Surgical robotic system

Abstract

This application relates to a surgical robotic system. Apparatus, systems, and methods for providing degrees of freedom to a conduit associated with a robotic surgical system are disclosed. The surgical robotic system can be configured to have six degrees of freedom associated with vertical lift, rotation about the shoulder, rotation about the elbow, roll of the forearm, pitch of the end effector, and rotation of the conduit independent of the end effector. The robotic surgical system allows an instrument in the conduit to be properly oriented to a surgical site of a patient along a trajectory.

Description

[0001] Cross-reference to related applications

[0002] This application is a continuation-in-part of U.S. Patent Application No. 17 / 098,958, filed November 16, 2020, which is a continuation-in-part of U.S. Patent Application No. 15 / 652,914 (now US10,874,466), filed July 18, 2017; a continuation-in-part of U.S. Patent Application No. 15 / 371,304 (now US10,646,280), filed December 7, 2016; a continuation-in-part of U.S. Patent Application No. 15 / 157,444 (published as U.S. Patent Publication No. 2016-0256225), filed May 18, 2016; and a continuation-in-part of U.S. Patent Application No. 15 / 095,883 (now US10,874,466), filed April 11, 2016. The entire contents of the following patent applications are incorporated herein by reference: 10,893,912), which is a continuation-in-part of U.S. Patent Application No. 14 / 062,707 (now US10,357,184), filed October 24, 2013; 13 / 924,505 (now US9,782,229), filed June 21, 2013; and a non-provisional patent application claiming priority to U.S. Provisional Patent Application No. 61 / 662,702 (now expired), filed June 21, 2012, and U.S. Provisional Patent Application No. 61 / 800,527 (now expired), filed March 15, 2013. Technical Field

[0003] This disclosure relates to improved tool insertion using robot-assisted surgical techniques. Background Technology

[0004] Various medical protocols require precise three-dimensional positioning of surgical instruments within the body for optimal treatment. Robotic surgical systems can possess five degrees of freedom to facilitate accurate positioning of surgical instruments relative to the body. These five degrees of freedom, from the base of the robotic surgical system to the end effector, include: (1) vertical linear motion, (2) shoulder rotation in the horizontal plane, (3) elbow rotation in the horizontal plane, (4) forearm rolling, and (5) pitch of the end effector. Utilizing these five degrees of freedom, the robotic surgical system can be moved to a range of positions and angles where catheters can be secured to allow for the placement of screws and other linearly oriented devices within the body.

[0005] These five degrees of freedom allow the end effector's catheter to align with the trajectory vector, but the rotational position of the catheter about the trajectory vector may not be selectable independently, but rather depends on the position of these other joints. When using five degrees of freedom in this configuration, the robot's linear movement toward the patient is typically associated with some residual rotation of the catheter during movement.

[0006] The disadvantages of a five-degree-of-freedom robotic system may include: the robot's inability to move the catheter along a fixed trajectory without residual rotation around the catheter, its inability to provide active rotational motion to perform surgical tasks (such as drilling or inserting screws), and its inability to automatically orient the cutting blade while keeping the catheter perpendicular to the surface.

[0007] Therefore, additional degrees of freedom are needed for the catheters associated with a five-degree-of-freedom surgical robotic system. As described in this disclosure, this can be achieved using robot-assisted surgical techniques. Summary of the Invention

[0008] To meet these and other needs, devices, systems and methods for automatically rotating catheters have been provided.

[0009] According to one exemplary embodiment, a surgical robot system has a robot base, a robot arm connected to and electronically communicating with the robot base, and an end effector connected to and electronically communicating with the robot arm and the robot base. The end effector includes a catheter configured to receive surgical instruments. The catheter is configured to automatically rotate about a central axis of the catheter as the robot arm and the end effector move along a trajectory to a surgical site.

[0010] According to one exemplary embodiment, a method of moving a surgical robotic system relative to a patient. The method includes registering the surgical robotic system to the patient's anatomical structure. The surgical robotic system includes a robotic base, a robotic arm connected to and electronically communicating with the robotic base, and an end effector connected to and electronically communicating with the robotic arm and the robotic base. The end effector includes a catheter and is configured to receive surgical instruments. The catheter is configured to automatically rotate about a central axis of the catheter as the robotic arm and the end effector move along a trajectory. The method further includes moving the robotic arm and the end effector along the trajectory to the patient's anatomical structure. Attached Figure Description

[0011] The following detailed description of the present invention and certain embodiments thereof can be understood with reference to the following drawings:

[0012] Figure 1 It is a top view of the potential layout for the positions of robotic systems, patients, surgeons and other medical personnel during surgical procedures;

[0013] Figure 2 A robotic system comprising a surgical robot and a camera for positioning relative to a patient, according to one embodiment, is shown.

[0014] Figure 3 A surgical robot system according to an exemplary embodiment is shown;

[0015] Figure 4 A portion of a surgical robot according to an exemplary embodiment is shown;

[0016] Figure 5 A block diagram of a surgical robot according to an exemplary embodiment is shown;

[0017] Figure 6 A surgical robot according to an exemplary embodiment is shown;

[0018] Figures 7A to 7C An end effector according to an exemplary embodiment is shown;

[0019] Figure 8 The surgical instrument and the end effector are shown before and after insertion of the surgical instrument into the end effector according to one embodiment;

[0020] Figures 9A to 9C Parts of an end effector and a robotic arm according to an exemplary embodiment are shown;

[0021] Figure 10 A dynamic reference array, imaging array, and other components according to an exemplary embodiment are shown;

[0022] Figure 11 A registration method according to an exemplary implementation is illustrated;

[0023] Figures 12A to 12B An embodiment of an imaging apparatus according to an exemplary embodiment is shown;

[0024] Figure 13 This illustrates certain forces applied to the target bone from surgical instruments;

[0025] Figure 14 An end effector of a robot system conforming to the principles of this disclosure is shown; and

[0026] Figure 15 An exemplary method for detecting accidental movement of surgical instruments, conforming to this disclosure, is shown.

[0027] Figure 16 An exemplary method for detecting the deflection of surgical instruments is shown.

[0028] Figure 17A two-bar method for detecting the deflection of an instrument relative to a catheter is shown.

[0029] Figure 18 A comparison is shown between an instrument with axial cutting capability and an instrument with both axial and transverse cutting capabilities.

[0030] Figure 19 A method for inserting an instrument via an inclined surface is shown.

[0031] Figures 20A to 20E Five degrees of freedom associated with the robotic surgical system are shown.

[0032] Figures 21A to 21C A robotic surgical system conforming to the principles of this disclosure is shown.

[0033] Figures 22A to 22F A robotic surgical system conforming to the principles of this disclosure is shown.

[0034] Figure 23 A motorized end effector conforming to the principles of this disclosure is shown.

[0035] Figure 24 An end effector including an inertial sensor is shown that conforms to the principles of this disclosure.

[0036] Figure 25 An end effector including a force sensor, conforming to the principles of this disclosure, is shown. Detailed Implementation

[0037] It should be understood that this disclosure, in its application, is not limited to the construction details and component arrangements shown in the description or accompanying drawings herein. The teachings of this disclosure may be used and practiced in other embodiments and in various ways. Furthermore, it should be understood that the wording and terminology used herein are for descriptive purposes and should not be considered limiting. The use of “comprising,” “including,” or “having,” and variations thereof herein means to include items listed herein and their equivalents, as well as additional items. Unless otherwise specified or limited, the terms “mounted,” “connected,” “supported,” and “coupled,” and variations thereof are used extensively and include direct and indirect mounting, connection, support, and coupling. Moreover, “connected” and “coupled” are not limited to physical or mechanical connections or couplings.

[0038] The following discussion is provided to enable those skilled in the art to implement and use embodiments of this disclosure. Various modifications to the illustrated embodiments will be apparent to those skilled in the art, and the principles herein can be applied to other embodiments and applications without departing from the embodiments of this disclosure. Therefore, embodiments are not intended to be limited to those shown, but should have the broadest scope consistent with the principles and features disclosed herein. Refer to the accompanying drawings, in which similar elements have similar reference numerals. The drawings are not necessarily drawn to scale, depict selected embodiments, and are not intended to limit the scope of embodiments. Those skilled in the art will recognize that the examples provided herein have many useful alternative forms and fall within the scope of embodiments.

[0039] Now turn to the attached diagram. Figure 1 and Figure 2 A surgical robot system 100 according to an exemplary embodiment is illustrated. The surgical robot system 100 may include, for example, a surgical robot 102, one or more robotic arms 104, a base 106, a display 110, an end effector 112 (e.g., including a catheter 114), and one or more tracking markers 118. The surgical robot system 100 may include a patient tracking device 116, which also includes one or more tracking markers 118 adapted for direct attachment to a patient 210 (e.g., to the bone of the patient 210). The surgical robot system 100 may also utilize a camera 200, for example, positioned on a camera holder 202. The camera holder 202 may have any suitable configuration to move, orient, and support the camera 200 in a desired location. The camera 200 may include any suitable camera or multiple cameras, such as one or more infrared cameras (e.g., bifocal or stereophotogrammetry cameras), capable of identifying active and passive tracking markers 118 in a given measurement volume visible, for example, from the viewpoint of the camera 200. Camera 200 can scan a given measurement volume and detect light from marker 118 in order to identify and determine the position of marker 118 in three dimensions. For example, active marker 118 may include an infrared emitting marker activated by an electrical signal (e.g., an infrared light-emitting diode (LED)), and passive marker 118 may include retroreflective markers that reflect infrared light emitted, for example, by an illuminator or other suitable device on camera 200 (e.g., they reflect incident IR radiation into the direction of the incident light).

[0040] Figure 1 and Figure 2A potential configuration for placing the surgical robotic system 100 in an operating room environment is shown. For example, the robot 102 may be positioned near or beside the patient 210. Although shown near the head of the patient 210, it should be understood that the robot 102 can be positioned at any suitable location near the patient 210, depending on the area of ​​the patient 210 where surgery is being performed. The camera 200 may be separate from the robotic system 100 and positioned at the feet of the patient 210. This position allows the camera 200 to have a direct line of sight to the surgical field 208. Again, it is contemplated that the camera 200 can be positioned at any suitable location with a line of sight to the surgical field 208. In the configuration shown, the surgeon 120 may be positioned opposite the robot 102 but still able to manipulate the end effector 112 and the display 110. The surgical assistant 126 may again be positioned opposite the surgeon 120, able to access both the end effector 112 and the display 110. The positions of the surgeon 120 and the assistant 126 may be interchanged if desired. The traditional area where the anesthesiologist 122 and nurse or scrub technician 124 are located remains unobstructed by the positions of the robot 102 and camera 200.

[0041] Regarding other components of the robot 102, the display 110 may be attached to the surgical robot 102, and in other exemplary embodiments, the display 110 may be detached from the surgical robot 102 either within the operating room where the surgical robot 102 is located or at a remote location. An end effector 112 may be coupled to the robotic arm 104 and controlled by at least one motor. In an exemplary embodiment, the end effector 112 may include a catheter 114 capable of receiving and orienting a surgical instrument 608 (further described herein) for performing surgery on the patient 210. As used herein, the term "end-effector" may be used interchangeably with the terms "end-effecter" and "effecter element." Although generally shown with catheter 114, it should be understood that the end effector 112 may be replaced by any suitable instrument suitable for surgical procedures. In some embodiments, the end effector 112 may include any known structure for achieving movement of the surgical instrument 608 in a desired manner.

[0042] Surgical robot 102 is capable of controlling the translation and orientation of end effector 112. For example, robot 102 is capable of moving end effector 112 along the x-axis, y-axis, and z-axis. End effector 112 can be configured to selectively rotate about one or more of the x-axis, y-axis, and z-axis, as well as the Z-frame axis (such that one or more of the Euler angles (e.g., roll, pitch, and / or yaw) associated with end effector 112 can be selectively controlled). In some exemplary embodiments, selective control of the translation and orientation of end effector 112 can allow medical procedures to be performed with significantly improved accuracy compared to conventional robots utilizing, for example, a six-DOF robotic arm that includes only a rotational axis. For example, surgical robot system 100 can be used to manipulate patient 210, and robotic arm 104 can be positioned above patient 210's body, wherein end effector 112 is selectively angled relative to the z-axis toward patient 210's body.

[0043] In some exemplary embodiments, the position of the surgical instrument 608 can be dynamically updated, allowing the surgical robot 102 to know the position of the surgical instrument 608 at any time during the procedure. Therefore, in some exemplary embodiments, the surgical robot 102 can rapidly move the surgical instrument 608 to a desired position without any further assistance from the physician (unless the physician intends otherwise). In some other embodiments, the surgical robot 102 can be configured to correct the path of the surgical instrument 608 if it deviates from a selected, pre-planned trajectory. In some exemplary embodiments, the surgical robot 102 can be configured to allow stopping, modifying, and / or manually controlling the movement of the end effector 112 and / or the surgical instrument 608. Therefore, in use, in the exemplary embodiments, a physician or other user can operate the system 100 and can choose to stop, modify, or manually control the autonomous movement of the end effector 112 and / or the surgical instrument 608. Further details of the surgical robot system 100, including the control and movement of the surgical robot 102 over the surgical instrument 608, can be found in co-pending U.S. Patent Application Serial No. 13 / 924,505, the full text of which is incorporated herein by reference.

[0044] The robotic surgical system 100 may include one or more tracking markers 118 configured to track the movement of a robotic arm 104, an end effector 112, a patient 210, and / or surgical instruments 608 in three dimensions. In an exemplary embodiment, the plurality of tracking markers 118 may be mounted (or otherwise secured) to an outer surface of the robot 102, such as, but not limited to, a base 106 of the robot 102, the robotic arm 104, or the end effector 112. In an exemplary embodiment, at least one of the plurality of tracking markers 118 may be mounted or otherwise secured to the end effector 112. One or more tracking markers 118 may be further mounted (or otherwise secured) to the patient 210. In an exemplary embodiment, the plurality of tracking markers 118 may be positioned on the patient 210 spaced apart from the surgical field 208 to reduce the likelihood of obstruction by the surgeon, surgical instruments, or other parts of the robot 102. Furthermore, one or more tracking markers 118 may be further mounted (or otherwise secured) to surgical instruments 608 (e.g., screwdrivers, dilators, implant inserters, etc.). Thus, the tracking markers 118 enable each of the marked objects (e.g., end effector 112, patient 210, and surgical instruments 608) to be tracked by the robot 102. In an exemplary embodiment, the system 100 can use tracking information collected from each of the marked objects to calculate, for example, the orientation and position of the end effector 112, the surgical instrument 608 (e.g., positioned within a tube 114 of the end effector 112), and the relative position of the patient 210.

[0045] In an exemplary embodiment, one or more of the markers 118 may be optical markers. In some embodiments, the positioning of one or more tracking markers 118 on the end effector 112 can maximize the accuracy of position measurements by being used to check or verify the position of the end effector 112. Further details of the surgical robot system 100, including the control, movement, and tracking of the surgical robot 102 and surgical instruments 608, can be found in co-pending U.S. Patent Application Serial No. 13 / 924,505, the entire contents of which are incorporated herein by reference.

[0046] Exemplary embodiments include one or more markers 118 coupled to surgical instrument 608. In exemplary embodiments, these markers 118, such as those coupled to patient 210 and surgical instrument 608, and those coupled to end effector 112 of robot 102, may include conventional infrared light-emitting diodes (LEDs) or those capable of using commercially available infrared optical tracking systems (such as...). Tracking diode. This is a registered trademark of Northern Digital Inc., Waterloo, Ontario, Canada. In other embodiments, mark 118 may include a conventional reflective ball capable of tracking using a commercially available optical tracking system, such as Polaris Spectra. Polaris Spectra is also a registered trademark of Northern Digital, Inc. In an exemplary embodiment, mark 118 coupled to end effector 112 is an active mark that includes an infrared light-emitting diode that can be turned on and off, and mark 118 coupled to patient 210 and surgical instrument 608 includes a passive reflective ball.

[0047] In an exemplary embodiment, light emitted and / or reflected from marker 118 can be detected by camera 200 and can be used to monitor the position and movement of the marked object. In an alternative embodiment, marker 118 may include a radio frequency and / or electromagnetic reflector or transceiver, and camera 200 may include, or be replaced by, a radio frequency and / or electromagnetic transceiver.

[0048] Similar to the Surgical Robot System 100, Figure 3 A surgical robot system 300 and a camera mount 302 in a docked configuration, conforming to an exemplary embodiment of this disclosure, are shown. The surgical robot system 300 may include a robot 301 comprising a display 304, an upper arm 306, a lower arm 308, an end effector 310, a column 312, casters 314, a cabinet 316, a tablet drawer 318, a connector panel 320, a control panel 322, and an information ring 324. The camera mount 302 may include a camera 326. These components are in... Figure 5 A more detailed description is provided in the text. Figure 3 A surgical robot system 300 in a docked configuration is shown, wherein a camera holder 302 is nested with the robot 301, for example, when not in use. Those skilled in the art will understand that the camera 326 and the robot 301 can be detached from each other and positioned in any suitable location during surgery, for example, as... Figure 1 and Figure 2 As shown. Figure 4 A base 400 conforming to an exemplary embodiment of this disclosure is shown. The base 400 may be part of a surgical robot system 300 and includes a cabinet 316. The cabinet 316 may house certain components of the surgical robot system 300, including but not limited to a battery 402, a power distribution module 404, a platform interface board module 406, a computer 408, a handle 412, and a tablet drawer 414. The connections and relationships between these components are shown in... Figure 5 A more detailed description is provided in the text.

[0049] Figure 5A block diagram illustrating certain components of an exemplary embodiment of a surgical robot system 300 is shown. The surgical robot system 300 may include a platform subsystem 502, a computer subsystem 504, a motion control subsystem 506, and a tracking subsystem 532. The platform subsystem 502 may further include a battery 402, a power distribution module 404, a platform interface board module 406, and a tablet charging station 534. The computer subsystem 504 may further include a computer 408, a display 304, and a speaker 536. The motion control subsystem 506 may further include a drive circuit 508, motors 510, 512, 514, 516, 518, stabilizers 520, 522, 524, 526, an end effector 310, and a controller 538. The tracking subsystem 532 may further include a position sensor 540 and a camera converter 542. The system 300 may also include a foot switch 544 and a tablet computer 546.

[0050] Input power is provided to system 300 via power supply 548, which can be supplied to power distribution module 404. Power distribution module 404 receives the input power and is configured to generate different power supply voltages for other modules, components, and subsystems of system 300. Power distribution module 404 can be configured to provide different voltage supplies to platform interface module 406, which can supply power to other components, such as computer 408, display 304, speaker 536, driver 508, for example, to power motors 512, 514, 516, 518, end effector 310, ring 324, camera converter 542, and other components of system 300 (e.g., fans for cooling electrical components within cabinet 316).

[0051] The power distribution module 404 can also supply power to other components, such as a tablet charging station 534 that may be located within the tablet drawer 318. The tablet charging station 534 can communicate wirelessly or wiredly with the tablet computer 546 to charge it. The tablet computer 546 can be used by a surgeon conforming to this disclosure and described herein. The power distribution module 404 can also be connected to a battery 402, which acts as a temporary power source when the power distribution module 404 is not receiving power from the input power 548. At other times, if necessary, the power distribution module 404 can be used to charge the battery 402.

[0052] Other components of the platform subsystem 502 may include a connector panel 320, a control panel 322, and a ring 324. The connector panel 320 is used to connect different devices and components to the system 300 and / or associated components and modules. The connector panel 320 may include one or more ports for receiving wires or connections from different components. For example, the connector panel 320 may have: a ground terminal port for grounding the system 300 to other devices, a port for connecting a foot switch 544 to the system 300, and a port for connecting to a tracking subsystem 532, which may include a position sensor 540, a camera converter 542, and a camera 326 associated with a camera mount 302. The connector panel 320 may also include other ports to allow USB, Ethernet, and HDMI communication with other components such as a computer 408.

[0053] Control panel 322 provides various buttons or indicators for operating control system 300 and / or providing information about system 300. For example, control panel 322 may include buttons for turning system 300 on or off, raising or lowering column 312, and raising or lowering stabilizers 520-526, which may be designed to engage casters 314 to lock system 300 and prevent physical movement. Other buttons may stop system 300 in an emergency, potentially by cutting off all motor power and applying mechanical brakes to stop all movement. Control panel 322 may also have indicators to inform the user of certain system conditions, such as line power indicators or the charging status of battery 402.

[0054] Ring 324 can be a visual indicator used to notify the user of system 300 of different operating modes of system 300 and to issue certain warnings to the user.

[0055] Computer subsystem 504 includes computer 408, display 304, and speaker 536. Computer 504 includes an operating system and software for operating system 300. Computer 504 can receive and process information from other components (e.g., tracking subsystem 532, platform subsystem 502, and / or motion control subsystem 506) to display information to a user. Furthermore, computer subsystem 504 may also include speaker 536 to provide audio to the user.

[0056] The tracking subsystem 532 may include a position sensor 504 and a converter 542. The tracking subsystem 532 may correspond to a camera mount 302 including a camera 326, such as... Figure 3The position sensor 504 may be a camera 326. The tracking subsystem can track the position of certain markings located on different components of the system 300 and / or instruments used by the user during surgery. This tracking can be performed in a manner consistent with this disclosure, including using infrared technology to track the position of active or passive elements such as LEDs or reflective markers, respectively. The position, orientation, and location of structures with these types of markings can be provided to a computer 408, which can then display them to the user on a display 304. For example, a surgical instrument 608 with these types of markings and tracked in this manner (which may be referred to as a navigation space) can be displayed to the user in relation to a three-dimensional image of the patient's anatomy. The motion control subsystem 506 can be configured to physically move the column 312, upper arm 306, lower arm 308, or rotary end effector 310. Physical movement can be performed using one or more motors 510-518. For example, motor 510 can be configured to vertically raise or lower the column 312. Figure 3 As shown, motor 512 can be configured to laterally move upper arm 308 about the engagement point with column 312. Figure 3 As shown, motor 514 can be configured to laterally move the lower arm 308 about its engagement point with the upper arm 308. Motors 516 and 518 can be configured such that one motor can control rolling and the other can control tilting to move the end effector 310, thereby providing multiple angles at which the end effector 310 can move. These movements can be implemented by controller 538, which can control these movements via load sensors disposed on the end effector 310, and activate these movements by a user engaging these load sensors, thereby moving the system 300 in a desired manner.

[0057] Furthermore, system 300 can provide automatic movement of the column 312, upper arm 306, and lower arm 308 by having the user indicate the position of surgical instruments or components on a three-dimensional image of the patient's anatomy on display 304 (which may be a touchscreen input device). The user can initiate this automatic movement by pressing a foot switch 544 or some other input device.

[0058] Figure 6A surgical robot system 600 conforming to an exemplary embodiment is illustrated. The surgical robot system 600 may include an end effector 602, a robotic arm 604, a catheter 606, an instrument 608, and a robot base 610. The instrument 608 may be attached to a tracking array 612 including one or more tracking markers (such as marker 118) and having an associated trajectory 614. The trajectory 614 is capable of representing a path of movement configured for the instrument 608 to travel once it is positioned through or secured within the catheter 606, for example, the path of insertion of the instrument 608 into a patient. In exemplary operation, the robot base 610 may be configured to electronically communicate with the robotic arm 604 and the end effector 602, such that the surgical robot system 600 can assist a user (e.g., a surgeon) in manipulating a patient 210. The surgical robot system 600 may be consistent with the previously described surgical robot systems 100 and 300.

[0059] Tracking array 612 can be mounted on instrument 608 to monitor the position and orientation of instrument 608. Tracking array 612 can be attached to instrument 608 and may include tracking markers 804. Figure 8 As best shown, the tracking marker 804 can be, for example, a light-emitting diode and / or other types of reflective markers (e.g., marker 118 as described elsewhere herein). The tracking device can be one or more line-of-sight devices associated with the surgical robotic system. For example, the tracking device can be one or more cameras 200, 326 associated with the surgical robotic systems 100, 300, and can also track the tracking array 612 for the defined or relative orientation of the instrument 608 with respect to the robotic arm 604, the robotic base 610, the end effector 602, and / or the patient 210. The tracking device can conform to those structures described in conjunction with the camera holder 302 and the tracking subsystem 532.

[0060] Figure 7A , Figure 7B and Figure 7CTop, front, and side views of an end effector 602 consistent with an exemplary embodiment are shown respectively. The end effector 602 may include one or more tracking markers 702. Tracking markers 702 may be light-emitting diodes or other types of active and passive markers, such as the previously described tracking marker 118. In the exemplary embodiment, the tracking marker 702 is an active infrared emitting marker activated by an electrical signal (e.g., an infrared light-emitting diode (LED)). Therefore, the tracking marker 702 can be activated such that the infrared marker 702 is visible to cameras 200, 326, or the tracking marker can be deactivated such that the infrared marker 702 is not visible to cameras 200, 326. Thus, when the marker 702 is activated, the end effector 602 can be controlled by systems 100, 300, 600, and when the marker 702 is deactivated, the end effector 602 can be locked in place and cannot be moved by systems 100, 300, 600.

[0061] The marker 702 may be positioned on or within the end effector 602, such that it is visible to one or more cameras 200, 326, or other tracking devices associated with the surgical robot system 100, 300, 600. The cameras 200, 326, or other tracking devices can track the end effector 602 as it moves to different positions and viewing angles by tracking the movement of the marker 702. The position of the marker 702 and / or the end effector 602 may be displayed on the displays 110, 304 associated with the surgical robot system 100, 300, 600, for example, as shown in the image. Figure 2 The display 110 and / or shown Figure 3 The display 304 is shown. The displays 110 and 304 allow the user to ensure that the end effector 602 is in the desired position relative to the robot arm 604, the robot base 610, the patient 210, and / or the user.

[0062] For example, such as Figure 7A As shown, markers 702 can be placed around the surface of end effector 602 such that a tracking device positioned away from surgical field 208 and towards robots 102, 301 and cameras 200, 326 can view at least three of the markers 702 through a series of common orientations of end effector 602 relative to tracking devices 100, 300, 600. For example, distributing markers 702 in this way allows the end effector 602 to be monitored by the tracking device as it is translated and rotated within surgical field 208.

[0063] Furthermore, in an exemplary embodiment, the end effector 602 may be equipped with an infrared (IR) receiver that can detect when the external cameras 200, 326 are ready to read the marker 702. Upon this detection, the end effector 602 may then illuminate the marker 702. The IR receiver's detection that the external cameras 200, 326 are ready to read the marker 702 may indicate a need to synchronize the duty cycle of the marker 702 (which may be a light-emitting diode) with the external cameras 200, 326. This also allows for lower power consumption of the robotic system as a whole, whereby the marker 702 will be illuminated only at appropriate times, rather than continuously. Additionally, in an exemplary embodiment, the marker 702 may be de-energized to prevent interference with other navigational tools, such as different types of surgical instruments 608.

[0064] Figure 8 A type of surgical instrument 608 is illustrated, comprising a tracking array 612 and tracking markers 804. Tracking markers 804 can be of any type described herein, including but not limited to light-emitting diodes or reflective balls. Markers 804 are monitored by tracking devices associated with surgical robot systems 100, 300, 600, and can be one or more of line-of-sight cameras 200, 326. Cameras 200, 326 can track the position of the instrument 608 based on the position and orientation of the tracking array 612 and markers 804. A user (such as surgeon 120) can orient the instrument 608 in such a manner that the tracking array 612 and markers 804 are sufficiently recognized by the tracking devices or cameras 200, 326 to display the instrument 608 and markers 804 on, for example, a display 110 of an exemplary surgical robot system.

[0065] The surgeon 120 can place the instrument 608 into the catheter 606 of the end effector 602 and adjust the manner in which the instrument 608 is placed. Figure 8 As is evident from the description. The hollow tubes or conduits 114, 606 of the end effectors 112, 310, 602 are sized and configured to receive at least a portion of the surgical instrument 608. The conduits 114, 606 are configured to be oriented by the robotic arm 104 such that the insertion and trajectory of the surgical instrument 608 can reach a desired anatomical target within or above the body of the patient 210. The surgical instrument 608 may include at least a portion of a generally cylindrical instrument. Although a screwdriver is illustrated as a surgical tool 608, it should be understood that any suitable surgical tool 608 can be positioned by the end effector 602. For example, the surgical instrument 608 may include one or more of a guidewire, cannula, retractor, drill, reamer, screwdriver, insertion tool, removal tool, etc. Although the hollow tubes 114, 606 are generally shown as having a cylindrical configuration, those skilled in the art will understand that the conduits 114, 606 may have any suitable shape, size, and configuration required to receive the surgical instrument 608 and access the surgical site.

[0066] Figures 9A to 9C A portion of an end effector 602 and a robotic arm 604 conforming to an exemplary embodiment is shown. The end effector 602 may further include a body 1202 and a gripper 1204. The gripper 1204 may include a handle 1206, a ball bearing 1208, a spring 1210, and a lip 1212. The robotic arm 604 may further include a recess 1214, a mounting plate 1216, a lip 1218, and a magnet 1220. The end effector 602 can be mechanically interfacing and / or engaging with the surgical robot system and the robotic arm 604 via one or more couplings. For example, the end effector 602 can be engaged with the robotic arm 604 via a positioning coupling and / or a reinforcing coupling. Through these couplings, the end effector 602 can be secured to the robotic arm 604 outside a flexible sterile barrier. In an exemplary embodiment, the positioning coupling may be a magnetic motion mount, and the reinforcing coupling may be a five-bar over-center clamping link.

[0067] Regarding the positioning coupling, the robot arm 604 may include a mounting plate 1216 (which may be made of a non-magnetic material), one or more recesses 1214, a lip 1218, and a magnet 1220. The magnet 1220 is mounted below each of the recesses 1214. A portion of the gripper 1204 may include a magnetic material and is attracted by one or more magnets 1220. Through the magnetic attraction of the gripper 1204 and the robot arm 604, the ball 1208 is placed into the corresponding recess 1214. For example, as... Figure 9B The ball bearing 1208 shown will be placed as follows Figure 9A The recess 1214 is shown. This placement can be considered as a magnetically assisted motion coupling. The magnet 1220 can be configured to be robust enough to support the entire weight of the end effector 602, regardless of the orientation of the end effector 602. The positioning coupling can be any type of motion mount that only restricts six degrees of freedom.

[0068] Regarding the reinforced coupling, a portion of clamp 1204 can be configured as a fixed ground connection, thus clamp 1204 can function as a five-bar linkage. Closing clamp handle 1206 secures end effector 602 to robot arm 604 because lips 1212 and 1218 engage clamp 1204 in a manner that secures end effector 602 and robot arm 604. When clamp handle 1206 is closed, spring 1210 can be stretched or stressed when clamp 1204 is in the locked position. The locked position can be a position that provides access past the center link. Because the closed position is past the center, the link will not open unless a force is applied to clamp handle 1206 to release clamp 1204. Therefore, in the locked position, end effector 602 can be securely fixed to robot arm 604.

[0069] Spring 1210 may be a tensioned bending bundle. Spring 1210 may be made of a material exhibiting high stiffness and high yield strain, such as natural PEEK (polyetheretherketone). The linkage between end effector 602 and robotic arm 604 provides a sterile barrier between end effector 602 and robotic arm 604 without impeding the fastening of the two couplings.

[0070] The reinforcing coupling can be a link with multiple spring members. The reinforcing coupling can be latched using a cam or a friction-based mechanism. The reinforcing coupling can also be a sufficiently strong electromagnet that facilitates the fastening of the end effector 102 to the robot arm 604. The reinforcing coupling can be a multi-piece collar that is completely separable from the end effector 602 and / or the robot arm 604, sliding on the interface between the end effector 602 and the robot arm 604, and tightened by a screw mechanism, an over-center link, or a cam mechanism.

[0071] refer to Figure 10 and Figure 11 Certain registration procedures can be performed before or during surgery to track patient objects and target anatomical structures in navigation and image spaces. To perform this registration, methods such as... Figure 10 The registration system 1400 is shown.

[0072] To track the position of patient 210, patient tracking device 116 may include a patient fixation device 1402 to be secured to a rigid anatomical structure of patient 210, and a dynamic reference base (DRB) 1404 may be securely attached to the patient fixation device 1402. For example, the patient fixation device 1402 may be inserted into an opening 1406 of the dynamic reference base 1404. The dynamic reference base 1404 may include markings 1408 visible to tracking devices such as tracking subsystem 532. As previously described herein, these markings 1408 may be optical markings or reflective spheres, such as tracking markings 118.

[0073] The patient fixation device 1402 is attached to a rigid anatomical structure of the patient 210 and remains attached throughout the surgical procedure. In an exemplary embodiment, the patient fixation device 1402 is attached to a rigid region of the patient 210, such as bone located away from the target anatomical structure undergoing surgery. To track the target anatomical structure, a dynamic reference base 1404 is associated with the target anatomical structure using a registration clamp temporarily placed on or near the target anatomical structure to align the dynamic reference base 1404 with the target anatomical structure.

[0074] The registration clamp 1410 is attached to the patient fixation device 1402 using the pivot arm 1412. The pivot arm 1412 is attached to the patient fixation device 1402 by inserting the patient fixation device 1402 through the opening 1414 of the registration clamp 1410. The pivot arm 1412 is attached to the registration clamp 1410 by, for example, inserting a knob 1416 through the opening 1418 of the pivot arm 1412.

[0075] Using the pivot arm 1412, the registration jig 1410 can be positioned above the target anatomical structure, and its position can be determined in both image and navigation space using tracking markers 1420 and / or reference points 1422 on the registration jig 1410. The registration jig 1410 may include a set of markers 1420 visible in the navigation space (e.g., markers 1420 may be detected by the tracking subsystem 532). As previously described herein, the tracking markers 1420 may be optical markers visible in infrared light. The registration jig 1410 may also include a set of reference points 1422 visible in the imaging space (e.g., a three-dimensional CT image), such as bearing balls. (See also: Regarding...) Figure 11 In more detail, using the registration clamp 1410, the target anatomical structure can be associated with the dynamic reference base 1404, thereby allowing the depiction of the object in navigation space to overlay on the image of the anatomical structure. The dynamic reference base 1404, located away from the target anatomical structure, can serve as a reference point, thereby allowing the registration clamp 1410 and / or pivot arm 1412 to be removed from the surgical area.

[0076] Figure 11 An exemplary method 1500 for registration is provided in accordance with this disclosure. Method 1500 begins at step 1502, wherein a graphical representation (or image) of the target anatomical structure is imported into systems 100, 300, 600, such as computer 408. The graphical representation may be a three-dimensional CT or fluorescence microscopy scan of the target anatomical structure of patient 210, which includes a detectable imaging pattern of registration fixture 1410 and reference points 1420.

[0077] At step 1504, the imaging pattern of reference point 1420 is detected and registered in the imaging space and stored in computer 408. Optionally, at this time at step 1506, a graphic representation of registration fixture 1410 can be overlaid on the image of the target anatomical structure.

[0078] At step 1508, the navigation pattern of the registration jig 1410 is detected and registered by identifying marker 1420. Marker 1420 may be an optical marker identified in the navigation space via infrared light by the tracking subsystem 532 through the position sensor 540. Therefore, the position, orientation, and other information of the target anatomical structure are registered in the navigation space. Thus, the registration jig 1410 can be identified in the image space using reference point 1422 and in the navigation space using marker 1420. At step 1510, the registration of the registration jig 1410 in the image space is transferred to the navigation space. For example, this transfer is accomplished relative to the position of the navigation pattern of marker 1420 by using the relative position of the imaging pattern of reference point 1422.

[0079] At step 1512, the registration of the navigation space (already registered with the image space) of the registration jig 1410 is further transferred to the navigation space of the dynamic registration array 1404 attached to the patient fixation device 1402. Therefore, since the navigation space is associated with the image space, the registration jig 1410 can be removed and the target anatomical structure in both the navigation space and the image space can be tracked using the dynamic reference base 1404.

[0080] At steps 1514 and 1516, the navigation space may overlay the image space and the object with markings visible in the navigation space (e.g., a surgical instrument 608 with optical markings 804). The object can be tracked by a graphical representation of the surgical instrument 608 on an image of the target anatomical structure.

[0081] Figures 12A to 12B An imaging device 1304 is shown that can be used in conjunction with robotic systems 100, 300, and 600 to acquire preoperative, intraoperative, postoperative, and / or real-time image data of patient 210. Imaging system 1304 can be used to image any suitable subject for any suitable surgical procedure. Imaging system 1304 can be any imaging device, such as imaging device 1306 and / or C-arm 1308. It may be necessary to acquire X-rays of patient 210 from multiple different locations without frequent manual repositioning of patient 210 (which may be required in X-ray systems). Figure 12A As shown, the imaging system 1304 can be in the form of a C-arm 1308, which includes an elongated C-shaped member terminating at a relatively distal end 1312 of the "C" shape. The C-shaped member 1130 may further include an X-ray source 1314 and an image receiver 1316. The space within the C-arm 1308 provides space for a physician to care for the patient, largely unaffected by the X-ray support structure 1318. Figure 12BAs shown, the imaging system may include an imaging device 1306 having a gantry housing 1324 attached to a support structure imaging device support structure 1328, such as a wheeled trolley 1330 with wheels 1332, which can enclose an image capture section (not shown). The image capture section may include an X-ray source and / or emitting section and an X-ray receiver and / or image receiving section, which may be positioned approximately 180 degrees apart from each other and mounted on a rotor (not shown) relative to the trajectory of the image capture section. The image capture section is operable to rotate 360 ​​degrees during image acquisition. The image capture section may rotate about a center point and / or axis, thereby allowing image data of the patient 210 to be acquired from multiple directions or multiple planes. Although certain imaging systems 1304 are illustrated herein, it should be understood that those skilled in the art can choose any suitable imaging system.

[0082] Now refer to this disclosure Figure 13 , Figure 13 A surgical instrument 1600 with a tip 1602 and bone 1604 is shown, the bone being the target bone for the patient during surgery. Three forces (Fi, Fi, Fi) associated with the instrument 1600 penetrating the bone 1604 are also shown. 插入 F p and F n For example, in a medical procedure where a surgeon drills into a patient's bone. Surgical tool 1600 can be any surgical instrument or tool associated with a surgical application, including but not limited to drills, awls, taps, screwdrivers, or other types of surgical tools. When forces intended to penetrate bone are applied to the tool, these forces can be referred to as reaction forces at the tool-bone interface. Insertion force (F) 插入 It can be decomposed into a component force (F) perpendicular to the surface. N ) and the component of force parallel to the surface (F) P ).

[0083] When the tip 1602 of the instrument 1600 is positioned and fixed on the surface of the bone 1604, the physical mechanism generated by the aforementioned force includes: (1) the bone 1604 may move away from the insertion force F as a whole. 插入 (2) The frictional resistance preventing the tip 1602 from sliding can be overcome, thereby causing the tip 1602 to move along F in a direction parallel to the bone surface 1604. P The direction is lateral, or (3) the tip can be such as F 插入 It penetrates the bone in the expected direction.

[0084] This disclosure aims to keep the instrument 1600 aligned as desired and to prevent the tip 1602 from being subjected to forces (F) parallel to the surface of the bone 1604. PThis can lead to drifting or "scraping". Instrument 1600 can be operated via a rigidly fixed conduit with minimal tolerance between the inner diameter of the conduit and the outer diameter of the tool. Such conduits have been previously described herein. For the conduit to drive instrument 1600 or other hardware into bone 1604 completely and effectively, the conduit should not move relative to bone 1604, and instrument 1600 or other hardware should not bend relative to the conduit or bone 1604.

[0085] As previously described herein, surgical robots capable of rigidly locking to the floor can effectively maintain the static, rigid position of the catheter (e.g., robot system 300). In robot-assisted surgery, scraping can lead to a variety of situations. For example, forces generated parallel to the surface of bone 1604 during the insertion of instrument 1600 through the catheter at an angle and into contact with bone 1604, which may depend at least partially or entirely on the instrument insertion force and angle, can cause instrument bending and / or patient movement.

[0086] For example, inserting instrument 1600 through a catheter (at an angle or perpendicular to bone 1604) may cause instrument 1600 to reach a depth or point where it is completely within the catheter or the instrument handle has bottomed out (i.e., completely at the top inlet of the catheter, at which point the tool cannot be inserted further unless the catheter is advanced longitudinally). If the surgeon applies additional downward force after instrument 1600 has bottomed out, this force is absorbed by the catheter rather than transmitted to instrument 1600 to further penetrate bone 1604. This example may lead to several unintended consequences. One unintended consequence is that if the surgeon is unaware that instrument 1600 has bottomed out, the additional force applied by rotating the screwdriver or tap when the screw or tap cannot be moved forward may damage or dislodge the screw hole in the patient's bone. Another unintended consequence is that the surgeon may be unable to achieve the desired or expected penetration of the instrument or tool they are attempting to advance.

[0087] As previously described, the robotic system 300 may include load sensors (which control multi-axial movement of the robotic arm) disposed on the end effector 310. Using the multi-axis load sensors mounted to the catheter and / or end effector, the lateral deflection and longitudinal bottoming forces / torques described above can be quantified in real time during surgical procedures. Consistent with this disclosure, the robotic system 300 may use the forces and torques monitored by the multi-axis load sensors on the robotic catheter to provide specific feedback to the surgeon to help prevent inaccurate, incomplete, or improper insertion of instruments or tools.

[0088] Figure 14An exemplary embodiment of a robotic arm 1700 conforming to this disclosure is shown. The robotic arm 1700 may include an end effector 1702, a conduit 1704, and a wristband 1706 mounted to the end effector 1702. The wristband 1706 may further include one or more multi-axis load sensors 1708.

[0089] A multi-axis load sensor 1708, mounted to an end effector 1702 via a wristband 1706, may be able to measure torque and force along, around, and across the axis of the conduit (e.g., the longitudinal axis of the conduit 1704). The multi-axis load sensor 1708 may include strain gauges applied to a properly oriented rigid internal member, such that they can accurately measure force and torque with negligible elastic deformation.

[0090] The multi-axis load sensor 1708 can support the end effector 1702 and the conduit 1704 in such a way that the force and torque applied to the conduit 1704 can be detected by one or more load sensors in the load sensor 1708. For example... Figure 14 As shown, the directions of the forces and torques sensed by one or more load sensors 1708 are indicated by arrows Mx, My, and Mz, as well as arrows labeled X, Y, and Z.

[0091] When a surgeon inserts an instrument 1600 (e.g., a drill) through a catheter 1704 and uses the instrument 1600 to penetrate bone 1604 at a position perpendicular to a flat surface, most of the force applied by the surgeon can be transmitted to the drill as a longitudinal force downward along the axis of the drill bit. It is possible that a relatively small lateral force (such as...) is expected. Figure 14 Torque in the X or Y direction (as shown) or across the axis of the conduit (e.g. Figure 14 As shown in Mx or My), and a relatively small longitudinal force is expected to be applied to catheter 1704 (e.g., in the case of Mx or My). Figure 14 (as shown in the Z direction).

[0092] Continuing the previous example, when the surgeon twists the tool, since the tool should rotate freely within catheter 1704, a relatively small amount of this torque should be transmitted to the load sensor (in...). Figure 14 (Illustrated as Mz). The surgeon may misalign the applied force; in such cases, the rigid fixation catheter 1704 can be used to prevent lateral movement of the instrument. This lateral force can be monitored as a moderate lateral (X, Y, or combined XY) force by one or more load sensors in the multiaxial load sensor 1708.

[0093] If the instrument 1600 (e.g., a drill or tool) is inserted into the bone 1604 at a steep angle, causing scraping by the tip 1602, the forces detected by one or more multiaxial load sensors 1708 may change in some predictable way. For example, the torque across the catheter 1704 (such as...) Figure 14 The Mx or My shown may increase, and the catheter 1704 is laterally ( Figure 14 The force (in the X or Y direction) may increase. This increased torque can be directed perpendicular to the slope direction of bone 1604, such as... Figure 13 As shown. Similarly, the direction of the force will be in the direction of the downward slope of bone 1604, as... Figure 13 As shown, and perpendicular to the increased torque. Since the lateral force may cause the instrument 1600 to press against the side of the catheter 1704 and bend slightly, a slight increase in the downward force on the catheter 1704 can be expected (e.g., Figure 14 (shown in the Z direction). In this example, the significantly increased values ​​are likely to be bending moment and lateral force.

[0094] In another example, where the instrument 1600 (e.g., a drill or tool) has bottomed out within the catheter 1704, when the surgeon applies additional downward force, it is expected that in the direction of the catheter 1704 (e.g., ... Figure 14 The downward longitudinal force (in the Z direction, as shown) will suddenly increase sharply without significantly increasing any other detected torque or force. Additionally, if the surgeon releases instrument 1600, some residual downward force (Z) is expected because instrument 1600 may still interact with catheter 1704. For example, if the surgeon is inserting a screw with a locking screwdriver but the screwdriver has reached its bottom, the downward force will remain unchanged after releasing the screwdriver due to the tension of its handle against the top of the catheter.

[0095] The robot system continuously monitors forces and torques via software, checking whether each force and torque remains within the expected range or threshold. When encountering a force / torque pattern that meets the aforementioned undesirable conditions, the software may respond with a message. Examples of messages could be "Caution - Tool scraping may be occurring" or "Caution - Tool may have reached its depth limit."

[0096] Figure 15An exemplary method 1800 for detecting the presence of instrument scraping during surgical procedures is illustrated. Method 1800 begins at step 1802, where, as previously described herein, an end effector and guide can be automatically or manually positioned relative to the patient undergoing surgery. At step 1804, an instrument or tool (e.g., instrument 1600) can be inserted into a catheter of a robotic system. At step 1806, the instrument can be inserted into the patient and advanced to contact the patient's target bone for surgical procedures. For example, as previously described, the instrument can be advanced to contact the target bone to drill screw holes for pedicle screws. At step 1808, the robotic system can monitor forces and torques measured by one or more load sensors on the robotic system, such as those disposed on the end effector. At step 1810, the monitored forces and torques can be compared to expected forces and torques that would conform to the surgical procedure. At step 1812, if the monitored force and torque fall within the expected range or a predetermined threshold, the surgery continues in step 1814, and method 1800 continues to step 1810, as previously described. If the monitored force and torque do not fall within the expected range or a predetermined threshold, the robotic system issues a warning or notification to indicate that scraping has occurred.

[0097] In another embodiment, a method for quantifying the number of millimeters of scraping that occurs is provided, and a method for overcoming any scraping that does actually occur.

[0098] As described above, the 6-axis load sensor mounted to the robotic arm is configured to detect forces laterally oriented relative to the catheter. In optimal procedures, the lateral forces applied to the catheter should generally be minimized. In one embodiment, the force detected and applied should be along the axis of the catheter. In embodiments where lateral forces occur, these forces can cause the surgical instrument to scrape or move along the bone surface without penetrating the bone, or if the force is excessive, it can cause lateral scraping or movement of the bone away from the surgical instrument. In some embodiments, lateral forces can cause the tip of the tool to bend and deflect laterally from the axis of the surgical instrument and the central axis of the catheter.

[0099] In some implementations, the robotic arm can hold the catheter in a fixed position even in the presence of lateral forces. In one implementation, when lateral forces push bone and cause it to move away from the rigid catheter, the amount of bone movement can be tracked using a dynamic reference base (DRB) attached to the patient. The DRB includes a series of tracking markers, such as reflective balls, whose positions are tracked using a tracking system such as the Polaris Spectra optical tracking system (Northern Digital, Inc.). Because the amount of bone movement is monitored, the system can report any deviations to the user, and automated robotic adjustments to the catheter position can counteract additional movement caused by lateral forces.

[0100] Turn now Figure 16 In some embodiments, if the instrument tip bends relative to the instrument's tracking array due to lateral forces, the amount of deflection of the instrument relative to its tracking array can be measured. In one embodiment, strain gauges can be used to measure the deflection of the instrument tip caused by lateral forces. Strain gauges are typically resistance-based and configured to detect slight increases or decreases in surface length. In one embodiment, a pair of strain gauges oriented parallel to the instrument axis on opposite sides of the axis and attached to the instrument surface can measure deflection toward or away from the strain gauges. In another embodiment, three or more strain gauges can be mounted parallel to each other around the perimeter of the instrument at a given longitudinal position and configured to estimate the longitudinal shortening or lengthening around the perimeter of the instrument at the locations where the strain gauges are attached.

[0101] Figure 16 The diagram illustrates the magnified lateral deflection of instrument 2000 caused by the lateral force indicated by the arrow. A strain gauge 2002, mounted on the opposite side of instrument 2000, measures the elongation of instrument 2000 on the force-measuring side and the shortening of instrument 2000 on the force-opposite side. If instrument 2000 or catheter deflects, its length on the side of the axis deflects decreases, while the length on the opposite side of the axis increases. The deflection of a cylinder (including the axis of the instrument or catheter) responds to the applied lateral force using the following formula: Deflection = FL 3 / 3EI, where F is the lateral force applied at the tip; L is the length from the tip to the fulcrum (assuming a cantilever); E is the elastic modulus of the shaft material, such as cobalt-chromium or stainless steel; and I is the moment of inertia, which is a geometric property related to the cross-section of the tool. In one embodiment, when the instrument is configured as a cylinder, I = πd 4 / 64, where d is the diameter of the cylinder.

[0102] If the instrument is a uniform cylinder, tip deflection can be estimated by knowing the lateral forces and the contact point of the instrument within the catheter. In some embodiments, if the instrument tapers towards the tip or is otherwise non-uniform, the exact contact point within the catheter may be difficult to determine because it will be inside the tube at the point where the instrument begins to taper and will no longer be in close contact with the tube. In this case, tip deflection is calibrated based on the strain gauges mounted to the instrument, particularly the attachment points of the strain gauges, and the geometry of the internal portion of the catheter. This data is then used to calculate the estimated deflection of the instrument 2000.

[0103] In another implementation of calibrating tip deflection, a neural network can be used to measure strain from a set of strain gauges attached around the axis of the instrument. A neural network is a mathematical approach where the response patterns of nodes (in this case, the outputs from the strain gauge array) are used as input to produce a well-defined output (in this case, lateral deflection), provided that the output is sufficiently unique for different sets of inputs. In some implementations, the neural network for instrument deflection measurement is used by applying a known test load laterally at different approach angles and contact locations around the tool tip when measuring deflection using optical tracking, a coordinate measuring machine (CMM), or other methods. Once this data is part of the neural network, the strain gauge outputs are continuously fed into the neural network computer model, and the deflection data can be streamed and displayed by the system.

[0104] In another implementation, neural networks or physical modeling can be used by utilizing the interaction data of device 2004 and catheter 2006 in the two regions, such as Figure 17 As shown. In the first region, the taper of the instrument 2004 ends within the catheter 2006, so the lever arm used for deflection is the point where force is applied to the point where the instrument's maximum diameter contacts the catheter. As long as the instrument 2004 remains within this region, the lever arm remains fixed for the fixed load application point. In the second region, the taper of the instrument 2004 ends outside the catheter 2006, so the lever arm used for deflection is the point where force is applied to the point where the instrument 2004 exits the catheter 2006. As the instrument 2004 protrudes further, the lever arm increases in length. Based on the tracking array position of the instrument relative to the tracking array position of the catheter, the system can track the current region and appropriately interpret the neural network model or physical model of the tool to calculate the tip force and displacement.

[0105] In one embodiment, a 6-axis load cell mounted to the robotic arm can assess the forces and torques generated by the interaction between the instrument tip and bone. If scraping occurs due to the application of lateral forces to the instrument, any possible scraping can be overcome or mitigated using the following methods. In one embodiment, the instrument tip can be configured to be sharp and capable of penetrating bone with both axial and lateral cutting capabilities. When lateral forces are applied, the sharp tip of the instrument can be similar to drilling a surface at an angle of 45° relative to a drill, such as... Figure 18 shown. Specifically, Figure 18 Instrument 2008 with axial cutting capability is shown, and instrument 2010 with axial and lateral cutting capability against an impact inclined surface is shown.

[0106] In a preferred embodiment, an instrument with a sharp tip cuts through the bone surface before scraping. In some cases, scraping may be performed even if the instrument has a larger cutting surface. In these cases, in one embodiment, a repetitive puncture motion can be used to insert the instrument through the bone surface without moving the bone. This percussion motion can be applied by the surgeon, and a tactile response to the penetration is signaled as the instrument has traveled through the bone surface, such as... Figure 19 As shown. Figure 19 The gradual or tapping motion shown prevents scraping.

[0107] Turn now Figures 20A to 20E This illustrates a robotic surgical system with five degrees of freedom. These five degrees of freedom, from the base of the robotic surgical system to the end effector, include: (1) vertical linear motion ( Figure 20A (2) Shoulder rotation in the horizontal plane Figure 20B (3) Elbow rotation in the horizontal plane Figure 20C (4) Rolling of the forearm Figure 20D ), and (5) the pitch of the end effector ( Figure 20E Using these five degrees of freedom, the robotic surgical system can be moved to a range of positions and angles, where catheters can be secured to place screws and other linear trajectories into the body.

[0108] These five degrees of freedom allow the end effector's catheter to align with the trajectory vector, but the catheter's rotational position about the trajectory vector may not be selectable independently, but rather depends on the position of these other joints. When using five degrees of freedom in this configuration, the robot's linear movement close to the patient is typically associated with some residual rotation of the catheter during movement. Figures 21A to 21C ).

[0109] Figures 21A to 21C A robotic surgical system 2100 is shown, comprising a robotic arm 2102, a base 2104, and a catheter 2106. Figures 21A to 21C Together, they illustrate the movement of the robotic arm 2102 along a straight line. When Figures 20A to 20E When the joints shown move in a coordinated manner, the constraint movement keeps the conduit 2106 centered along the line, and the rotational position of the conduit 2106 relative to the line and the room changes.

[0110] Based on the principles of this disclosure, instead of fixing the rotational orientation of the catheter relative to the proximal joints and allowing the rotational position of the catheter to be determined by the kinematics of these other joints, additional degrees of freedom can be added to the robotic system. These additional degrees of freedom will include automatic rotation about the central axis of the catheter. (Reference) Figure 23The motorized end effector 2302, motor 2304, rotary bearing 2306, and conduit 2308 can be used to provide automatic rotation. Automatic rotation can be achieved by connecting the conduit 2308 to the end effector 2302 using the rotary bearing 2306, and driving the rotational position of the conduit 2308 using the rotary motor 2302 (such as a servo motor). The position driving the rotational movement of the conduit 2308 can be based on feedback from various types of sensors or from user input via software, as discussed in more detail below.

[0111] Maintaining the desired orientation while moving the trajectory line downwards has several advantages. For example, certain types of surgical implants (such as interbody fusion devices) are inserted in a specific orientation. A system that sets and maintains the orientation of the implant at all points along the insertion trajectory will ensure that the implant is inserted in the proper final orientation and does not adhere to or become stuck in tissue or other instruments during insertion.

[0112] Another example of situations requiring specific orientation when moving along a path other than a straight line is when a surgeon wants to trace or cut tissue in a specific orientation. For example, such as... Figures 22A to 22F As shown, when cutting soft tissue with a scalpel or cutting bone with a bone scalpel, if the flat blade 2202 is perpendicular to the axis of the catheter, it is desirable to keep the flat cutting blade oriented in a certain way (i.e., tangent to the cutting line).

[0113] As the robotic arm moves along the intended cutting path, the additional degree of freedom of the rotating blade 2202 within the guide tube automatically maintains the blade 2202 in the desired orientation. (See figure.) Figure 22A and Figure 22D The orientation of blade 2202 in the first position is shown. Figure 22B and Figure 22E The blade 2202 is shown moving to the second position, and Figure 22C and Figure 22F The blade 2202 is shown moving along the path to the third position.

[0114] As described above, the robotic system is operable to control this additional degree of freedom through several methods. Software input can fix the catheter's rotation at a specific position relative to the robot base, such as 0°, 90°, 180°, 270°, or any value between 0 and 360°. Through forward kinematics, the actual position of the catheter relative to the robot base can be determined for any set of joint positions, and then the rotational position of the catheter can be adjusted so that the rotational orientation of the catheter relative to the base remains fixed at the specified value. Alternatively, when positioning the catheter at the location required for the planned trajectory, the rotational position required for correct orientation of the surgical implant can be specified manually or automatically in the software. Through inverse kinematics, the rotational position of the catheter at that location can be predicted. The rotational position of the catheter can then be adjusted so that the target rotational position is achieved once the robotic arm has moved into place.

[0115] Additional rotational degrees of freedom can also utilize feedback from tracking, such as optical tracking of a reflective sphere as described above. If the tracking system is registered to a patient's anatomy (such as a CT scan), by tracking both the patient and the robot, the software can automatically determine the necessary rotational position of the catheter relative to the anatomy at any location on the robot, ensuring the implant is rotated and oriented as needed for implantation. For example, for an intervertebral implant inserted into the intervertebral space between two vertebrae, the placement angle can be determined by plotting or automatically detecting the orientation of the intervertebral space from medical images. This position will be set relative to a reference array on the patient, and the catheter rotation will automatically update to maintain this angle, regardless of the arm's position, to ensure the implant is inserted in the correct orientation.

[0116] Feedback from the tracking system can also utilize camera-based tracking of visible light patterns located on the catheter. Trackable patterns can be manually added to the catheter, for example, by etching or printing lines on it, or the pattern can be a natural edge of the catheter itself or an extension of the catheter. Using positional feedback from the catheter's orientation and location tracking, the system can drive the catheter's rotational position to the desired rotation. For example, the system can ensure the catheter is properly aligned with the intervertebral space for insertion of an intervertebral implant.

[0117] refer to Figure 24The end effector 2302 may include an inertial sensor 2402. Another feedback method for maintaining a fixed rotational orientation of the catheter relative to the patient or room is to use an inertial or tilt sensor 2402. Such sensors can detect the direction of gravity and guide the robotic system to orient the catheter to maintain a specific alignment relative to the gravity vector. For example, an inertial sensor radially offset from the centerline of the catheter can provide feedback guiding the catheter to always rotate to a position where the radial vector passing through the sensor from the centerline of the catheter is oriented as close as possible to the gravity line in the rotational degrees of freedom. That is, there exists a solution within the range of 0-360° catheter rotation where the angular difference between the gravity vector and the radial vector passing through the inertial sensor from the center of the catheter is minimized.

[0118] However, most straight-line trajectories for surgical purposes have an angle, and this method is a simple way to keep the rotational orientation of the catheter fixed relative to the robot base while traveling in a straight line, although normal rotation will occur due to the joint position being closer to the base.

[0119] refer to Figure 25 The end effector 2302 may include a force sensor 2502. Another feedback method for setting the rotational orientation of the catheter is the force sensor 2502. Such sensors are effective when the robot is used to perform certain actions perpendicular to the central axis of the catheter (e.g., cutting). The magnitude and direction of the force sensed from the force sensor embedded in the catheter can be used to change the rotational orientation of the catheter to facilitate the procedure. For example, if the robot is moving laterally to cut or push tissue, the direction of the force can be sensed, and the robot system can send a command to rotate the catheter so that the sharpest edge faces the direction of the greatest force.

[0120] Although several embodiments of the invention have been disclosed in the foregoing description, it should be understood that many modifications and other embodiments of the invention will conceive of based on the teachings presented in the foregoing description and the accompanying drawings. Therefore, it should be understood that the invention is not limited to the specific embodiments disclosed above, and many modifications and other embodiments are intended to be included within the scope of the appended claims. Furthermore, although specific terms are used herein and in the appended claims, they are used in a general and descriptive sense only and are not intended to limit the described invention or the appended claims.

[0121] Those skilled in the art will understand that although the invention has been described above in conjunction with specific embodiments and examples, the invention is not necessarily limited thereto, and many other embodiments, examples, uses, modifications, and deviations from these embodiments, examples, and uses will be included in the appended claims. The entire disclosure of each patent and publication referenced herein is incorporated by reference as if each such patent or publication were individually incorporated by reference. Various features and advantages of the invention are set forth in the following claims.

Claims

1. A surgical robotic system, comprising: a robotic base; a robotic arm connected to and in electronic communication with the robotic base; an end effector connected to and in electronic communication with the robotic arm, wherein the end effector comprises a conduit configured to receive a surgical instrument, wherein the conduit is connected to the end effector via a rotational bearing, and the end effector is configured for selective rotation about one or more of an x-axis, a y-axis, and a z-axis, and a Z-frame axis, and wherein the conduit is configured to automatically rotate about a central axis of the conduit as the robotic arm and the end effector move along a trajectory to a surgical site, and wherein the rotation of the conduit is at a fixed angle relative to the robotic base and is automatically rotated to maintain the fixed angle relative to the robotic base.

2. The surgical robotic system of claim 1, wherein the end effector comprises a servo motor to automatically rotate the conduit.

3. The surgical robotic system of claim 1, further comprising a tracking system to track a position of the end effector.

4. The surgical robotic system of claim 3, wherein the tracking system is configured to be registered to a patient anatomy, and wherein the conduit is configured to automatically rotate to a fixed position relative to the patient anatomy.

5. The surgical robotic system of claim 1, further comprising an inertial sensor, and wherein the conduit is configured to automatically rotate to a fixed position relative to a patient based on feedback from the inertial sensor.

6. The surgical robotic system of claim 5, wherein the inertial sensor is radially offset from the central axis of the conduit.

7. The surgical robotic system of claim 6, further comprising a force sensor configured to provide feedback to rotate the conduit.

8. The surgical robotic system of claim 7, wherein the force sensor is embedded in the conduit.

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