may not be described in detail. The term "and / or" includes any and all combinations of one or more of the associated listed items.

[0162] It should be understood that, although the terms first, second, third, etc. can be used herein to describe various elements / operations, these elements / operations should not be limited by these terms. These terms are only used to distinguish an element / operation from another element / operation. Therefore, without departing from the teaching of the present invention concept, the first element / operation in some embodiments can be referred to as the second element / operation in other embodiments. Throughout this specification, the same reference numerals or the same figure designators represent the same or similar elements.

[0163] As used herein, the terms "comprise / comprising / comprises", "include / including / includes", "have / has / having" or variations thereof are open ended and include one or more stated features, integers, elements, steps, components, or functions, but do not preclude the presence or addition of one or more other features, integers, elements, steps, components, functions, or combinations thereof. In addition, as used herein, the general abbreviation "such as", derived from the Latin phrase "exempli gratia", may be used to introduce or specify one or more general examples of previously mentioned items and is not intended to limit such items. The general abbreviation "that is", derived from the Latin phrase "id est", may be used to specify a specific item from a more general statement.

[0164] Example embodiments are described herein with reference to block diagrams and / or flow diagrams of computer-implemented methods, devices (systems and / or apparatuses), and / or computer program products. It should be understood that the blocks of the block diagrams and / or flow diagrams and the combination of blocks in the block diagrams and / or flow diagrams can be implemented by computer program instructions executed by one or more computer circuits. These computer program instructions can be provided to processor circuits of general-purpose computer circuits, special-purpose computer circuits, and / or other programmable data processing circuits to produce a machine so that instructions executed by processors of computers and / or other programmable data processing devices convert and control transistors, values ​​stored in memory locations, and other hardware components within such circuit systems to implement the functions / actions specified in the block diagrams and / or one or more flow diagram blocks, and thereby create a device (function) and / or structure for implementing the functions / actions specified in the block diagrams and / or one or more flow diagram blocks.

[0165] These tangible computer program instructions may also be stored in a computer-readable medium that can direct a computer or other programmable data processing device to operate in a particular manner, so that the instructions stored in the computer-readable medium produce an article of manufacture containing instructions for implementing the functions / actions specified in the block diagram or one or more flowchart blocks. Thus, embodiments of the inventive concept may be embodied in hardware and / or software (including firmware, resident software, microcode, etc.) that runs on a processor such as a digital signal processor, which may be collectively referred to as a "circuitry system," "module," or variations thereof.

[0166] It should also be noted that, in some alternative implementations, the function / action marked in the frame may not occur in the order marked in the flow chart. For example, according to the function / action involved, the two frames shown continuously can actually be performed substantially simultaneously, or the frame can sometimes be performed in reverse order. In addition, the function of a given frame of a flow chart and / or block diagram can be divided into multiple frames, and / or the function of two or more frames of a flow chart and / or block diagram can be integrated at least in part. Finally, without departing from the scope of the inventive concept, other frames can be added / inserted between the frames shown, and / or frame / operation can be omitted. In addition, although some figures in the figure include arrows on the communication path to illustrate the main direction of communication, it should be understood that communication can occur in the direction opposite to the arrows depicted.

[0167] Without substantially departing from the principle of the inventive concept, many changes and modifications may be made to the embodiments. All such variants and changes are intended to be included in the scope of the inventive concept herein. Therefore, the subject matter disclosed above should be considered illustrative rather than restrictive, and the examples of the attached embodiments are intended to cover all such modifications, enhancements and other embodiments that fall within the spirit and scope of the inventive concept. Therefore, in order to be allowed to the greatest extent by law, the scope of the inventive concept will be determined by the most widely allowed interpretation of the present disclosure, which comprises the examples of the following embodiments and their equivalents, and should not be limited to or confined to the aforementioned specific detailed description.

Claims

1. A surgical system, comprising: a tracking system configured to determine a pose of the anatomical structure to be cut; A surgical robot comprising: Robot base, a robot arm connected to the robot base and having an end effector coupling, at least one motor operatively connected to move the robotic arm relative to the robotic base, and at least one controller configured to control the motor; and A passive end effector, the passive end effector comprising: a base configured to be attached to the end effector coupling of the robotic arm positioned by the surgical robot, a dynamic reference array attached to the passive end effector, the dynamic reference array containing tracking markers, and First institution and second institution; The first mechanism comprises: a first link segment having a first end and a second end, the first end being coupled to a rotatable connection to the base, and a second link segment having a first end coupled to a rotatable connection to the second end of the first link segment and a second end coupled to a rotatable connection for a tool attachment mechanism coupled to a surgical saw having a saw blade configured to oscillate for cutting; wherein the tracking system continuously monitors the real-time position of the saw blade relative to the anatomical structure to be cut based on tracking the dynamic reference array; The controller is configured to: determining a pose of a target plane based on a surgical plan defining locations where the anatomical structure is to be cut and based on the pose of the anatomical structure, and generating manipulation information based on a comparison of the pose of the target plane and the pose of the surgical saw, wherein the manipulation information indicates where the passive end effector needs to be moved to position a working plane of the passive end effector so that a cutting plane of the saw blade is aligned with the target plane; wherein the first link segment extends between a rotatable connection to a first location on the base and a rotatable connection to a first end of the second link segment, the second mechanism comprising a third link segment and a fourth link segment, the third link segment extending between a rotatable connection to a second location on the base and a rotatable connection to an end of the fourth link segment proximate the base, wherein the rotatable connection at the first location and the rotatable connection at the second location on the base are spaced apart on opposite sides of an axis of rotation of the base when rotated by the robotic arm; The tool attachment mechanism includes a fifth link segment extending between rotatable connections to distal ends of the second link segment and the fourth link segment away from the base.

2. The surgical system of claim 1 , wherein the at least one controller is further configured to: The movement of the at least one motor is controlled based on the manipulation information to reposition the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at a distance from the anatomical structure to be cut, wherein the distance is within the movement range of the tool attachment mechanism of the passive end effector.

3. The surgical system of claim 1 , wherein the at least one controller is further configured to: The manipulation information is provided to a display device for display, thereby guiding the operator to move the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and so that the saw blade is positioned at a distance from the anatomical structure to be cut, the distance being within the movement range of the tool attachment mechanism of the passive end effector.

4. The surgical system of claim 3, wherein the at least one controller is further configured to: The manipulation information is configured for display on a head-mounted display device having a perspective display screen, which displays the manipulation information as an overlay on the anatomical structure to be cut to guide the operator to move the passive end effector so that the cutting plane of the saw blade becomes aligned with the target plane and the saw blade is positioned at the distance from the anatomical structure, which distance is within the movement range of the tool attachment mechanism of the passive end effector.

5. The surgical system of claim 4, wherein to configure the manipulation information for display on the head mounted display device, the at least one controller: generating a graphical representation of the target plane, the graphical representation displayed as an overlay anchored to and aligned with the anatomical structure to be cut, and Another graphical representation of the cutting plane of the saw blade is generated, the graphical representation showing the overlay anchored to and aligned with the saw blade.

6. A surgical system according to claim 4, wherein, in order to configure the manipulation information for display on the head-mounted display device, the at least one controller generates a graphical representation of the cutting depth produced by the saw blade as a graphical representation of the anatomical structure being cut.

7. A surgical system according to claim 1, wherein the tracking system is configured to determine the posture of the anatomical structure to be cut by the saw blade based on determining the posture of tracking markers attached to the anatomical structure, and is configured to determine the posture of the surgical saw based on determining the posture of tracking markers on at least one of the surgical saw and the passive end effector.

8. A surgical system according to claim 1, wherein the tracking system is configured to determine the posture of the surgical saw based on a rotational position sensor, and the rotational position sensor is configured to measure the rotational position of the first link segment and the second link segment during movement of the tool attachment mechanism within the working plane.

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