Systems and methods for evaluating and assisting surgical performance

Abstract

In an example, a system includes a processor that may receive instrument data from a surgical instrument related to operation of the surgical instrument during a surgical procedure; (ii) receiving, from the surgical navigation system, position data indicative of a position of the surgical instrument relative to the patient's anatomy during the surgical procedure; (iii) determining kinematic data based on the position data; (iv) determining a plurality of surgical performance indicators indicative of characteristics of the surgical performance using the instrument data and the kinematic data; (v) analyzing (a) kinematic data and instrument data with respect to (b) a plurality of surgical performance metrics; and (vi) causing the user interface to output information based on the analysis to provide feedback to a surgeon and / or stakeholder (e.g., a hospital administrator) relating to the performance of the surgical procedure.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This disclosure claims the benefit of U.S. Provisional Application No. 63 / 443,588, filed February 6, 2023, the contents of which are incorporated herein by reference in their entirety. Technical Field

[0003] The present disclosure generally relates to systems and methods for obtaining and processing information related to surgical performance, and more specifically to systems and methods for using data obtained from surgical instruments and / or equipment in an operating room before, during, and / or after surgery to assess surgical performance, assist in surgical performance, and / or reduce the cognitive load of a surgeon during a surgical procedure. Background Art

[0004] Many factors influence the patient's postoperative outcome during a surgical procedure. For example, multiple studies have found a relationship between patient outcomes and the technical skill of the surgeon performing the surgery. As another example, during surgery, the surgeon may be overwhelmed with information from various sources. Conflicting information presented to the surgeon can increase cognitive load, which in some cases can negatively impact the patient's outcome. Summary of the Invention

[0005] In an example, a non-transitory computer-readable medium stores instructions executable to cause a processor to perform functions comprising determining a plurality of surgical data sets for a plurality of surgical procedures and determining a plurality of surgical performance indicators indicative of surgical performance characteristics based on the plurality of procedure data sets. Determining the plurality of surgical data sets may comprise, for each of the plurality of surgical procedures, determining a corresponding surgical data set from the plurality of surgical data sets by: (i) receiving instrument data related to operation of the surgical instrument during the surgical procedure from a surgical instrument, wherein the instrument data is based on one or more instrument parameters determined for the surgical instrument at a plurality of time points during the surgical procedure; (ii) receiving position data from a surgical navigation system, the position data indicating a position of the surgical instrument relative to a patient anatomy at the plurality of time points during the surgical procedure; (iii) determining kinematic data for the plurality of time points based on at least one of the position data or the instrument data; and (iv) correlating the instrument data, the position data, and the kinematic data for each of the plurality of time points to determine a corresponding surgical data set for the surgical procedure.

[0006] In another example, a non-transitory computer-readable medium has instructions stored therein that are executable to cause a processor to perform functions including: (i) receiving instrument data from a surgical instrument relating to operation of the surgical instrument at multiple time points during a surgical procedure; (ii) receiving position data from a surgical navigation system, the position data indicating a position of the surgical instrument relative to the patient's anatomy at multiple time points during the surgical procedure; (iii) determining kinematic data for the multiple time points based on the position data, (iv) determining multiple surgical performance indicators indicative of characteristics of surgical performance using the instrument data and the kinematic data, (v) analyzing (a) the kinematic data and the instrument data relative to (b) the multiple surgical performance indicators, and (vi) causing a user interface to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure.

[0007] In another example, a non-transitory computer-readable medium stores instructions that are executable to cause a processor to perform functions including: (i) receiving preoperative information about a surgical procedure to be performed; (ii) determining a plurality of surgical performance indicators using the preoperative information; (iii) receiving instrument data from a surgical instrument related to operation of the surgical instrument at a plurality of time points during the surgical procedure; (iv) receiving position data from a surgical navigation system indicating a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; (v) determining kinematic data for the plurality of time points based on the position data; (vi) analyzing (a) the kinematic data and the instrument data relative to (b) the plurality of surgical performance indicators; and (vii) causing a user interface to output information based on the analysis to provide the surgeon with feedback regarding the performance of the surgical procedure.

[0008] The features, functions, and advantages that have been discussed can be achieved independently in various embodiments or may be combined in yet other embodiments further details of which can be seen with reference to the following description and drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0009] The novel features which are believed to be characteristic of the illustrative embodiments are set forth in the appended claims.However, the illustrative embodiments together with the preferred mode of use, further objects and description will be best understood from the following detailed description of illustrative embodiments of the disclosure read in conjunction with the accompanying drawings.

[0010] Figure 1 A simplified block diagram of a system for evaluating and / or assisting in surgical performance is shown in accordance with an exemplary embodiment.

[0011] Figure 2 A simplified block diagram of a system for evaluating and / or assisting in surgical performance is shown according to another example.

[0012] Figure 3 A first display screen of an application for evaluating and / or assisting in surgical performance is depicted according to an example.

[0013] Figure 4 A second display screen of an application for evaluating and / or assisting in surgical performance is depicted according to an example.

[0014] Figure 5 A third display screen of an application for evaluating and / or assisting in surgical performance is depicted according to an example.

[0015] Figure 6 A fourth display screen of an application for evaluating and / or assisting in surgical performance is depicted according to an example.

[0016] Figure 7A third display screen of an application for evaluating and / or assisting in surgical performance is depicted according to an example.

[0017] Figure 8 A fourth display screen of an application for evaluating and / or assisting in surgical performance is depicted according to an example.

[0018] Figure 9 A flow chart of a method for evaluating surgical performance of a surgical procedure is depicted, according to an example.

[0019] Figure 10 Depicted is a flow chart of a method for evaluating surgical performance of a surgical procedure according to an example.

[0020] Figure 11 Depicted is a flow chart of a method for evaluating surgical performance of a surgical procedure according to an example. DETAILED DESCRIPTION

[0021] The disclosed embodiments will now be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all, disclosed embodiments are shown. Indeed, several different embodiments may be described and these should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are described so that this disclosure will be thorough and complete and will fully convey the scope of this disclosure to those skilled in the art.

[0022] As described above, factors such as surgical skill and / or the surgeon's cognitive load can affect the patient's postoperative outcome after surgery. The present disclosure provides systems and methods that can help assess surgical performance, assist in surgical performance, and / or reduce the surgeon's cognitive load during surgery.

[0023] It is generally accepted that an increase in surgical caseload and years of practice are associated with improved surgical performance, depending on the procedure. However, while surgical expertise is often defined by the number of surgical procedures performed—the surgeon's volume—this number does not always correlate with complication rates, suggesting that it is an inadequate measure of surgical skill. Experience alone may not be sufficient to reduce the risks associated with surgery, and surgical performance cannot be maintained through passive accumulation of experience. Instead, a focus on improving performance throughout a surgeon's career, such as through the use of monitoring tools and structured behavior modification programs, may be beneficial.

[0024] The current standard for evaluating surgeons is peer review, either intraoperatively or postoperatively via video footage. Peer review is prone to bias due to subjectivity and individual differences in the rating process (e.g., surgeons sometimes disagree on what constitutes a "good" procedure). The present disclosure provides a way to quantify surgical technique in a more consistent and objective manner, based at least in part on information measured directly from one or more surgical devices used in the surgical procedure. Determining and / or using surgical performance metrics according to the systems and methods of the present disclosure can reduce subjectivity and bias and can provide objective feedback that is useful to individual surgeons, patients, and / or others (e.g., credentialing and licensing boards).

[0025] In additional or alternative aspects, the present disclosure further provides systems that can use computer-based data analysis and / or machine learning computer algorithms to provide scalable assessments of surgical technique and / or surgical performance. In addition, in examples, information determined by such computer algorithms can be used before, during, and / or after surgery to (i) allow surgeons to obtain personalized feedback on their surgical technique, (ii) train surgeons or surgical team members to perform surgical procedures, (iii) provide patients with information related to the performance of surgical procedures, (iv) plan surgical procedures to be performed, (v) provide predictive analysis and recommendations for surgical techniques for surgical procedures to be performed (e.g., to reduce the occurrence of complications), (vi) provide feedback on how surgical instruments perform during surgical procedures, (vii) provide knowledge sharing tools, and / or (viii) provide memory aids to remind surgeons of clinical choices for particular surgical procedures.

[0026] As described above, the present disclosure additionally or alternatively provides for reducing the cognitive load of a surgeon during a surgical procedure. Current methods for assessing cognitive load primarily rely on self-reporting by surgeons after surgery (e.g., using the NASA-TLX tool or Surg TLX). However, retrospective analysis of cognitive load (i.e., not real-time analysis) may result in a failure to capture intraoperative fluctuations in cognitive load. In some examples, the systems and methods of the present disclosure can help quantify cognitive load in real time and measure its impact at different stages of actual surgery. For example, in some examples, the systems and methods of the present disclosure provide for measuring the level of cognitive load of a surgeon based on information provided by one or more surgeon monitoring devices, which can sense one or more physiological conditions of the surgeon during surgery. In some cases, the physiological conditions sensed by the surgeon monitoring device can additionally provide an indication of the surgeon's psychological condition (e.g., the surgeon's mental state and / or emotional state). For example, the wearable device may include one or more devices selected from smart rings, eye-tracking glasses, belt-based sensors (e.g., chest strap sensors, thigh strap sensors, and calf strap sensors), smart watches, immersive devices (e.g., augmented reality (AR) and extended reality (XR) headsets), and flexible epidermal sensors (e.g., wireless heart rate patch monitors). In some embodiments, the system and method may further provide intraoperative feedback to the surgeon based on the sensed physiological condition of the surgeon to help reduce the surgeon's cognitive load level.

[0027] In an example, the systems and methods of the present disclosure can be applied in non-robotic surgery and / or robotic surgery. In addition, in an example, the systems and methods of the present disclosure can be implemented in one or more surgical fields, including, for example, neurosurgery, spinal surgery, endoscopy, orthopedics, and ear, nose and throat (ENT) / otolaryngology.

[0028] Now refer to Figure 1 , shows a simplified block diagram of a system 100 for determining multiple surgical performance indicators according to an example. Figure 1 As shown, system 100 includes a controller 110 and one or more surgical devices 112 that operate during one or more surgical procedures. In this example, the one or more surgical devices 112 include at least one surgical instrument 114 and at least one surgical navigation system 116. As described in further detail below, in other examples, surgical devices 112 may include additional or alternative devices.

[0029] In general, each surgical instrument 114 is operable to perform a surgical task during a surgical procedure. By way of example, the surgical instruments 114 may include at least one instrument selected from the group consisting of a drill, a bone cutter, an electrosurgical tool, a suction tool, an irrigation tool, a shaver, a microscope, a camera (e.g., an endoscope), a surgical retractor, and a lighting device. Additionally or alternatively, the surgical instruments 114 may include one or more surgical instruments that can perform at least one surgical task selected from the group consisting of: a drilling operation, a cutting operation, a shaving operation, a tissue retraction operation, a suction operation, an irrigation operation, a probing operation, a clamping operation, a coagulation operation, a heating operation, a cooling operation, an ablation operation, an electrical stimulation operation, an image capture operation, a sawing operation, and a grinding operation.

[0030] In an example, one or more of the surgical instruments 114 may include a working element operable to perform at least one surgical task. For example, the working element may include a drill bit, an electrosurgical electrode, an ablation end effector (e.g., a cryoablation balloon, an electrode, a laser emitter, and / or a heating element), a fluid valve, a vacuum source, and a cutting blade. In some examples, the surgical instrument 114 may include one or more user input devices that can be actuated to operate the working element of the surgical instrument 114. For example, the user input device may include one or more devices selected from the group consisting of: one or more buttons, one or more switches, one or more foot pedals, one or more touch screens, one or more dials, one or more triggers, one or more cranks, and one or more suction control ports.

[0031] In some examples, surgical instruments 114 may include one or more handheld devices that a surgeon can grasp, manipulate, and move during a surgical procedure. In other examples, surgical instruments 114 may include one or more stationary devices that remain in a fixed position relative to a patient (and / or operating room) during a surgical procedure. In other examples, surgical instruments 114 may include both handheld and stationary devices. For example, in one example, surgical instruments 114 may include an electrosurgical pencil and an electrosurgical generator, wherein the electrosurgical pencil is grasped and moved by the surgeon, while the electrosurgical generator remains in a fixed position during a surgical procedure.

[0032] In some examples, surgical instrument 114 can be completely operated by the surgeon without robotic assistance. In other examples, surgical instrument 114 can include a partially automated robotic device operated by the surgeon, and / or a fully automated robotic device that performs a surgical procedure based on the surgeon's preoperative programming input to surgical instrument 114.

[0033] like Figure 1As shown, controller 110 may receive instrument data from surgical instrument 114 related to the operation of surgical instrument 114 during a surgical procedure. The instrument data may be based on one or more instrument parameters determined by surgical instrument 114 at various points in time during each surgical procedure.

[0034] In some embodiments, instrument parameters can be sensed by an instrument sensor 118 coupled to the surgical instrument 114. By way of example, the instrument sensor 118 can include one or more sensors selected from the group consisting of: a current sensor, a voltage sensor, an electrical power sensor, a flow sensor configured to detect liquid flow, a flow sensor configured to detect gas flow, a temperature sensor, an accelerometer, a piezoelectric sensor, a force sensor (e.g., a ground reaction force sensor), a vibration sensor, a chemical sensor, an optical sensor, a pressure sensor, a humidity sensor, a position sensor, a Hall effect sensor, a capacitive sensor, and a Doppler flow sensor. In some examples, the instrument sensor 118 can be removably coupled to the housing of the surgical instrument 114. In other examples, the instrument sensor 118 can additionally or alternatively be non-removably coupled to the housing of the surgical instrument 114 (e.g., disposed within an interior cavity of the housing of the surgical instrument 114).

[0035] In other embodiments, the surgical instrument 114 can additionally or alternatively determine instrument parameters independently of the instrument sensor 118. For example, in some embodiments, the surgical instrument 114 can determine instrument parameters based on the settings and / or operating mode of the surgical instrument 114. As an example, in embodiments where the surgical instrument 114 comprises a bone drill, instrument parameters of drilling speed and / or torque can be determined based on a setting selected from a plurality of settings on the surgical instrument 114. As another example, in embodiments where the surgical instrument 114 comprises an electrosurgical pencil and an electrosurgical generator, instrument parameters of the power and waveform of the electrosurgical energy applied to tissue by the electrosurgical pencil can be determined based on a setting selected from a plurality of settings on the electrosurgical generator.

[0036] In general, the surgical navigation system 116 is configured to determine the position of one or more of the surgical instruments 114 relative to the patient's anatomy during a surgical procedure. In some embodiments, the surgical navigation system 116 may additionally or alternatively determine the orientation of the surgical instruments 114 relative to the patient's anatomy. As an example, the surgical navigation system 116 may be configured to determine the position data using at least one surgical navigation modality selected from the group consisting of: (i) electromagnetic surgical navigation, (ii) optical surgical navigation, (iii) ultrasonic surgical navigation, and (iv) machine vision surgical navigation.

[0037] For example, in an embodiment where the surgical navigation system 116 is configured to use electromagnetic surgical navigation, the surgical navigation system 116 can include an electromagnetic field generator and a position sensor. The electromagnetic field generator can be arranged to transmit an electromagnetic field toward the patient's anatomy. The position sensor can include a current sensor (e.g., a sensor coil) that can sense the electromagnetic field and responsively generate a position sensor signal based on one or more characteristics of the electromagnetic field at a given position of the position sensor. In this example, the position sensor can be coupled to the surgical instrument 114 so that the position signal generated by the position sensor indicates the position and / or orientation of the surgical instrument relative to the patient's anatomy.

[0038] In embodiments where the surgical navigation system 116 is configured to use optical surgical navigation, the surgical navigation system 116 may include one or more cameras configured to track one or more fiducial markers coupled to the surgical instrument 114 and / or the patient's anatomy. The fiducial markers may include one or more passive markers (e.g., one or more markers that reflect light) and / or one or more active markers (e.g., one or more markers that emit light).

[0039] In embodiments where the surgical navigation system 116 is configured to use ultrasound surgical navigation, the surgical navigation system 116 may include one or more ultrasound signal transmitters and one or more ultrasound signal detectors coupled to the surgical instrument 114 and / or the patient's anatomy. The ultrasound signal transmitters may transmit ultrasound signals, the ultrasound signal detectors may detect the ultrasound signals transmitted by the ultrasound signal transmitters, and the surgical navigation system 116 may determine position data based on the ultrasound signals transmitted by the ultrasound signal transmitters and the ultrasound signals received by the ultrasound signal detectors (e.g., based on a time of flight between the ultrasound signal transmitters and the ultrasound signal detectors).

[0040] In embodiments where the surgical navigation system 116 is configured to use machine vision for surgical navigation, the surgical navigation system 116 may include one or more light sources and / or one or more cameras. The light sources may illuminate the patient's anatomy and / or the surgical instrument 114. The cameras may capture one or more images of the patient's anatomy and / or the surgical instrument 114 at the surgical site during the surgical procedure. The surgical navigation system 116 may process these images to determine positional data indicating the position of the surgical instrument 114 relative to the patient's anatomy.

[0041] In some examples, surgical navigation system 116 may include one or more position sensors 120 that may be coupled to surgical instrument 114 and / or patient anatomy. Position sensors 120 may be detected by one or more components of surgical navigation system 116 (e.g., via electromagnetic sensing, optical sensing, and / or ultrasonic sensing), and surgical navigation system 116 may determine position data based on the detected position sensors 120. In other examples, surgical navigation system 116 may omit position sensors 120.

[0042] In some examples that include a position sensor 120, the surgical navigation system 116 can include a registration system that is configured to establish a reference frame for the patient anatomy and the position sensor 120 (and therefore the position of the surgical instrument 114 indicated by the position sensor 120). For example, in one embodiment, the position sensor 120 can be tracked along features of the patient anatomy to establish the reference frame. In another embodiment, for example, the surgical navigation system 116 can include one or more touch points on the patient anatomy. At each touch point, the surgical navigation system 116 can register the touch point in space and use the registered touch points to determine a reference frame for the patient anatomy in space (e.g., using a three-dimensional coordinate system). In this way, the position sensor 120 and the patient anatomy can be mapped to a common frame of reference such that the position of the surgical instrument 114 sensed by the position sensor 120 can be associated with the patient anatomy (e.g., mapped in space).

[0043] In some examples, the surgical navigation system 116 can be an image-guided surgery system that is configured to correlate in real time the sensed position of the surgical instrument 114 and one or more images of the patient's anatomy (e.g., preoperative images of the patient's anatomy obtained for the surgical procedure). As an example, the image can be at least one image type selected from the group consisting of a computed tomography (CT) scan, a magnetic resonance imaging (MRI), and a three-dimensional image. In some embodiments where the surgical navigation system 116 is an image-guided surgery system, the surgical navigation system 116 can be configured to provide position data and image data related to the patient's anatomy to the controller 110. In such embodiments, both the image data and the position data can be related to a common reference frame relative to the patient's anatomy. In other embodiments, the surgical navigation system 116 can provide position data to the controller 110 without providing any image data.

[0044] As described above, surgical instrument 114 can provide instrument data to controller 110, and surgical navigation system 116 can provide position data to controller 110. In some examples, surgical instrument 114 and / or surgical navigation system 116 can be communicatively connected to controller 110 via a network. Examples of networks can include one or more of the following: a direct or indirect physical communication connection, a mobile communication network, the Internet, an intranet, a local area network, a wide area network, a storage area network, and any other form of connecting two or more systems, components, or storage devices together.

[0045] The controller 110 is a computing device that is configured to receive data (e.g., instrument data and / or position data) from a surgical device 112 operating during one or more surgical procedures and, based on the data, determine a plurality of surgical performance indicators that are indicative of characteristics of surgical performance. The controller 110 can be implemented using hardware, software, and / or firmware. For example, the controller 110 can include one or more processors 122 and a non-transitory computer-readable medium 124 (e.g., volatile and / or non-volatile memory) that stores machine language instructions or other executable instructions. These instructions, when executed by the one or more processors 122, cause the system 100 to perform the various operations described herein. Thus, the controller 110 can receive data (including data indicated by the surgical instrument 114 and / or the surgical navigation system 116) and store the data in memory.

[0046] The processor 122 and / or the non-transitory computer-readable medium 124 can be implemented in any number of physical devices / machines. For example, the controller 110 can include one or more shared or dedicated general-purpose computer systems / servers. Thus, the principles and advantages of distributed processing, such as redundancy and replication, can be implemented as needed to improve the robustness and performance of the controller 110 device and system.

[0047] The physical device / machine may be implemented by preparing integrated circuits or by interconnecting a network of appropriate conventional component circuits, as understood by those skilled in the electrical arts. For example, the physical device / machine may include a field programmable gate array (FPGA), an application specific integrated circuit (ASIC), a digital signal processor (DSP), etc. The physical device / machine may reside on a wired or wireless network, such as a LAN, a WAN, the Internet, the cloud, near field communication, etc., to communicate with each other and / or with other systems (e.g., Internet / network resources).

[0048] As described above, the controller 110 can receive data from the surgical device 112 operating during one or more surgical procedures and, based on the data, determine a plurality of surgical performance indicators indicative of characteristics of surgical performance. In an example, the non-transitory computer-readable medium 124 stores instructions executable to cause the processor 122 to perform functions including determining a plurality of surgical data sets for a plurality of surgical procedures and determining a plurality of surgical performance indicators indicative of characteristics of surgical performance based on the plurality of surgical data sets.

[0049] In this example, determining multiple surgical data sets may include: for each surgical procedure in the multiple surgical procedures, determining a corresponding surgical data set in the multiple surgical data sets by: (i) receiving instrument data related to the operation of the surgical instrument 114 during the surgical procedure from the surgical instrument 114, wherein the instrument data is based on one or more instrument parameters determined by the surgical instrument 114 at multiple moments during the surgical procedure; (ii) receiving position data from the surgical navigation system 116, the position data indicating the position of the surgical instrument 114 relative to the patient's anatomy at the multiple time points during the surgical procedure; (iii) determining kinematic data for the multiple time points based on at least one of the position data or the instrument data; and (iv) associating the instrument data, position data, and kinematic data for each of the multiple time points to determine a corresponding surgical data set for the surgical procedure.

[0050] By way of example, the kinematic data may include data on one or more kinematic parameters selected from the group consisting of: (i) the trajectory of the surgical instrument 114, (ii) the velocity of the surgical instrument 114, (iii) the motion of the surgical instrument 114 in three-dimensional space, (iv) the inertia of the surgical instrument 114, (v) the acceleration of the surgical instrument 114, (vi) the tremor of the surgical instrument 114 (e.g., movement resulting from interaction between the surgical instrument 114 and the patient's anatomy, e.g., the surgical instrument 114 bouncing off the patient's bone); The kinematic data may include information regarding the movement of the surgical instrument 114 relative to the patient's anatomy, (i) the movement of the surgical instrument 114 relative to the patient's anatomy, (ii) the movement of the surgical instrument 114 relative to the patient's anatomy, (iii) the movement of the surgical instrument 114 relative to the patient's anatomy, (iv) the movement of the surgical instrument 114 relative to the patient's anatomy, (v) the movement of the surgical instrument 114 relative to the patient's anatomy, (vii) jitter of the surgical instrument 114, e.g., due to an unsteady hand of the surgeon, (ix) the smoothness of the movement of the surgical instrument 114 (e.g., jerkiness of the movement of the surgical instrument 114 due to relatively rapid starts and stops and / or relatively rapid changes in direction of movement), (x) the forces applied by the surgical instrument 114 to the patient's anatomy at the surgical site, (xi) deviations in movement relative to the preoperatively planned path of the surgical instrument 114, and (xii) the operating location of the surgical instrument 114 relative to the preoperatively planned target site. Thus, the kinematic data may include information regarding intentional movement of the surgical instrument 114 relative to the patient's anatomy by the surgeon, unintentional movement of the surgical instrument 114 relative to the patient's anatomy by the surgeon, and / or movement of the surgical instrument 114 due to interaction with the patient's anatomy.

[0051] As described above, the processor 122 can associate the instrument data, position data, and kinematic data at the multiple time points with each other. In one example, the processor 122 can associate the instrument data, position data, and kinematic data with each other based on time information (e.g., timestamp information) provided by the surgical instrument 114 and the surgical navigation system 116. Compared to considering these data separately, the time synchronization of the instrument data, position data, and kinematic data can enable each surgical data set to more completely represent how the surgeon uses the surgical instrument 114 and / or the performance of the surgical instrument 114 itself during the surgical procedure. In addition, because the underlying data of the surgical data set is obtained from the surgical device 112 used to perform the surgical procedure, the processor 122 can determine surgical performance indicators based on objective data, which can provide a more consistent and superior basis for evaluating and characterizing surgical performance compared to previous methods (e.g., based on subjective peer review of video clips).

[0052] In some examples, the processor 122 may analyze the surgical data set using descriptive analysis, diagnostic analysis, predictive analysis, and / or prescriptive analysis to determine surgical performance indicators. For example, the processor 122 may analyze the surgical data set to identify patterns in surgical techniques (e.g., indicated by instrument data, position data, and kinematic data) that are predictors of clinical outcomes. In some examples, the processor 122 may additionally or alternatively determine the surgical performance indicators by using the surgical data set as training data for a machine learning algorithm. Because the surgical performance indicators are determined at least in part based on surgical data sets from multiple surgical procedures, the processor 122 may analyze the surgical data sets from the multiple surgical procedures to obtain insights that may be useful for future surgical procedures. In fact, as described in further detail below, surgical performance indicators can provide a basis for preoperative planning of future surgical procedures, providing intraoperative feedback to the surgeon during the surgical procedure, and / or providing postoperative feedback to the surgeon and / or patient regarding the performance of the surgical procedure.

[0053] In some examples, determining a surgical performance indicator can include: (i) detecting the occurrence of a surgical event during one or more surgical procedures in each surgical procedure based on a surgical dataset, (ii) identifying one or more portions of the surgical dataset that indicate a cause of the surgical event, and (iii) determining the surgical performance indicator based on the one or more portions of the surgical dataset identified as indicating a cause of the surgical event. As an example, the surgical event can be at least one event selected from the group consisting of: (i) vibration of the surgical instrument 114, (ii) an entanglement event (e.g., gauze and / or tissue entangled in a rotating element of the surgical instrument 114), (iii) overheating of the surgical instrument 114, and (iv) proximity of the surgical instrument to a critical anatomical structure. In such examples, the surgical performance indicator can provide information that can help better understand characteristics of surgical performance that may increase and / or decrease the risk of a surgical event. This information can help plan future surgical procedures before surgery, provide intraoperative feedback to the surgeon during surgery, and / or provide postoperative information to provide feedback on the performance of the surgical procedure.

[0054] As described above, surgical performance indicators indicate characteristics of surgical performance. In one example, a surgical performance indicator may include one or more threshold values ​​that define an expected range of values ​​for at least one of: (i) one or more instrument parameters of instrument data, or (ii) one or more kinematic parameters of kinematic data. In some embodiments, the threshold values ​​may be communicated to the surgeon preoperatively to provide guidance for performing future surgical procedures, may be communicated to the surgeon intraoperatively to provide real-time feedback to the surgeon during the surgical procedure, and / or may be communicated to the surgeon postoperatively to provide feedback to the surgeon regarding when the surgeon exceeded the threshold value and / or deviated from the threshold value during the surgical procedure. Other uses of surgical performance indicators including threshold values ​​will be described in more detail below.

[0055] In another example, a surgical performance indicator may additionally or alternatively define a scoring system for evaluating instrument data, position data, and kinematic data of at least one surgical procedure selected from a plurality of surgical procedures. For example, in one embodiment, the surgical performance indicator may define data for comparison with the instrument data, position data, and / or kinematic data of the surgical procedure to be scored. The surgical performance indicator may further define one or more scores that may be based on a comparison between the surgical performance indicator and the instrument data, position data, and / or kinematic data of the surgical procedure to be scored.

[0056] In another example, the surgical performance index may additionally or alternatively define a classification system for classifying multiple types of surgical techniques. For example, the multiple types of surgical techniques may include two or more types selected from the group consisting of: (i) an aggressive approach for surgical performance, (ii) a conservative approach for surgical performance, (iii) a more sedate approach for surgical performance, (iv) an abrupt approach for surgical performance, (v) a relatively fast approach for surgical performance (e.g., a shorter time to perform the surgical procedure), and (vi) a relatively slow approach for surgical performance.

[0057] In another example, surgical performance indicators may additionally or alternatively be provided for determining multiple reference fingerprints. For example, the controller 110 may use one or more dimensionality reduction techniques to identify, extract, and summarize features of the surgical technique into a unique identifier. In an example, the controller 110 may also be configured to provide suggestions and / or guidance related to the surgical technique, the setting of the surgical instrument 114, the selection of a subset of the surgical instrument 114 from a plurality of surgical instruments 114, and / or the selection of a working element of the surgical instrument 114 from a plurality of working elements based on the reference fingerprints. For example, the controller 110 may be configured to determine a query fingerprint for the surgeon based on one or more surgical procedures performed by a particular surgeon, compare the query fingerprint with the reference fingerprints, identify the reference fingerprint that is closest to the query fingerprint, and provide information associated with the identified reference fingerprint to the surgeon before and / or during the surgery to facilitate the surgical procedure.

[0058] In some embodiments, the surgical instrument 114 and the surgical navigation system 116 can be a single surgical instrument 114 and a single surgical navigation system 116 that are used throughout all surgical procedures. For example, surgical procedures can be performed in a single location (e.g., in a single operating room) using a reusable surgical instrument 114 and a reusable surgical navigation system 116. In other embodiments, a different surgical instrument 114 and / or a different surgical navigation system 116 can be used during each surgical procedure. For example, instrument data can be obtained from the surgical instrument 114 and / or position data can be obtained from the surgical navigation system 116 at multiple different locations. Additionally or alternatively, for example, the surgical instrument 114 and / or the surgical navigation system 116 can be a disposable device that is intended to be discarded after use in a single surgical procedure.

[0059] In the above examples, the controller 110 can determine surgical performance indicators based on the instrument data and the position data. In other examples, the controller 110 can evaluate and / or assist in surgical performance based on additional or alternative information sources.

[0060] Figure 2 A simplified schematic diagram of a system 200 according to another example is shown, which includes one or more additional surgical devices 112 and / or one or more data sources 226. Figure 2 As shown, the system 200 includes a controller 110 and a surgical device 112, as described above with respect to Figure 1 As described. Figure 2 In the embodiment, the controller 110 includes a processor 122 and a non-transitory computer readable medium 124, and the surgical device 112 may include a surgical instrument 114 and a surgical navigation system 116, as described above with respect to Figure 1 described.

[0061] In addition, if Figure 2 As shown, data sources 226 may include one or more data sources selected from the group consisting of: a result data source 228, a surgeon history data source 230, and a patient-specific data source 232. The data sources 226 may be communicatively connected to the controller 110 (e.g., via the network described above with respect to the surgical instrument 114, the surgical navigation system 116, and the controller 110). The processor 122 may use the data provided by the data sources 226 and the surgical dataset to determine surgical performance indicators.

[0062] In an example where a result data source 228 is included, the result data source 228 may store result data related to postoperative outcomes of surgical procedures. In such an example, the processor 122 may additionally or alternatively receive corresponding result data related to the postoperative outcomes of each surgical procedure, and the processor 122 may further determine a plurality of surgical performance indicators based on the corresponding result data. For example, the result data may include an indication of at least one postoperative outcome selected from the group consisting of: (i) patient-reported pain score, (ii) length of stay, (iii) postoperative complications, (iv) functional recovery, (v) relief of symptoms, and (vi) mortality. Determining surgical performance indicators based on the surgical datasets and the result data associated with each surgical dataset can help identify aspects of the instrument data, position data, and kinematic data (which can be indicative of surgical technique) that may lead to positive and / or negative surgical outcomes. This, in turn, can help determine surgical performance indicators that can provide actionable insights to the surgeon.

[0063] In an example including a surgeon historical data source 230, the historical surgeon data source may store historical surgeon data. In such an example, for each of a plurality of surgical procedures, the processor 122 may additionally or alternatively receive historical surgeon data associated with one or more surgical procedures previously performed by the surgeon performing the surgical procedure, and the processor 122 may further determine a surgical performance metric based on the historical surgeon data. By way of example, the historical surgeon data may include at least one item of information selected from the group consisting of: number of surgical procedures performed in the past, types of surgical procedures performed in the past, years of experience, number of hours of surgery performed by the surgeon, surgeon certification, and average time to complete surgical procedures. Determining surgical performance metrics based on surgical datasets and the historical surgeon data associated with each surgical dataset may also help identify aspects of instrument data, positional data, and kinematic data that may contribute to positive and / or negative surgical outcomes for surgical procedures performed by surgeons with a certain level of experience and / or surgical tendencies. As described in further detail below, the historical surgeon data may additionally or alternatively be used to determine surgical performance metrics based on preoperative information provided for future surgical procedures to be performed by a particular surgeon.

[0064] In an example including a patient-specific data source 232, the patient-specific data source may store patient-specific data related to one or more health records of a patient undergoing a surgical procedure. In such an example, for each surgical procedure in a plurality of surgical procedures, the processor 122 may additionally or alternatively receive patient-specific data related to one or more health records of a patient undergoing the surgical procedure, and the processor 122 may further determine a surgical performance indicator based on the patient-specific data. For example, the patient-specific data may include at least one item of information selected from the group consisting of: age, sex, height, weight, bone density, body mass index, allergy indications, patient medical history, demographic data, family health history, laboratory and test results, medications, previous diagnoses, progress notes, medical images (e.g., radiographic images, CT images, and / or MRI images), immunizations, patient-reported outcome measures (PROMs), information related to the nature of the patient's medical condition (e.g., characteristics of cellular tissue and / or bone). Determining surgical performance indicators based on surgical datasets and patient-specific data associated with each surgical dataset can also help identify aspects of instrument data, positional data, and kinematic data that may lead to favorable surgical outcomes and / or unfavorable surgical outcomes for patients with certain medical histories and / or health conditions. As described in further detail below, patient-specific data can additionally or alternatively be used to determine surgical performance indicators based on preoperative information provided for future surgical performances performed on a particular patient.

[0065] As described above, in some examples, the processor 122 can receive image data associated with the patient's anatomy from the surgical navigation system 116. In other examples, the processor 122 can additionally or alternatively receive image data from the patient-specific data source 232. Both the image data received from the patient-specific data source 232 and the position data received from the surgical navigation system can be relative to a common reference frame relative to the patient's anatomy. For example, the image data received from the patient-specific data source can be generated using a registration system separate from the surgical navigation system 116.

[0066] like Figure 2 As shown, the surgical device 112 may additionally or alternatively include one or more patient monitoring devices 234 in communication with the controller 110. The patient monitoring device 234 may determine patient physiological data related to the patient's physiological condition at multiple time points during the surgical procedure. As an example, the patient physiological data may relate to at least one physiological parameter selected from the group consisting of: (i) the patient's heart rate, (ii) the patient's respiratory rate, (iii) the patient's body temperature, (iv) the patient's blood pressure, and (v) the patient's blood oxygen saturation. Figure 2 As shown, patient monitoring device 234 may include one or more patient sensors 236 configured to sense physiological parameters.

[0067] In an example including one or more patient monitoring devices 234, for each of a plurality of surgical procedures, the processor 122 may receive patient physiological data related to the patient's physiological condition at a plurality of time points during the surgical procedure. Furthermore, for each of the plurality of surgical procedures, the processor 122 may determine a corresponding surgical dataset by correlating the instrument data, position data, kinematic data, and patient physiological data for each of the plurality of time points to determine a corresponding surgical dataset for the surgical procedure.

[0068] like Figure 2 As shown, the surgical device 112 may additionally or alternatively include one or more surgeon monitoring devices 238 in communication with the controller 110. The surgeon monitoring device 238 may determine surgeon physiological data related to the surgeon's physiological condition at multiple points in time during the surgical procedure. As an example, the surgeon's physiological data may relate to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's respiratory rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) a measure of the surgeon's pupil dilation, (vi) a measure of the surgeon's eye gaze, (vii) a measure of the surgeon's glances, and (viii) a measure of the surgeon's body movement. Figure 2As shown, the surgeon monitoring device 234 may include one or more surgeon sensors 240 configured to sense physiological parameters. As an example, the surgeon monitoring device 238 may include wearable sensors that contact the surgeon's skin (e.g., Oura rings and / or belt-based sensors) and / or wearable sensors that can monitor the surgeon's eyes (e.g., glasses with eye tracking capabilities).

[0069] In an example including one or more surgeon monitoring devices 238, for each of a plurality of surgical procedures, the processor 122 may receive surgeon physiological data related to the surgeon's physiological condition at a plurality of time points during the surgical procedure. Furthermore, for each of the plurality of surgical procedures, the processor 122 may determine a corresponding surgical dataset by correlating the instrument data, position data, kinematic data, and surgeon physiological data at each of the plurality of time points to determine a corresponding surgical dataset for the surgical procedure. By determining surgical performance indicators based on the surgical datasets including the surgeon physiological data, the surgical performance indicators may provide insights into how the surgeon physiological data may impact patient outcomes.

[0070] The surgeon physiological data may additionally or alternatively provide an indication of the cognitive load of the surgeon performing the surgical procedure. As described in further detail below, the processor 122 may use the surgeon physiological data to determine when the surgeon's cognitive load is high and provide feedback accordingly to help reduce the cognitive load.

[0071] In other examples, one or more of the surgeon monitoring devices 238 can be coupled to the surgeon, and at least one of the surgeon monitoring devices 238 can be coupled to one or more other members of the surgical team. In such examples, the surgeon monitoring devices 238 can determine surgeon physiological data related to the physiological condition of the surgeon and the other members of the surgical team at multiple points in time during the surgical procedure, as described above.

[0072] Additionally, as described above, in some cases, the physiological condition sensed by the surgeon monitoring device may also provide an indication of the surgeon's psychological condition. Thus, in an example, determining surgical performance indicators based on a surgical dataset that includes the surgeon's physiological data may also provide insights into how the surgeon's and / or other members of the surgical team's psychological or emotional state may affect patient outcomes.

[0073] like Figure 2As shown, the system 200 may additionally or alternatively include a user interface 242 that can receive one or more inputs from a user and / or provide one or more outputs to the user. By way of example, the user interface 242 may include one or more buttons, one or more switches, one or more dials, one or more keyboards, one or more touch screens, one or more display devices 244, one or more indicator lights, one or more speakers, and / or one or more tactile output devices. The user interface 242 is communicatively coupled to the controller 110.

[0074] As described above, the controller 110 can determine surgical performance indicators to provide the surgeon and / or patient with preoperative, intraoperative, and / or postoperative information related to one or more surgical procedures. Example implementations of providing preoperative, intraoperative, and / or postoperative information of a surgical procedure to the surgeon and / or patient are described below.

[0075] In one example, the processor 122 can receive preoperative information for a surgical procedure to be performed. The processor 122 can receive the preoperative information from, for example, the user interface 242 and / or the data source 226. The preoperative information can include patient-specific data for the patient of the surgical procedure to be performed and / or historical surgeon data for the surgeon of the surgical procedure to be performed. The preoperative information can additionally or alternatively include surgeon preference data 246 related to one or more preferences of the surgeon who will perform the surgical procedure. As an example, the surgeon preference data 246 can include one or more preferences selected from the group consisting of: (i) preferences related to the type of surgical instrument 114, (ii) preferences related to the setup of the surgical instrument 114, (iii) preferences related to the manner in which the surgical instrument 114 is held or gripped, and (iv) preferences for the order in which the steps of performing the surgical procedure are to be performed.

[0076] Processor 122 can use preoperative information to determine a plurality of surgical performance indicators. For example, processor 122 can be configured to use preoperative information and a surgical dataset as input to determine surgical performance indicators. In this manner, surgical performance indicators can be tailored to the specific circumstances of the surgical procedure being performed, compared to implementations that do not use preoperative information as input.

[0077] Processor 122 may receive instrument data from surgical instrument 114 relating to the operation of surgical instrument 114 at multiple points in time during the surgical procedure. Processor 122 may also receive position data from surgical navigation system 116 indicating the position of the surgical instrument relative to the patient's anatomy at multiple points in time during the surgical procedure. Processor 122 may determine kinematic data for the multiple points in time based on the position data. Processor 122 may then analyze (i) the kinematic data and the instrument data with respect to (ii) multiple surgical performance indicators.

[0078] The processor 122 may cause the user interface 242 to output information based on the analysis to provide the surgeon with feedback regarding the performance of the surgical procedure. The user interface 242 may output information via a display device 244, a speaker, an indicator light, and / or a tactile device. Figure 3-8 Examples of information that may be displayed on display device 244 are shown and described.

[0079] In some embodiments, the processor 122 can determine multiple surgical performance indicators and output information before the surgery. For example, the processor 122 can determine a surgical plan for performing the surgical procedure based on the preoperative information and / or the surgical performance indicators. The processor 122 can cause the user interface 242 to output information related to the surgical plan. As an example, the surgical plan can include at least one item of information selected from the group consisting of: (i) a preoperatively planned route for movement of the surgical instrument 114 and / or surgical implant, (ii) a target position for actuating the surgical instrument 114, (iii) selection of the surgical instrument 114 from a plurality of potential surgical instruments 114, and (iv) potential complications that may be encountered.

[0080] In some embodiments, the processor 122 can additionally or alternatively perform analysis and cause the user interface 242 to output information in real time during the surgical procedure. For example, the user interface 242 can output at least one item of information selected from the group consisting of: (i) a prediction of an adverse event (e.g., damage to a critical anatomical structure), (ii) an alert regarding poor performance of the surgical instrument 114, (iii) an alert regarding deviation from the preoperative plan, and (iv) an alert regarding poor psychological and / or physiological status of the surgeon and / or surgical team. This can help provide real-time feedback, thereby helping to improve surgical performance during the surgical procedure.

[0081] In some embodiments including a surgeon monitoring device 238, the processor 122 can receive surgeon physiological data related to the physiological condition of a surgeon performing a surgical procedure. The processor 122 can also determine, based on the surgeon physiological data, that the surgeon's cognitive load is greater than a threshold amount of cognitive load. In response to determining that the surgeon's cognitive load is greater than the threshold amount of cognitive load, the processor 122 can cause the user interface 242 to output this information. In some examples, the information output by the user interface 242 can include instrument guidance information for operating a surgical instrument based on a plurality of surgical performance indicators. In other examples, the information output by the user interface 242 can additionally or alternatively include kinematic guidance for navigating the surgical instrument 114 based on a plurality of surgical performance indicators.

[0082] In some embodiments, the processor 122 can additionally or alternatively perform analysis and cause the user interface 242 to output information post-operatively. For example, the user interface 242 can provide information for a post-operative review of the surgeon's surgical performance during the surgical procedure.

[0083] In another example, processor 122 may additionally or alternatively determine and / or repeatedly update a surgical performance indicator based on instrument data, position data, and / or kinematic data received during the surgical procedure. For example, in another example, processor 122 may receive instrument data from surgical instrument 114 related to the operation of surgical instrument 114 at multiple points in time during the surgical procedure. Processor 122 may also receive position data from surgical navigation system 116 indicating the position of surgical instrument 114 relative to the patient's anatomy at multiple points in time during the surgical procedure. Processor 122 may determine kinematic data for the multiple points in time based on the position data and use the instrument data and kinematic data to determine a surgical performance indicator indicative of characteristics of surgical performance. Processor 122 may also analyze (i) the kinematic data and instrument data relative to (ii) multiple surgical performance indicators. Processor 122 may also cause user interface 242 to output information based on the analysis to provide the surgeon with feedback regarding the performance of the surgical procedure. As described above, processor 122 may cause user interface 242 to output the information before, during, and / or after the procedure. In embodiments where the processor 122 can cause the user interface 242 to output information intraoperatively, the processor 122 can determine surgical performance indicators, perform analysis, and cause the user interface to output information in real time intraoperatively during the surgical procedure. The processor 122 can also additionally or alternatively cause the user interface 242 to output information in response to the processor 122 determining that the cognitive load level is greater than a cognitive load threshold amount, as described above.

[0084] In some examples, processor 122 may additionally or alternatively cause surgical instrument 114 to automatically adjust one or more instrument parameters based on instrument data, position data, kinematic data, surgeon physiological data, patient physiological data received during the surgical procedure, and / or surgical performance indicators. For example, processor 122 may cause surgical instrument 114 to adjust motor speed, motor rotation direction, motor torque, motor temperature, motor current, motor power consumption, electrosurgical current, electrosurgical voltage, electrosurgical waveform, electrosurgical impedance (e.g., resistance encountered by surgical instrument 114 when cutting / aspirating / coagulating tissue), irrigation flow rate, aspiration flow rate, depth control (e.g., depth level of screw placement and / or cutting depth), and camera visibility settings (e.g., lighting intensity, white balance settings, image magnification settings, focus settings, image enhancement functions, and / or air and water insufflation settings) during surgery. For example, this can help automatically adjust the operation of the surgical instrument 114 to (i) guide the surgical procedure toward surgical performance indicators, (ii) reduce risks associated with high cognitive load, and / or (iii) reduce risks associated with changes in patient condition during the surgical procedure.

[0085] In one embodiment, the processor 122 may analyze (i) the kinematic data and the instrument data relative to (ii) a plurality of surgical performance indicators. The processor 122 may also determine adjustments to instrument parameters based on the analysis and responsively cause the surgical instrument 114 to adjust one or more instrument parameters in accordance with the adjustments to the instrument parameters.

[0086] In some embodiments, processor 122 may additionally or alternatively receive surgeon physiological data related to the physiological condition of the surgeon performing the surgical procedure. Processor 122 may determine, based on the surgeon physiological data, that the surgeon's cognitive load is greater than a threshold amount of cognitive load. In response to determining that the surgeon's cognitive load is greater than the threshold amount of cognitive load, processor 122 may cause surgical instrument 114 to adjust one or more instrument parameters.

[0087] In some examples, the processor 122 and the user interface 242 can be configured to allow the surgeon and / or the institution (e.g., the surgeon's employer and / or the hospital administrator at which the surgeon has practicing privileges) to set one or more goals for surgical performance. For example, the processor 122 can additionally or alternatively be configured to receive surgical performance goal data related to one or more goals for surgical performance from the user interface 242. As an example, the one or more goals for surgical performance can include one or more goals selected from the group consisting of: (i) a goal to understand the surgeon's surgical technique, (ii) a goal to understand operating room workflow management, (iii) a goal to improve safety related to surgical technique, (iv) a goal to achieve a balance between safety and effectiveness, (v) a goal to understand the surgical outcomes of surgical procedures performed by the surgeon, (vi) a goal to reduce complication rates, (vii) a goal to obtain continuing professional development (CPD) credits, (viii) a goal to train operating room staff, (ix) a goal to understand patient factors, (x) a goal to reduce wear and tear on the surgeon's body, and / or (xi) a goal to learn and improve surgical skills.

[0088] The user interface 242 can receive user input selecting one or more of the surgical performance goals and communicate the user input to the processor 122. In some embodiments, the processor 122 can determine surgical performance goal data based on the user input. The processor 122 can also set and / or adjust surgical performance indicators based on the surgical performance goal data. In such embodiments, the surgical performance goals can help fine-tune the surgical performance indicators and guide current and / or future surgical performance toward the surgeon's and / or institution's desired values.

[0089] In some embodiments, the processor 122 can additionally or alternatively be configured to provide information to the surgeon before, during, and / or after surgery based on surgical performance metrics. In such embodiments, the processor 122 can use surgical performance target data to determine what information to provide, when to provide it, and how to provide it to the surgeon to facilitate the surgeon's progress toward a surgical performance target (e.g., a surgical performance target selected via the user interface 242). Accordingly, the processor 122 can (i) analyze one or more datasets as described above (e.g., instrument data, position data, kinematic data, outcome data, historical surgeon data, patient-specific data, image data, patient physiological data, and / or surgeon physiological data), and (ii) determine, based on the analysis and the surgical performance target data, information that can be output to the surgeon via the user interface 242. In this example, for a given dataset, the processor 122 is configured to cause the user interface 242 to output a first set of information for a first surgical performance target data and a second set of information for a second surgical performance target data, wherein the first surgical performance target data is different from the second surgical performance target data, and the first set of information is different from the second set of information.

[0090] In some embodiments, the processor 122 and the user interface 242 can be configured to provide information showing progress toward surgical performance goals and / or deficiencies in progress toward surgical performance goals. This can help the surgeon and / or the institution better understand the surgeon's performance and where the surgeon may wish to focus their attention to further improve performance.

[0091] Now refer to Figure 3 , shows a display screen 350 of an application for evaluating and / or assisting surgical performance according to an example. Figure 3 As shown, the display screen 350 may include a summary of historical surgeon data for a particular surgeon. For example, the display screen 350 may include a first indication 352A of the number of surgical procedures performed within a given timeframe and / or a second indication 352B of the average amount of time to complete that number of surgical procedures. The display screen 350 may also include a first link 354A to upcoming surgical procedures that the surgeon is about to perform, a second link 354B to past surgeries that the surgeon has previously performed, and / or a third link 354C to personalized insights based on analysis of surgical data sets associated with the surgeon and surgical performance indicators determined by the processor 122.

[0092] Now refer to Figure 4 , shows a display screen 450 of an application for evaluating and / or assisting surgical performance according to another example. Figure 4In FIG, the processor 122 causes the user interface 242 to display a graphical depiction of at least one of the instrument data, position data, or kinematic data over time. For example, in FIG. Figure 4 , display screen 450 includes a respective identifier 456A- 456E for each surgical instrument 114 and graphical depictions 458A- 458E of instrument data for surgical instruments 114 relative to an axis 460 indicating a plurality of points in time during the surgical procedure.

[0093] In this example, the display screen 450 includes: a first identifier 456A of the drill corresponding to the first graphical depiction 458A of the instrument data of the drill; a second identifier 456B of the camera corresponding to the second graphical depiction 458B of the instrument data of the camera; a third identifier 456C of the aspirator corresponding to the third graphical depiction 458C of the instrument data of the aspirator; a fourth identifier 456D of the bipolar electrosurgical device corresponding to the fourth graphical depiction 458D of the instrument data of the bipolar electrosurgical device; and a fifth identifier 456E of the suction device corresponding to the fifth graphical depiction 458E of the instrument data of the suction device.

[0094] exist Figure 4 In the embodiment of the present invention, the plurality of surgical performance indicators define one or more expected value ranges of at least one of: (i) one or more instrument parameters of the instrument data, or (ii) one or more kinematic parameters of the kinematic data. Figure 4 As shown, the processor 122 may cause the user interface to display an indication 462 indicating that a portion of the instrument data falls outside of at least one of the one or more expected value ranges defined by the plurality of surgical performance indicators.

[0095] like Figure 4 As shown, the processor 122 may additionally or alternatively cause the user interface 242 to display a link 464A to a pre-operative image of the anatomical structure of the surgical site and / or to display a link 464B to a post-operative image of the anatomical structure.

[0096] although Figure 4 Graphical depictions 458A458E of the instrument data and an indication that the instrument data is outside of an expected range of values ​​are displayed, but in other examples, the processor 122 may cause the user interface 242 to display a graphical depiction of the kinematic data and / or an indication that a portion of the kinematic data is outside of at least one of one or more expected ranges of values ​​defined by a plurality of surgical performance indicators.

[0097] Now refer to Figure 5 , shows a display screen 550 of an application for evaluating and / or assisting surgical performance according to an example. Figure 5, display screen 550 includes a plurality of indicators 556A-556C that correspond to respective graphical depictions 558A-558C of instrument parameters indicated by the instrument data at a plurality of points in time during the surgical procedure (eg, indicated by axis 560).

[0098] exist Figure 5 In the embodiment, the plurality of surgical performance indicators define one or more expected value ranges of at least one of: (i) one or more instrument parameters of the instrument data, or (ii) one or more kinematic parameters of the kinematic data. Figure 5 As shown, processor 122 may cause the user interface to display an indication 562 that a portion of the instrument data is outside of at least one of one or more expected value ranges defined by the plurality of surgical performance indicators.

[0099] In addition, Figure 5 In the embodiment of the present invention, the processor 122 can cause the user interface 242 to display an animation 564 of the movement of the surgical instrument 114 superimposed on the image of the anatomical structure based on the position and kinematic data. In one example, the animation 564 can include multiple colors, and each color can be based on the kinematic data. For example, the colors can provide a color-coded indication of the kinematic data, such that N ranges of kinematic data values ​​are each indicated by N colors, where N is an integer value greater than two. In one example embodiment, the smoothness of movement of a first range can be represented by a first color, the smoothness of movement of a second range can be represented by a second color, and the smoothness of movement of an nth range can be represented by an nth color, where n is an integer value greater than two.

[0100] In addition, if Figure 5 As shown, in embodiments where the kinematic data involves multiple kinematic parameters, the processor 122 may associate the kinematic parameters at multiple time points with each other. Similarly, in embodiments where the instrument data involves multiple instrument parameters, the processor 122 may associate the instrument parameters at each time point with each other.

[0101] exist Figure 5 In the illustrated example, the instrument data relates to speed, vibration, and current of surgical instrument 114. In another example, the instrument data may relate to operation of a motor of surgical instrument 114. The instrument data may relate to one or more instrument parameters selected from the group consisting of motor speed, motor torque, motor temperature, motor current, and motor power consumption.

[0102] Now refer to Figure 6 , shows a display screen 650 of an application for evaluating and / or assisting surgical performance according to an example. Figure 6In FIG, the processor 122 may cause the user interface 242 to display the amount of deviation between (i) the actual position of the device implanted by the surgical instrument 114 and (ii) the preoperatively planned position of the device to be implanted by the surgical instrument 114. Figure 6 , the processor 122 may cause the user interface to display an indication 666 of a threshold amount of deviation defined by the plurality of surgical performance indicators.

[0103] Now refer to Figure 7 , shows a display screen 750 of an application for evaluating and / or assisting surgical performance according to another example. Figure 7 , the processor 122 may cause the user interface 242 to simultaneously display (i) an animation 768 of the surgical procedure, and (ii) a graphical depiction of at least one of instrument data, position data, or kinematic data of the surgical procedure over time.

[0104] For example, in Figure 7 , the display screen 750 includes a plurality of indicators 756A-756C corresponding to respective graphical depictions 758A-758C. In this example, the graphical depictions 758A-758C include (i) a first graphical depiction 758A of the acceleration of the tip of the surgical instrument 114 indicated by the kinematic data at a plurality of points in time, (ii) a second graphical depiction 758B of the force indicated by the instrument data (e.g., the force measured by the force sensor) at a plurality of points in time, and (iii) the revolutions per minute (RPM) of the working element of the surgical instrument 114 (e.g., a drill bit) at a plurality of points in time. Figure 7 As shown, processor 122 can be configured to play animation 768 and display graphical depictions 758A-758C in a time-synchronized manner so that display screen 750 can provide an indication of how surgical instrument 114 is operating at each point in time throughout the surgical procedure.

[0105] like Figure 7 As shown, animation 768 may include an animated object representing the surgical instrument 114 and an animated object representing the patient's anatomical structure. In some examples, the processor 122 may determine the object representing the patient's anatomical structure based on image data related to the patient's anatomical structure. For example, as described above, the processor 122 may receive image data related to the patient's anatomical structure from the surgical navigation system 116 and / or the patient-specific data source 232, and the processor 122 may determine the animated object representing the anatomical structure based on the image data. Compared to other examples in which the animated object representing the anatomical structure is a general representation of the anatomical structure, this may provide a more realistic and / or more accurate visualization of the surgical procedure. However, in other examples, the animated object representing the anatomical structure may be a general representation of the anatomical structure. For example, this helps to reduce the computational load on the processor 122.

[0106] In some examples, the processor 122 can determine the animation 768 based on the instrument data, position data, and kinematic data of the surgical procedure. Thus, the animation 768 can depict (i) the relative position, orientation, and / or motion of the surgical instrument 114 relative to the patient's anatomy, (ii) the actuation of the surgical instrument 114, and / or (iii) the interaction between the surgical instrument 114 and the patient's anatomy at multiple points in time during the surgical procedure. In such an example, the animation 768 can be specific to the procedure performed by the physician practitioner, rather than a generic animation. Furthermore, this can help provide improved visualization of the use of the surgical instrument 114 and / or surgical technique. However, in other examples, the animation 768 can be a generic animation displayed for all executions of a particular type of surgical procedure. For example, this can help reduce the computational load on the processor 122.

[0107] In some examples, display screen 750 may also include surgical performance indicators displayed on animation 768. For example, processor 112 may cause display screen 750 to include a tool tip trajectory that is color-coded based on the smoothness of movement of surgical instrument 114, as one example.

[0108] In addition, Figure 7 In the embodiment of the present invention, the processor 122 may cause the display screen 750 to display text 770, which may provide the surgeon with technical advice related to the performance of the surgical procedure as feedback. Figure 7 In the example, displayed text 770 provides technical advice related to the operating technique of surgical instrument 114. In another example, displayed text 770 may provide technical advice related to recommendations for using different surgical instruments 114 and / or different working elements on surgical instrument 114. Processor 122 may determine the text and technical advice based on one or more analyses of instrument data, position data, kinematic data, and / or surgical performance indicators.

[0109] Now refer to Figure 8 , shows a display screen 850 of an application for evaluating and / or assisting surgical performance according to another example. Figure 8 In FIG. 8 , the processor 122 may cause the user interface 242 to simultaneously display (i) an animation 768 of the surgical procedure, and (ii) a video 872 recorded by the image capture device during the surgical procedure. Figure 8 As shown, processor 122 can be configured to play animation 768 and display video 872 in a time-synchronized manner so that display screen 850 can provide instructions on how to operate surgical instrument 114 at each point in time throughout the surgical procedure.

[0110] exist Figure 8In the example embodiment, the image capture device is located outside the surgical site, so that the video 872 depicts the hands and / or body of the physician practitioner from outside the surgical site. In contrast, the animation 768 can show how the surgical instrument 114 interacts with the patient's anatomy within the surgical site. In this way, the video 872 can help show how the physician practitioner grasps the surgical instrument, moves the surgical instrument, and / or actuates the surgical instrument in a manner that is time-synchronized with the animation 768, demonstrating the effects produced within the surgical site. This can help provide additional or alternative insights into the surgical techniques used during the surgical procedure.

[0111] In other examples, the image capture device can be one of the surgical instruments 114 to capture video from within the surgical site. For example, the video can be captured by an endoscope, surgical microscope, and / or exoscope. In such an example, displaying the animation 768 in a time-synchronized manner with the video 872 can help the physician practitioner review the surgical procedure in conjunction with the actual view of the surgical site that the physician practitioner would have had available during the surgical procedure.

[0112] Now refer to Figure 9 , according to an example, a flow chart of a process 900 for evaluating surgical performance is shown. Figure 9 As shown, process 900 includes determining a plurality of surgical data sets for a plurality of surgical procedures at block 910, and determining a plurality of surgical performance indicators indicative of characteristics of surgical performance based on the plurality of surgical data sets at block 912. Determining the plurality of surgical data sets at block 910 may include, for each surgical procedure in the plurality of surgical procedures, determining a corresponding surgical data set from the plurality of surgical data sets by: (i) receiving instrument data related to operation of the surgical instrument during the surgical procedure at block 914, wherein the instrument data is based on one or more instrument parameters determined for the surgical instrument at a plurality of time points during the surgical procedure, (ii) receiving position data from a surgical navigation system at block 916, wherein the position data indicates a position of the surgical instrument relative to a patient anatomy at a plurality of time points during the surgical procedure, (iii) determining kinematic data for the plurality of time points based on at least one of the position data or the instrument data at block 918, and (iv) correlating the instrument data, the position data, and the kinematic data for each of the plurality of time points to determine a corresponding surgical data set for the surgical procedure at block 920.

[0113] Now refer to Figure 10 According to another example, a process 1000 for evaluating surgical performance is shown. Figure 10As shown, process 1000 includes: (i) at block 1010, receiving instrument data related to the operation of the surgical instrument at multiple time points during the surgical procedure from a surgical instrument; (ii) at block 1012, receiving position data from a surgical navigation system, the position data indicating the position of the surgical instrument relative to the patient's anatomy at multiple time points during the surgical procedure; (iii) at block 1014, determining kinematic data for the multiple time points based on the position data; (iv) at block 1016, using the instrument data and the kinematic data to determine multiple surgical performance indicators indicative of characteristics of surgical performance; (v) at block 1018, analyzing (a) the kinematic data and the instrument data relative to (b) multiple surgical performance indicators; and (vi) at block 1020, based on the analysis, causing a user interface to output information to provide the surgeon with feedback related to the performance of the surgical procedure.

[0114] Now refer to Figure 11 According to another example, a process 1100 for evaluating surgical performance is shown. Figure 11 As shown, process 1100 includes: (i) at block 1110, receiving preoperative information about a surgical procedure to be performed, (ii) at block 1112, determining a plurality of surgical performance indicators using the preoperative information, (iii) at block 1114, receiving instrument data from a surgical instrument related to operation of the surgical instrument at a plurality of time points during the surgical procedure, (iv) at block 1116, receiving position data from a surgical navigation system indicating the position of the surgical instrument relative to the patient's anatomy at a plurality of time points during the surgical procedure, (v) at block 1118, determining kinematic data for the plurality of time points based on the position data, (vi) at block 1120, analyzing (a) the kinematic data and the instrument data relative to (b) the plurality of surgical performance indicators, and (vii) at block 1122, causing a user interface to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure.

[0115] Figure 9-11Any block shown in can represent a module, segment or part of program code, which includes one or more instructions executable by a processor for implementing a specific logical function or step in a process. The program code can be stored on any type of computer-readable medium or data storage, for example, a storage device including a disk or hard disk. In addition, the program code can be encoded in a machine-readable format on a computer-readable storage medium, or encoded on other non-transitory media or products. The computer-readable medium may include a non-transitory computer-readable medium or memory, for example, a computer-readable medium that stores data in a short period of time such as a register memory, a processor cache and a random access memory (RAM). The computer-readable medium may also include a non-transitory medium, such as a secondary or persistent long-term memory, such as a read-only memory (ROM), an optical disc or disk, or a compact disc read-only memory (CD-ROM). The computer-readable medium may also be any other volatile or non-volatile storage system. For example, a computer-readable medium may be considered to be a tangible computer-readable storage medium.

[0116] In some cases, components of the devices and / or systems described herein may be configured to perform a function such that the components are actually configured and constructed (using hardware and / or software) to achieve such performance. Example configurations include instructions executed by one or more processors to cause the system to perform a function. Similarly, components of a device and / or system may be configured to be arranged or adapted to, capable of, or suitable for performing a function, such as when operating in a particular manner.

[0117] The description of various advantageous arrangements has been provided for purposes of illustration and description and is not intended to be exhaustive or limited to the embodiments in the disclosed form. Many modifications and variations will be apparent to those skilled in the art. Furthermore, different advantageous embodiments may exhibit different advantages over other advantageous embodiments. The selected embodiments have been chosen and described in order to explain the principles of the embodiments, their practical application, and to enable others skilled in the art to understand the disclosure of various modifications of the various embodiments as may be appropriate for the particular application contemplated.

Claims

1. A non-transitory computer-readable medium having stored therein instructions, the instructions being executable to cause a processor to perform functions comprising: Determining a plurality of surgical data sets for a plurality of surgical procedures, wherein determining the plurality of surgical data sets comprises, for each surgical procedure in the plurality of surgical procedures, determining a corresponding surgical data set of the plurality of surgical data sets by: receiving instrument data from the surgical instrument related to operation of the surgical instrument during the surgical procedure, wherein the instrument data is based on one or more instrument parameters determined for the surgical instrument at a plurality of points in time during the surgical procedure; receiving, from a surgical navigation system, position data indicating the position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data for the plurality of time points based on at least one of the position data or the instrument data, and for each of the plurality of time points, correlating the instrument data, the position data, and the kinematic data to determine a corresponding surgical dataset for the surgical procedure; as well as A plurality of surgical performance indicators indicative of characteristics of surgical performance are determined based on the plurality of surgical data sets.

2. The non-transitory computer-readable medium of claim 1, wherein: Determining the plurality of surgical performance indicators includes using the plurality of surgical datasets as training data for a machine learning algorithm.

3. The non-transitory computer-readable medium according to any one of claims 1 to 2, wherein: The instructions can be executed to cause the processor to perform functions including: receiving image data related to the patient's anatomy from a surgical navigation system, Therein, both image data and position data are related to a common reference frame relative to the patient anatomy.

4. The non-transitory computer-readable medium according to any one of claims 1 to 3, wherein: The surgical navigation system is configured to determine position data using at least one surgical navigation modality selected from the group consisting of: (i) electromagnetic surgical navigation, (ii) optical surgical navigation, (iii) ultrasound surgical navigation, and (iv) machine vision surgical navigation.

5. The non-transitory computer-readable medium according to any one of claims 1 to 4, wherein: The instructions can be executed to cause the processor to perform functions including: For each surgical procedure, receiving corresponding outcome data related to a postoperative outcome of the surgical procedure, Wherein, determining the plurality of surgical performance indicators is further based on the corresponding result data.

6. The non-transitory computer-readable medium according to any one of claims 1 to 5, wherein: The kinematic data includes data of one or more kinematic parameters selected from the group consisting of: (i) the trajectory of the surgical instrument, (ii) the velocity of the surgical instrument, (iii) the movement of the surgical instrument in three-dimensional space, (iv) the inertia of the surgical instrument, (v) the acceleration of the surgical instrument, (vi) the vibration of the surgical instrument, (vii) the shaking of the surgical instrument due to the unstable hand of the surgeon, (ix) the smoothness of the movement of the surgical instrument, (x) the force applied by the surgical instrument to the patient's anatomical structure at the surgical site, (xi) the movement deviation relative to the preoperatively planned path of the surgical instrument, and (xii) the operating position of the surgical instrument relative to the preoperatively planned target site.

7. The non-transitory computer-readable medium according to any one of claims 1 to 6, wherein: The instrument data relates to the operation of a motor of the surgical instrument.

8. The non-transitory computer-readable medium of claim 7, wherein: The machine data relates to one or more machine parameters selected from the group consisting of motor speed, motor torque, motor temperature, motor current, and motor power consumption.

9. The non-transitory computer-readable medium of claim 8, wherein: The one or more instrument parameters include a plurality of instrument parameters, and Wherein, the processor is configured to associate the plurality of instrument parameters with each other at the plurality of time points.

10. The non-transitory computer-readable medium according to any one of claims 1 to 9, wherein: The surgical instrument includes at least one instrument selected from the group consisting of: a drill, a bone cutter, an electrosurgical tool, a suction tool, an irrigation tool, a shaver, a microscope, a camera, a surgical retractor, and a lighting device.

11. The non-transitory computer-readable medium according to any one of claims 1 to 10, wherein: The surgical instrument includes an instrument sensor coupled to the surgical instrument, wherein the instrument sensor includes one or more sensors selected from the group consisting of: an accelerometer, a ground reaction force sensor, a flow sensor configured to detect liquid flow, a flow sensor configured to detect gas flow, an electrical power sensor, a temperature sensor, a piezoelectric sensor, a vibration sensor, a chemical sensor, an optical sensor, a pressure sensor, a humidity sensor, a position sensor, a Hall effect sensor, a capacitive sensor, and a Doppler flow sensor.

12. The non-transitory computer-readable medium according to any one of claims 1 to 11, wherein: The instructions can be executed to cause the processor to perform functions including: For each surgical procedure of the plurality of surgical procedures, receiving patient-specific data associated with one or more health records of a patient undergoing the surgical procedure, Wherein, determining the plurality of surgical performance indicators is further based on the patient-specific data.

13. The non-transitory computer-readable medium according to any one of claims 1 to 12, wherein: The instructions can be executed to cause the processor to perform functions including: For each surgical procedure in the plurality of surgical procedures, receiving historical surgeon data associated with one or more surgical procedures performed in the past by the surgeon performing the surgical procedure; and Wherein determining the plurality of surgical performance indicators is further based on the historical surgeon data.

14. The non-transitory computer-readable medium according to any one of claims 1 to 13, wherein: The instructions can be executed to cause the processor to perform functions including: receiving, for each surgical procedure of the plurality of surgical procedures, surgeon physiological data associated with a physiological condition of a surgeon performing the surgical procedure at the plurality of time points, Wherein, for each of the multiple surgical operations, determining the corresponding surgical data set includes, for each of the multiple time points, associating instrument data, position data, kinematic data and surgeon physiological data to determine the corresponding surgical data set for the surgical operation.

15. The non-transitory computer-readable medium of claim 14, wherein: The surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's breathing rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) a measurement of the surgeon's pupil dilation, (vi) a measurement of the surgeon's eye gaze, (vii) a measurement of the surgeon's glances, and (viii) a measurement of the surgeon's body movement.

16. The non-transitory computer-readable medium of any one of claims 1 to 15, wherein: The instructions can be executed to cause the processor to perform functions including: receiving, for each of the plurality of surgical procedures, patient physiological data associated with the patient's physiological condition at a plurality of points in time during the surgical procedure, Wherein, for each of the multiple surgical operations, determining the corresponding surgical data set includes: for each of the multiple time points, associating instrument data, position data, kinematic data and patient physiological data to determine the corresponding surgical data set for the surgical operation.

17. The non-transitory computer-readable medium of claim 16, wherein: The patient physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the patient's heart rate, (ii) the patient's respiratory rate, (iii) the patient's body temperature, (iv) the patient's blood pressure, and (v) the patient's blood oxygen saturation.

18. The non-transitory computer-readable medium of any one of claims 1 to 17, wherein: Determining the plurality of surgical performance indicators includes: detecting, based on the plurality of surgical data sets, an occurrence of a surgical event during one or more surgical procedures of the plurality of surgical procedures; and identifying one or more portions of the surgical dataset that indicate a cause of the surgical event; and The plurality of surgical performance indicators are determined based on the one or more portions of the surgical dataset identified as indicative of a cause of the occurrence of the surgical event.

19. The non-transitory computer-readable medium of claim 18, wherein: The surgical event is at least one event selected from the group consisting of: (i) vibration of the surgical instrument, (ii) entanglement, (iii) overheating of the surgical instrument, and (iv) proximity of the surgical instrument to a critical anatomical structure.

20. The non-transitory computer-readable medium of any one of claims 1-19, wherein: The instructions can be executed to cause the processor to perform functions including: Receive preoperative information about future surgical procedures to be performed; and A surgical plan for performing the future surgical procedure is determined based on the preoperative information and the plurality of surgical performance indicators.

21. The non-transitory computer-readable medium of any one of claims 1-20, wherein: The plurality of surgical performance indicators include one or more threshold values ​​defining an expected value range for at least one of: (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data.

22. The non-transitory computer-readable medium of any one of claims 1-20, wherein: The plurality of surgical performance indicators define a scoring system for evaluating instrument data, position data, and kinematic data of at least one surgical procedure selected from the plurality of surgical procedures.

23. A non-transitory computer-readable medium having stored therein instructions executable to cause a processor to perform functions comprising: receiving instrument data from the surgical instrument relating to operation of the surgical instrument at a plurality of points in time during the surgical procedure; receiving position data from a surgical navigation system indicating the position of a surgical instrument relative to anatomy of a patient at a plurality of points in time during the surgical procedure; determining kinematic data for the plurality of time points based on the position data; determining a plurality of surgical performance indicators indicative of characteristics of surgical performance using the instrumentation data and the kinematic data; analyzing (i) the kinematic data and the instrument data relative to (ii) the plurality of surgical performance indicators; and The user interface is caused to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure.

24. The non-transitory computer readable medium of claim 23, wherein: Determining the plurality of surgical performance indicators includes using the instrument data and the kinematic data as input to a machine learning algorithm that has been trained on a plurality of surgical datasets, wherein each surgical dataset includes corresponding instrument data and corresponding kinematic data for a corresponding surgical procedure performed in the past.

25. The non-transitory computer-readable medium of any one of claims 23-24, wherein: Causing the user interface to output information based on the analysis is performed postoperatively after the surgical procedure is completed.

26. The non-transitory computer readable medium of claim 25, wherein: Causing the user interface to output information includes displaying on a display device a graphical depiction of at least one of the instrument data, the position data, or the kinematic data over time.

27. The non-transitory computer readable medium of claim 26, wherein: The plurality of surgical performance indicators define one or more expected value ranges for at least one of (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data.

28. The non-transitory computer readable medium of claim 27, wherein: The display information also includes an indication that a portion of the instrument data falls outside of at least one of the one or more expected value ranges defined by the plurality of surgical performance indicators.

29. The non-transitory computer-readable medium of claim 27, wherein: The display information further includes displaying an indication that a portion of the kinematic data falls outside of at least one of the one or more expected value ranges defined by the plurality of surgical performance indicators.

30. The non-transitory computer-readable medium of any one of claims 27-29, wherein: The displayed information also includes a link to a pre-operative image of an anatomical structure of the surgical site and a link to a post-operative image of the anatomical structure.

31. The non-transitory computer-readable medium of any one of claims 27-30, wherein: The display information also includes animations showing surgical instrument movement superimposed on the image of the anatomy based on the positional and kinematic data.

32. The non-transitory computer-readable medium of any one of claims 23-31, wherein: The displayed information also includes displaying an amount of deviation between (i) an actual position of a device implanted by the surgical instrument and (ii) a preoperatively planned position of the device to be implanted by the surgical instrument.

33. The non-transitory computer readable medium of claim 32, wherein: The display information also includes displaying an indication of a threshold amount of deviation defined by the plurality of surgical performance indicators.

34. The non-transitory computer-readable medium of claim 23, wherein: Determining the plurality of surgical performance indicators, performing the analysis, and causing the user interface to output information are performed intraoperatively and in real time during the surgical procedure.

35. The non-transitory computer readable medium of claim 34, wherein: The instructions can be executed to cause the processor to perform functions including: receiving surgeon physiological data related to the physiological condition of the surgeon performing the surgical procedure from a surgeon monitoring device; and determining that the surgeon's cognitive load is greater than a threshold amount of cognitive load based on the surgeon physiological data, Wherein, outputting the information is in response to determining that the cognitive load of the surgeon is greater than a threshold amount of cognitive load.

36. The non-transitory computer readable medium of claim 35, wherein: The surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's breathing rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) a measurement of the surgeon's pupil dilation, (vi) a measurement of the surgeon's eye gaze, (vii) a measurement of the surgeon's glances, and (viii) a measurement of the surgeon's body movement.

37. The non-transitory computer-readable medium of any one of claims 34-36, wherein: The information output by the user interface includes instrument guidance information for operating the surgical instrument based on the multiple surgical performance indicators.

38. The non-transitory computer-readable medium of any one of claims 34-37, wherein: The information output by the user interface includes kinematic guidance for navigating the surgical instrument based on the plurality of surgical performance indicators.

39. A non-transitory computer-readable medium having stored therein instructions executable to cause a processor to perform functions comprising: receiving preoperative information regarding the surgical procedure to be performed; determining a plurality of surgical performance indicators using the preoperative information; receiving instrument data from the surgical instrument relating to operation of the surgical instrument at a plurality of points in time during the surgical procedure; receiving position data from a surgical navigation system indicating the position of a surgical instrument relative to anatomy of a patient at a plurality of points in time during the surgical procedure; determining kinematic data for the plurality of time points based on the position data; analyzing (i) the kinematic data and the instrumentation data relative to (ii) the plurality of surgical performance indicators; and The user interface is caused to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure.

40. The non-transitory computer readable medium of claim 39, wherein: Determining the plurality of surgical performance indicators includes using the instrument data and the kinematic data as input to a machine learning algorithm that has been trained on a plurality of surgical datasets, wherein each surgical dataset includes corresponding instrument data and corresponding kinematic data for a corresponding surgical procedure performed in the past.

41. The non-transitory computer-readable medium of any one of claims 39-40, wherein: The pre-operative information includes patient-specific data related to one or more health records of a patient undergoing the surgical procedure.

42. The non-transitory computer readable medium of claim 41, wherein: The corresponding patient-specific data includes images of the anatomical structure captured prior to the surgical procedure.

43. The non-transitory computer-readable medium of any one of claims 41-42, wherein: The pre-operative information includes historical surgeon data related to one or more surgical procedures performed in the past by the surgeon performing the surgical procedure.

44. The non-transitory computer-readable medium of any one of claims 41-43, wherein: The pre-operative information includes surgeon preference data related to one or more preferences for performing the surgical procedure.

45. A method for evaluating surgical performance, comprising: Determining a plurality of surgical data sets for a plurality of surgical procedures, wherein determining the plurality of surgical data sets comprises: for each surgical procedure in the plurality of surgical procedures, determining a corresponding surgical data set in the plurality of surgical data sets by: receiving instrument data from a surgical instrument related to operation of the surgical instrument during a surgical procedure, wherein the instrument data is based on one or more instrument parameters determined for the surgical instrument at a plurality of points in time during the surgical procedure; receiving position data from a surgical navigation system indicating the position of a surgical instrument relative to anatomy of the patient at a plurality of points in time during the surgical procedure; determining kinematic data for the plurality of time points based on at least one of the position data or the instrument data; and For each of the multiple time points, the instrument data, position data and kinematic data are associated to determine a corresponding surgical data set for the surgical operation; and multiple surgical performance indicators indicating characteristics of the surgical performance are determined based on the multiple surgical data sets.

46. ​​A method for evaluating surgical performance, comprising: receiving instrument data from the surgical instrument relating to operation of the surgical instrument at a plurality of points in time during the surgical procedure; receiving position data from a surgical navigation system indicating the position of a surgical instrument relative to anatomy of a patient at a plurality of points in time during the surgical procedure; determining kinematic data for the plurality of time points based on the position data; determining a plurality of surgical performance indicators indicative of characteristics of surgical performance using the instrumentation data and the kinematic data; analyzing (i) the kinematic data and the instrument data relative to (ii) the plurality of surgical performance indicators; and The user interface is caused to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure.

47. A method for evaluating surgical performance, comprising: receiving preoperative information regarding the surgical procedure to be performed; Use preoperative information to determine multiple surgical performance indicators; receiving instrument data from the surgical instrument relating to operation of the surgical instrument at a plurality of points in time during the surgical procedure; receiving position data from a surgical navigation system indicating the position of a surgical instrument relative to anatomy of a patient at a plurality of points in time during the surgical procedure; determining kinematic data for the plurality of time points based on the position data; analyzing (i) the kinematic data and the instrumentation data relative to (ii) the plurality of surgical performance indicators; and The user interface is caused to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure.

48. The method according to any one of claims 45 to 47, wherein Determining the plurality of surgical performance indicators includes using the plurality of surgical datasets as training data for a machine learning algorithm.

49. The method according to any one of claims 45 to 48, wherein The instructions can be executed to cause the processor to perform functions including: receiving image data related to the patient's anatomy from a surgical navigation system, Wherein the image data and position data are both associated with a common reference frame relative to the patient anatomy.

50. The method according to any one of claims 45 to 49, wherein The surgical navigation system is configured to determine position data using at least one surgical navigation modality selected from the group consisting of: (i) electromagnetic surgical navigation, (ii) optical surgical navigation, (iii) ultrasound surgical navigation, and (iv) machine vision surgical navigation.

51. The method according to any one of claims 45 to 50, wherein: The instructions can be executed to cause the processor to perform functions including: For each surgical procedure, receiving corresponding outcome data related to a postoperative outcome of the surgical procedure, Wherein, determining the plurality of surgical performance indicators is further based on the corresponding result data.

52. The method according to any one of claims 45 to 51, wherein The kinematic data includes data of one or more kinematic parameters selected from the group consisting of: (i) the trajectory of the surgical instrument, (ii) the velocity of the surgical instrument, (iii) the movement of the surgical instrument in three-dimensional space, (iv) the inertia of the surgical instrument, (v) the acceleration of the surgical instrument, (vi) the vibration of the surgical instrument, (vii) the shaking of the surgical instrument due to the unstable hand of the surgeon, (ix) the smoothness of the movement of the surgical instrument, (x) the force applied by the surgical instrument to the patient's anatomical structure at the surgical site, (xi) the movement deviation relative to the preoperatively planned path of the surgical instrument, and (xii) the operating position of the surgical instrument relative to the preoperatively planned target site.

53. The method according to any one of claims 45 to 52, wherein: The instrument data relates to the operation of a motor of the surgical instrument.

54. The method of claim 53, wherein: The machine data relates to one or more machine parameters selected from the group consisting of motor speed, motor torque, motor temperature, motor current, and motor power consumption.

55. The method of claim 54, wherein The one or more instrument parameters include a plurality of instrument parameters, and Wherein, the processor is configured to associate the plurality of instrument parameters with each other at the plurality of time points.

56. The method according to any one of claims 45 to 55, wherein The surgical instrument includes at least one instrument selected from the group consisting of: a drill, a bone cutter, an electrosurgical tool, a suction tool, an irrigation tool, a shaver, a microscope, a camera, a surgical retractor, and a lighting device.

57. The method according to any one of claims 45 to 56, wherein The surgical instrument includes an instrument sensor coupled to the surgical instrument, wherein the instrument sensor includes one or more sensors selected from the group consisting of: an accelerometer, a ground reaction force sensor, a flow sensor configured to detect liquid flow, a flow sensor configured to detect gas flow, an electrical power sensor, a temperature sensor, a piezoelectric sensor, a vibration sensor, a chemical sensor, an optical sensor, a pressure sensor, a humidity sensor, a position sensor, a Hall effect sensor, a capacitive sensor, and a Doppler flow sensor.

58. The method according to any one of claims 45 to 57, wherein The instructions can be executed to cause the processor to perform functions including: For each surgical procedure of the plurality of surgical procedures, receiving patient-specific data associated with one or more health records of a patient undergoing the surgical procedure, Wherein, determining the plurality of surgical performance indicators is further based on the patient-specific data.

59. The method according to any one of claims 45 to 58, wherein The instructions can be executed to cause the processor to perform functions including: For each surgical procedure in the plurality of surgical procedures, receiving historical surgeon data associated with one or more surgical procedures performed in the past by the surgeon performing the surgical procedure; and Wherein, determining the plurality of surgical performance indicators is further based on the historical surgeon data.

60. The method according to any one of claims 45 to 59, wherein The instructions can be executed to cause the processor to perform functions including: receiving, for each surgical procedure of the plurality of surgical procedures, surgeon physiological data associated with a physiological condition of a surgeon performing the surgical procedure at the plurality of time points, Wherein, for each of the multiple surgical operations, determining the corresponding surgical data set includes, for each of the multiple time points, associating instrument data, position data, kinematic data and surgeon physiological data to determine the corresponding surgical data set for the surgical operation.

61. The method of claim 60, wherein: The surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's breathing rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) a measurement of the surgeon's pupil dilation, (vi) a measurement of the surgeon's eye gaze, (vii) a measurement of the surgeon's glances, and (viii) a measurement of the surgeon's body movement.

62. The method according to any one of claims 45 to 61, wherein The instructions can be executed to cause the processor to perform functions including: receiving, for each of the plurality of surgical procedures, patient physiological data associated with the patient's physiological condition at a plurality of points in time during the surgical procedure, Wherein, for each of the multiple surgical operations, determining the corresponding surgical data set includes: for each of the multiple time points, associating instrument data, position data, kinematic data and patient physiological data to determine the corresponding surgical data set for the surgical operation.

63. The method of claim 62, wherein the patient physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the patient's heart rate, (ii) the patient's respiratory rate, (iii) the patient's body temperature, (iv) the patient's blood pressure, and (v) the patient's blood oxygen saturation.

64. The method according to any one of claims 45 to 63, wherein Determining the plurality of surgical performance indicators includes: detecting, based on the plurality of surgical datasets, an occurrence of a surgical event during one or more surgical procedures of the plurality of surgical procedures; identifying one or more portions of the surgical dataset that indicate a cause of the surgical event; and The plurality of surgical performance indicators are determined based on the one or more portions of the surgical dataset identified as indicative of a cause of the occurrence of the surgical event.

65. The method of claim 64, wherein The surgical event is at least one event selected from the group consisting of: (i) vibration of the surgical instrument, (ii) entanglement, (iii) overheating of the surgical instrument, and (iv) proximity of the surgical instrument to a critical anatomical structure.

66. The method according to any one of claims 45 to 65, wherein The instructions can be executed to cause the processor to perform functions including: Receive preoperative information about future surgical procedures to be performed; and A surgical plan for performing the future surgical procedure is determined based on the preoperative information and the plurality of surgical performance indicators.

67. The method according to any one of claims 45 to 66, wherein The plurality of surgical performance indicators include one or more threshold values ​​defining an expected value range for at least one of: (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data.

68. The method according to any one of claims 45 to 67, wherein The plurality of surgical performance indicators define a scoring system for evaluating instrument data, position data, and kinematic data of at least one surgical procedure selected from the plurality of surgical procedures.

69. The method according to any one of claims 45 to 68, wherein Determining the plurality of surgical performance indicators includes using the instrument data and the kinematic data as input to a machine learning algorithm that has been trained on a plurality of surgical datasets, wherein each surgical dataset includes corresponding instrument data and corresponding kinematic data for a corresponding surgical procedure performed in the past.

70. The method according to any one of claims 46 to 69, wherein Causing the user interface to output information based on the analysis is performed postoperatively after the surgical procedure is completed.

71. The method according to claim 70, wherein Causing the user interface to output information includes displaying on a display device a graphical depiction of at least one of the instrument data, the position data, or the kinematic data over time.

72. The method of claim 71, wherein The plurality of surgical performance indicators define one or more expected value ranges for at least one of (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data.

73. The method of claim 72, wherein: The display information also includes an indication that a portion of the instrument data falls outside of at least one of the one or more expected value ranges defined by the plurality of surgical performance indicators.

74. The method of claim 72, wherein The display information further includes displaying an indication that a portion of the kinematic data falls outside of at least one of the one or more expected value ranges defined by the plurality of surgical performance indicators.

75. The method according to any one of claims 72 to 74, wherein The displayed information also includes a link to a pre-operative image of an anatomical structure of the surgical site and a link to a post-operative image of the anatomical structure.

76. The method of any one of claims 72-75, wherein The display information also includes animations showing surgical instrument movement superimposed on the image of the anatomy based on the positional and kinematic data.

77. The method according to any one of claims 45 to 76, wherein The displayed information also includes displaying an amount of deviation between (i) an actual position of a device implanted by the surgical instrument and (ii) a preoperatively planned position of the device to be implanted by the surgical instrument.

78. The method of claim 77, wherein The display information also includes displaying an indication of a threshold amount of deviation defined by the plurality of surgical performance indicators.

79. The method according to any one of claims 46 to 78, wherein Determining the plurality of surgical performance indicators, performing the analysis, and causing the user interface to output information are performed intraoperatively and in real time during the surgical procedure.

80. The method according to any one of claims 45 to 79, wherein The instructions can be executed to cause the processor to perform functions including: receiving surgeon physiological data related to the physiological condition of the surgeon performing the surgical procedure from a surgeon monitoring device; and determining that the surgeon's cognitive load is greater than a threshold amount of cognitive load based on the surgeon physiological data, Wherein, outputting the information is in response to determining that the cognitive load of the surgeon is greater than a threshold amount of cognitive load.

81. The method of claim 80, wherein The surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's breathing rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) a measurement of the surgeon's pupil dilation, (vi) a measurement of the surgeon's eye gaze, (vii) a measurement of the surgeon's glances, and (viii) a measurement of the surgeon's body movement.

82. The method of any one of claims 79 to 81, wherein The information output by the user interface includes instrument guidance information for operating the surgical instrument based on the multiple surgical performance indicators.

83. The method according to any one of claims 79 to 82, wherein The information output by the user interface includes kinematic guidance for navigating the surgical instrument based on a plurality of surgical performance indicators.

84. The method according to any one of claims 47 to 83, wherein The information output by the user interface includes kinematic guidance for navigating the surgical instrument based on the plurality of surgical performance indicators.

85. The method of claim 84, wherein The patient-specific data includes images of anatomical structures captured prior to the surgical procedure.

86. The method according to any one of claims 84-85, wherein The pre-operative information includes historical surgeon data related to one or more surgical procedures performed in the past by the surgeon performing the surgical procedure.

87. The method according to any one of claims 84 to 86, wherein The pre-operative information includes surgeon preference data related to one or more preferences for performing the surgical procedure.

88. The method of any one of claims 46-87, further comprising causing the surgical instrument to automatically adjust one or more instrument parameters based on at least one data selected from the group consisting of instrument data, position data, and kinematic data.

89. The method of claim 88, wherein The one or more instrument parameters include at least one parameter selected from the group consisting of: motor speed, motor rotation direction, motor torque, motor temperature, motor current, motor power consumption, electrosurgical current, electrosurgical voltage, electrosurgical waveform, electrosurgical impedance, irrigation flow rate, aspiration flow rate, depth control, and camera visibility setting.

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