Surgical tool

Abstract

A surgical instrument includes an expander, a cutter, a retractable brush, and at least one retractable drill. The expander is configured to expand a patient's tissue and is capable of being positioned in either an unexpanded or expanded configuration. The cutter is configured to cut the tissue and is located at the distal end of the expander. The cutter is configured to move between a cutting position when the expander is in the unexpanded configuration and a non-cutting position when the expander is in the expanded configuration. The retractable brush is configured to brush the surface of an anatomical element of the patient to remove material from the surface. The at least one retractable drill is configured to drill into the anatomical element.

Description

[0001] Cross-references to related applications

[0002] This application claims the benefit of U.S. Patent Application No. 17 / 339,708, filed June 4, 2021, entitled "Drilling Tool, Systems, and Methods," and U.S. Provisional Application No. 63 / 039,818, filed June 16, 2020, entitled "Drilling Tool, Systems, and Methods," the entire contents of which are incorporated herein by reference. Technical Field

[0003] This technology relates generally to surgical instruments, and more specifically to instruments used for surface preparation and drilling. Background Technology

[0004] During the surgical procedure, and specifically during bone drilling, multiple surgical tools can be used to prepare the surface of the anatomical element for drilling and insertion into the anatomical element. Sometimes scraping or the drill fails to engage with the anatomical element during drilling, causing the drill to slide on the surface of the anatomical element. Summary of the Invention

[0005] Exemplary aspects of this disclosure include:

[0006] The tool according to at least one embodiment of the present disclosure includes an expander configured to expand a patient's tissue, the expander having a plurality of arms, each arm having a distal end, the expander having an unexpanded configuration and an expanded configuration, the distal ends of the plurality of arms being positioned closer to each other when the expander is in the unexpanded configuration than when the expander is in the expanded configuration; a cutter configured to cut the tissue, the cutter being disposed at the distal end of one of the plurality of arms and configured to move between a cutting position when the expander is in the unexpanded configuration and a non-cutting position when the expander is in the expanded configuration; a retractable brush configured to brush a surface of the patient's anatomical element to remove material from the surface; and at least one retractable drill configured to drill into the anatomical element.

[0007] Any aspect of this document, wherein the expander may be biased toward the unexpanded configuration.

[0008] In any aspect of this document, extending the brush from the retracted position to the extended position may cause the expander to move from the unexpanded position to the expanded position.

[0009] In any aspect of this document, the cutter may move from the cutting position to the non-cutting position when the expander moves from the unexpanded configuration to the expanded configuration.

[0010] In any aspect of this document, the brush can automatically retract as the at least one retractable drill extends.

[0011] In any aspect thereof, the at least one retractable drill may include a first drill and a second drill, the second drill being disposed within the cannula of the first drill.

[0012] In any aspect of this document, the brush and the first drill can retract automatically when the second drill is in operation.

[0013] Any aspect of this document, wherein the second drill may extend and retract independently of the first drill.

[0014] In any aspect of this document, the first drill may be a burr configured to create a flat portion or a shallow recess on the surface of the anatomical element, and the second drill is a drill bit configured to drill a hole through the flat portion or the shallow recess.

[0015] In any aspect of this document, the tool may also include a first housing and a second housing disposed within the first housing.

[0016] Any aspect thereof, wherein each of the plurality of arms may be rotatably connected to the first housing.

[0017] In any aspect of this document, the brush may extend from the end of the second housing and the second housing may rotate within the first housing.

[0018] In any aspect of this document, the at least one retractable drill may be disposed inside the second housing when retracted.

[0019] In any aspect of this document, each of the first and second housings may be a tube.

[0020] Any aspect of this document, wherein the cutter can be selectively rotated from the cutting position to the non-cutting position.

[0021] In any aspect of this document, the cutter may be configured to rotate from the cutting position to the non-cutting position as the expander engages with the tissue during its movement from the unexpanded configuration to the expanded configuration.

[0022] A method for drilling into an anatomical element according to one embodiment of the present disclosure includes: cutting a patient's tissue using a cutter of a surgical instrument; expanding the patient's tissue using an expander of the surgical instrument, the expander having a plurality of arms, each arm having a free end, the plurality of arms being movable between an unexpanded position and an expanded position, in the unexpanded position the free ends being closer together to define a wedge configuration, and in the expanded position the free ends being farther apart than in the unexpanded position; cleaning the surface of the patient's anatomical element using a brush of the surgical instrument to remove material from the surface; and drilling into the anatomical element using at least one drill of the surgical instrument.

[0023] Any aspect of this article, wherein the method can be performed automatically by a robotic arm holding the surgical tool.

[0024] Any aspect thereof, wherein the method may further include using at least one drill to cut a flat portion on the surface of the anatomical element.

[0025] In any aspect of this document, expanding the tissue may include extending the brush adjacent to the expander to move the plurality of arms from the unexpanded position to the expanded position.

[0026] A system for minimally invasive drilling according to one embodiment of the present disclosure includes: a processor; and a memory storing instructions for execution by the processor, which, when executed, cause the processor to: cut the patient's tissue with a cutter of a surgical tool; expand the tissue with an expander of the surgical tool; brush the surface of the patient's anatomical element with a brush of the surgical tool to remove material from the surface; and drill a hole in the anatomical element with a drill of at least one surgical tool.

[0027] In any aspect of this document, the system may also include at least one robotic arm, wherein the surgical tool is disposed at the end of the at least one robotic arm.

[0028] Any aspect combined with any one or more other aspects.

[0029] Any one or more of the features disclosed in this document.

[0030] This document generally discloses any one or more of the features.

[0031] Any one or more of the features generally disclosed herein combined with any one or more other features generally disclosed herein.

[0032] Any aspect / feature / implementation can be combined with any one or more other aspects / features / implementations.

[0033] Use any one or more of the aspects or features disclosed herein.

[0034] It should be understood that any feature described herein may be combined with any other feature described herein to claim protection, regardless of whether the feature is derived from the same described implementation.

[0035] Details of one or more aspects of this disclosure are set forth in the following drawings and description. Other features, objectives, and advantages of the technology described in this disclosure will be apparent from the specification, drawings, and claims.

[0036] The phrases “at least one,” “one or more,” and “and / or” are open-ended expressions that possess both connective and disjoint qualities in operation. For example, the expressions “at least one of A, B, and C,” “at least one of A, B, or C,” “one or more of A, B, and C,” “one or more of A, B, or C,” and “A, B, and / or C” mean only A, only B, only C, A and B together, A and C together, B and C together, or A, B, and C together. When each of A, B, and C in the above expressions refers to an element such as X, Y, and Z, or such as X1-X… n Y1-Y m and Z1-Z o When referring to a single class of elements, the phrase means a single element selected from X, Y, and Z; a combination of elements selected from the same class (e.g., X1 and X2); and elements selected from two or more classes (e.g., Y1 and Z). o () combination.

[0037] The term "a / an" refers to one or more of the entities mentioned. Thus, the terms "a / an," "one or more," and "at least one" are used interchangeably herein. It should also be noted that the terms "comprising / including" and "having" are used interchangeably.

[0038] The foregoing is a simplified overview of this disclosure to provide an understanding of some aspects thereof. This summary is neither a broad nor an exhaustive overview of this disclosure and its various aspects, embodiments, and configurations. It is not intended to identify key or essential elements of this disclosure, nor to depict its scope, but rather to present selected concepts in a simplified form as an introduction to the more detailed description presented below. It should be understood that other aspects, embodiments, and configurations of this disclosure may utilize one or more of the features set forth above or described in detail below, individually or in combination.

[0039] Many additional features and advantages of the invention will become apparent to those skilled in the art upon consideration of the embodiments described below. Attached Figure Description

[0040] The accompanying drawings are incorporated in and form part of this specification to illustrate several examples of this disclosure. These drawings, together with the description, explain the principles of this disclosure. The drawings illustrate only preferred and alternative examples of how to carry out and use this disclosure, and should not be construed as limiting this disclosure to the examples shown and described only. Additional features and advantages will become apparent from the following more detailed description of various aspects, embodiments, and configurations of this disclosure, as illustrated by the figures referenced below.

[0041] Figure 1A A drilling tool according to at least one embodiment of the present disclosure is described;

[0042] Figure 1B At least one other embodiment according to this disclosure is depicted. Figure 1A A close-up view of the drilling tool;

[0043] Figure 2A The drilling tool of FIG1 is depicted according to at least another embodiment of the present disclosure;

[0044] Figure 2B At least one other embodiment according to this disclosure is depicted. Figure 2A A close-up view;

[0045] Figure 3A The drilling tool of FIG1 is depicted according to at least another embodiment of the present disclosure;

[0046] Figure 3B The drilling tool of FIG1 is depicted according to at least another embodiment of the present disclosure;

[0047] Figure 3C The drilling tool of FIG1 is depicted according to at least another embodiment of the present disclosure;

[0048] Figure 4 This is a block diagram of a system according to at least one embodiment of the present disclosure; and

[0049] Figure 5 This is a flowchart of a method according to at least one embodiment of the present disclosure. Detailed Implementation

[0050] It should be understood that the various aspects disclosed herein can be combined in combinations different from those specifically given in the specification and drawings. It should also be understood that, depending on the example or embodiment, certain actions or events of any process in the method described herein may be performed in a different order, and may be added, combined, or omitted entirely (e.g., all described actions or events may not be necessary for performing the described technique). Furthermore, although some aspects of this disclosure are described for clarity as being performed by a single module or unit, it should be understood that the methods of this disclosure can be performed by a combination of units or modules associated with, for example, computing devices and / or medical devices (including medical imaging devices).

[0051] In one or more examples, one or more steps of the described methods, processes, and techniques may be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functionality may be stored as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. A computer-readable medium may include a non-transitory computer-readable medium, which corresponds to a tangible medium, such as a data storage medium (e.g., RAM, ROM, EEPROM, flash memory, or any other medium that can be used to store desired program code in the form of instructions or data structures and is accessible by a computer).

[0052] Instructions can be executed by one or more processors, such as one or more digital signal processors (DSPs), general-purpose microprocessors (e.g., Intel Core i3, i5, i7, or i9 processors; Intel Celeron processors; Intel Xeon processors; Intel Pentium processors; AMD Ryzen processors; AMD Athlon processors; AMD Phenom processors; Apple A10 or 10X Fusion processors; Apple A11, A12, A12X, A12Z, or A13 Bionic processors; or any other general-purpose microprocessor), application-specific integrated circuits (ASICs), field-programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuit systems. Therefore, the term "processor" as used herein can refer to any of the foregoing structures or any other physical structures suitable for implementing the described techniques. Furthermore, this technique can be fully implemented in one or more circuit or logic elements.

[0053] Before explaining any embodiment of this disclosure in detail, it should be understood that this disclosure is not limited in its application to the construction details and component arrangements set forth in the following description or shown in the accompanying drawings. This disclosure can have other embodiments and can be practiced or carried out in various ways. Similarly, it should be understood that the wording and terminology used herein are for descriptive purposes and should not be considered limiting. The use of “including / comprising” or “having” and variations thereof herein is intended to cover the items listed thereafter and their equivalents, as well as additional items. Furthermore, this disclosure may use examples to illustrate one or more aspects thereof. Unless otherwise expressly stated, the use or listing of one or more examples (which may be indicated by “for example,” “by means of an example,” “e.g.,” “such as,” or similar language) is not intended to, and does not limit, the scope of this disclosure. Moreover, unless otherwise expressly stated, terms such as “about” and “approximately”, when used in conjunction with stated values, mean within ten percent of the stated value.

[0054] One of the challenges of drilling into bone is scraping. Scraping occurs due to the angle at which the drill bit impacts the bone and / or the presence of soft tissue on the bone. This disclosure describes apparatus, systems, and methods for reducing or avoiding scraping. Embodiments of this disclosure utilize a robotic end effector on a robotic arm. The robotic end effector holds a single tool, controllable from the root, to make a skin incision, widen the incision, prepare the surface of the anatomical element for drilling, and drill into the anatomical element. The use of the robotic arm makes it possible to control the position and orientation of the tool (including, for example, the height of the tool on the patient's skin and / or the target anatomical element, and the direction of tool orientation).

[0055] The drilling tools described herein include a penetrating expander, a metal brush, a grinding drill, and a drill bit. The penetrating expander is used to simultaneously cut through and expand the soft tissue above the target anatomical element. The penetrating expander includes a special plate that is movable during soft tissue penetration and immobile when the expander is moved to the expansion position. Once the penetrating expander is fully expanded, the surface of the anatomical element is cleaned with a metal brush, after which the grinding drill is used to cut a plane or shallow recess on the surface of the anatomical element. The plane or shallow recess is used to guide the drill bit onto the correct trajectory to eliminate scraping. The drill bit can then be used to drill into or mill the anatomical element.

[0056] The embodiments disclosed herein may be particularly useful during minimally invasive surgeries, such as minimally invasive spinal surgery.

[0057] Including a cutting blade, expander, brush, abrasive drill, and drill in a single tool significantly reduces the number of tool variations required for drilling in minimally invasive procedures, while reducing the likelihood of scraping, and thus increasing the effectiveness and accuracy of the procedure.

[0058] In some applications, multiple tools may be used to approach the surface of the dissected element and then thoroughly clean the surface, and / or mill or otherwise prepare the surface of the dissected element for drilling. However, using multiple tools can be cumbersome and time-consuming. Furthermore, multiple tools may not adequately prepare the surface and therefore may not sufficiently reduce the likelihood of scraping during drilling.

[0059] Embodiments of this disclosure provide a single, multi-functional tool that can prepare anatomical elements for drilling without tool switching, thereby reducing overall operational complexity, time, and cost. The tools according to embodiments of this disclosure are also advantageously small and non-invasive, and can be adapted for minimally invasive procedures. Embodiments of this disclosure also provide tools that can prepare anatomical elements to prevent or reduce the effects of scraping.

[0060] As described more fully below, a drilling tool according to at least some embodiments of the present disclosure can be designed to form and expand an opening in a patient’s tissue, prepare the surface of an anatomical element exposed by the opening for drilling, and drill the anatomical element, all of the above operations using components set or formed in a single housing of a single tool.

[0061] First refer to Figure 1A and Figure 1B The drilling tool 100 according to at least one embodiment of this disclosure includes an expander 102, a cutter 104, a retractable brush 106, and at least one retractable drill 108. In some embodiments, the tool 100 may have fewer or more components. The drilling tool 100 can be used to cut and expand a patient's tissue 110, remove soft tissue from the surface of an anatomical element 112 (which may be, for example, bone), cut flat portions or shallow depressions on the surface, and drill into the anatomical element 112 using a single tool 100 to perform each step during a surgical procedure. The tool 100 may be made of, as per [the relevant information] Figure 4 The described robot 404 is held in place and each step can be performed automatically (e.g., under the control of the robot 404) or manually (e.g., under the control of a surgeon).

[0062] In the illustrated embodiment, tool 100 includes a first housing 114 and a second housing 116 housed within the first housing 114. In other embodiments, tool 100 may have one or more housings. Each of the first housing 114 and the second housing 116 is tubular or cylindrical, but in other embodiments, housings 114 and 116 may be of any shape, including but not limited to square, rectangular, triangular, elliptical, etc. Each housing 114 and 116 may be formed of the same material, or each housing 114 and 116 may be formed of different materials from each other. The material may be any solid material, including but not limited to metals, steel, plastics, etc., or any combination thereof, and may be biocompatible. In the illustrated embodiment, at least one retractable drill 108 is partially or completely disposed within a hole in the second housing 116, a retractable brush 106 is disposed inside the first housing 114 and at an end of the second housing 116, and an expander 102 and a cutter 104 are disposed at the end of the first housing 114. In other embodiments, at least one retractable drill 108 may be disposed inside the first housing 114 (e.g., between the first housing 114 and the second housing 116), a retractable brush 106 may be disposed inside the second housing 116, and / or an expander 102 and a cutter 104 may be disposed at the end of the second housing 116.

[0063] like Figure 1B As shown, the cutter 104 (which may also be referred to herein as a blade or cutting blade) is configured to cut through the soft tissue 110 during the initial insertion of the tool 100 to form an incision with an opening 124 when the expander 102 is in the unexpanded position (also referred to herein as the unexpanded configuration) described in more detail below. The cutter 104 may be replaceable or repairable when it becomes dull. During use, the tool 100 may be extended until the cutter 104 contacts the anatomical element 112 beneath the tissue 110. In the example shown, the cutter 104 is positioned at the free end or distal end 122 of one of the plurality of arms 120. The following is about... Figure 2A and Figure 2B In more detail, the plurality of arms 120 may include arms 120a, arms 120b. In other examples, the tool 100 may have more than one cutter 104. For example, the cutter 104 may be located at the free end or distal end 122 of each of the plurality of arms 120 or more of the plurality of arms 120. Figure 1B As shown, when the expander 102 is in the unexpanded position or configured, the cutter 104 is positioned in the cutting position, and as... Figure 2BAs shown, when the expander 102 is in the expanded position or configuration, the cutter is positioned in the non-cutting position, as described in more detail below. In some embodiments, the cutter 104 can be selectively rotated from the cutting position to the non-cutting position, such as... Figure 2B As can be seen, the cutter 104 can be configured to automatically rotate from the cutting position to the non-cutting position when the expander 102 changes from a non-expanding position to an expanded position. Furthermore, in some embodiments, the cutter 104 can be configured to automatically rotate from the non-cutting position to the cutting position when the expander 102 engages tissue 110 during a movement from a non-expanding position or configuration to an expanded position or configuration. In other words, the expansioner 102 moving from a non-expanding configuration to an expanded configuration causes the cutter 104 to move from the cutting position to the non-cutting position. In other examples, when in the non-cutting position, the cutter 104 can be retracted or removed.

[0064] In some embodiments, the cutter 104 is biased to a cutting position, but in other embodiments, the cutter 104 is biased to a non-cutting position or not biased to either position. The cutter 104 may be held or locked in either the non-cutting or cutting position. When the expander 102 is in the expanding position, the non-cutting position advantageously reduces pressure on the tissue 110 and / or undesirable cutting. In other words, if the cutter 104 is held in the cutting position while the expander 102 is in the expanding position, the tissue 110 near the free end 122 of the arm 120b may undergo additional unnecessary cutting, thereby damaging the tissue. Similarly, the rotatability of the cutter 104 allows the cutter 104 to be moved to the non-cutting position at the start of expansion so that the cutter 104 can be rotated or folded without further cutting the tissue 110 during expansion.

[0065] Go to Figure 2A and Figure 2B The illustration shows the use of expander 102. Expander 102 is configured to expand a patient's tissue 110 and includes a plurality of arms 120. In the illustrated example, the plurality of arms 120 includes two arms 120a, 120b, but in other embodiments, the plurality of arms 120 may include more than two arms. Each arm 120a, 120b includes a free end 122. The plurality of arms 120 are rotatably connected to the ends of a first housing 114, and each arm 120a, 120b is operable to expand from a... Figure 1A The unexpanded position shown rotates to Figure 2AThe expansion positions are shown. In the illustrated embodiment, when the plurality of arms 120 are in the unexpanded position or configuration, the free ends or distal ends 122 intersect to define a point, and when the plurality of arms 120 are in the expanded position or configuration, the free ends or distal ends 122 are separated from each other. In other embodiments, when the expander 102 is in the unexpanded position or configuration, the free ends or distal ends 122 may be positioned closer to each other, but not in contact.

[0066] In the illustrated embodiment, each arm 120a, 120b is positioned opposite to each other; however, in other embodiments, each arm 120a, 120b may be positioned anywhere on the periphery of the end of the first housing 114. Each arm 120a, 120b is angled inward and contacts the other arm 120b, 120a, respectively, to form a wedge or triangle when the plurality of arms 120 are in the unexpanded position. In embodiments where the plurality of arms 120 includes more than two arms, each arm may intersect at that point to form a partial or full cone.

[0067] In some embodiments, the plurality of arms 120 are biased (e.g., by springs) to an unexpanded position (e.g., an insertion position) and thus remain in the unexpanded position until actuated or otherwise forced to rotate to the expanded position. In other embodiments, the plurality of arms 120 may be biased to the expanded position and held in the unexpanded position by force (e.g., during insertion). When the force acting on the plurality of arms 120 is removed or withdrawn, the plurality of arms 120 move to the expanded position. In other embodiments, the plurality of arms 120 may not be biased to any position.

[0068] In some embodiments, a plurality of arms 120 are actuated by extending a retractable brush 106, which pushes and applies force to the arms 120 to rotate them from a non-expanded position to an expanded position. The arms 120 can be locked in the expanded position such that they remain in the expanded position when the retractable brush 106 retracts into the first housing 114 and the force is removed from the arms 120. In some embodiments, the arms 120 can rotate back to the non-expanded position when the retractable brush 106 retracts and the force on the arms 120 is released. In other embodiments, the arms 120 can be actuated by a controller (not shown), a robot 404, and / or a surgeon. As shown, when the arms 120 are in the expanded position, each arm of the plurality of arms 120 is parallel to or aligned with the first housing 114. However, in other embodiments, when in the expanded position, each arm of the plurality of arms 120 may not be parallel to or aligned with the first housing 114. For example, when the multiple arms are not yet parallel to or in a straight line with the first housing 114 (e.g., the multiple arms may be angled toward the central axis of the first housing 114) or when the multiple arms have moved beyond being parallel to or in a straight line with the first housing 114 (e.g., the multiple arms may be angled away from the central axis of the first housing 114), the rotation of each of the multiple arms from the unexpanded position to the expanded position can stop. The amount of rotation of the multiple arms 120 can correspond to the amount of expansion of the tissue 110. In other words, when in the expanded position, the spacing between the free ends 122 of the multiple arms 120 can correspond to the maximum width or diameter of the opening 124 of the tissue 110.

[0069] Figures 3A to 3C The use of a retractable brush 106 and at least one drill 108 is illustrated. The brush 106 extends from end 126 of a second housing 116. The second housing 116 (and therefore the brush 106) is retractable, extendable, and / or rotatable within a first housing 114. The brush 106 can extend and retract independently between a retracted position and an extended position, but in some embodiments, the brush 106 may be fixed in a position at the end of the second housing 116. As described above, when the brush 106 (and / or the second housing 116) extends from the retracted position to the extended position, the brush 106 (and / or the second housing 116) can move the expander 102 from the unexpanded position to the expanded position. When the brush 106 is not in use, the brush 106 (and / or the second housing 116) can remain in or return to the retracted position so that the brush 106 does not obstruct the way when other components (e.g., expander 102, cutter 104 and / or at least one drill 108) are used.

[0070] The retractable brush 106 is configured to brush the patient's anatomical element 112 to remove material from the surface 128 of the anatomical element 112, and thus prepare the surface 128 for cutting and / or drilling, such as Figure 3A As shown. In some examples, the brush rotates and removes tissue from the bone. Brush 106 can be cleaned after use and / or can be replaceable. Brush 106 can be formed of or otherwise comprise steel bristles, but in other examples, brush 106 can be formed of or otherwise comprise of bristles of another metal or metal alloy, plastic bristles, or any other suitable material. In some embodiments, the brush can include a plurality of misaligned filaments (e.g., steel wool or metal wire sponge), or can be otherwise formed without generally aligned bristles. Brush 106 can extend around the entire periphery of the end 126 of the second housing 116, or brush 106 can extend partially around the periphery or can be segmented along the periphery. Similarly, as shown in the illustrated example, brush 106 can extend around or partially around at least one drill 108.

[0071] At least one drill 108 is disposed inside the first housing 114 and the second housing 116 when fully retracted, and is disposed outside the second housing 116 when extended. Figure 3B As shown, when partially extended and in use, at least one drill 108 may be disposed inside the first housing 114, or as... Figure 3C As shown, when extended and in use, the at least one drill can be disposed outside the first housing 114. During use, at least one drill 108 is configured to drill into the dissecting element 112.

[0072] In the illustrated embodiment, at least one drill 108 includes a first drill 130 and a second drill 132. In other embodiments, at least one drill may include one or more drills. In the illustrated embodiment, the second drill 132 is disposed within the cannula 136 of the first drill 130, but in other embodiments, the second drill 132 may be positioned adjacent to or spaced apart from the first drill 130. Each of the first drill 130 and the second drill 132 may be removed from the tool 100 for cleaning, repair, or replacement. Each of the first drill 130 and the second drill 132 may retract or extend independently and / or together. For example, the first drill 130 may retract and the second drill 132 may extend, the first drill 130 may extend and the second drill 132 may retract, and / or both the first drill 130 and the second drill 132 may extend or retract. Further, the first drill 130, the second drill 132, and the brush 106 may each retract or extend independently.

[0073] In the illustrated embodiment, the first drill 130 includes a grinding drill or rotary file configured to create a flat portion or shallow recess 134 on the surface 128 of the anatomical element 112, such as Figure 3B As shown, and the second drill 132 includes a drill bit configured to drill a hole through the flat portion 134, as... Figure 3C As shown. In other embodiments, the first drill 130 may include a drill bit or any other type of rotary drilling or cutting tool, and the second drill 132 may include a rotary file or any other type of rotary drilling or cutting tool. Figure 3B As shown, both the grinding drill and the drill bit can extend during use. During use, both the grinding drill and the drill bit can rotate together, or the grinding drill can rotate while the drill bit remains stationary. The flat portion 134 produced by the grinding drill provides a clean, flat surface perpendicular to the drill bit, advantageously reducing or preventing drill bit scraping. In other words, the flat portion 134 provides the drill bit with an angle of attack that improves the drill bit's ability to engage the anatomy element 112. However, in some embodiments, the drill bit can drill through the anatomy element 112 without the grinding drill producing the flat portion 134.

[0074] During use of tool 100, brush 106 and / or first drill 130 may retract while the drill bit is drilling. After the drill bit has exited the hole, tool 100 may be removed from the patient. Before removal, if any of these components (e.g., brush 106, first drill 130, and / or second drill 132) have not retracted, such components may be retracted, and expander 102 may be moved to an unexpanded position; however, it should be understood that expander 102 may remain in the expanded position during removal of tool 100. In other embodiments, one or more components of tool 100 may remain extended during removal of tool 100 from the patient.

[0075] Each component of tool 100 may be made of metal, metal alloy, plastic, composite material, any other suitable material enabling the component to achieve the purposes described herein, and / or any combination thereof. In some embodiments, one or more components of tool 100 may be made of a radiation-permeable material, such as polyetheretherketone (PEEK) or a thermoplastic resin with carbon fiber reinforcement. In other embodiments, these components of tool 100 are not radiation-permeable. The materials used to make the various components of tool 100 may be selected to enable tool 100 and / or one or more of its parts to be cleaned, sterilized (whether by heat, chemical treatment or other means), and / or reused. Additionally and / or alternatively, the materials used to make the various components of tool 100 may be selected to facilitate cleaning, replacement, or repair.

[0076] As mentioned above regarding Figure 1 to... Figure 3CThe described tool 100 can be used as follows Figure 4 In the system 400 shown, however it should be understood that tool 100 can be used independently of system 400. System 400 includes computing device 402, robot 404, tool 100, fluid source 420, vacuum source 422, and / or navigation system 406. In some embodiments of this disclosure, the system (such as...) Figure 4 System 400 may not include one or more of the components shown, but may include Figure 4 Other components not shown, and / or may include those related to Figure 4 The system 400 shown may include one or more components that are similar but not identical. For example, in some embodiments, the system 400 may not include the navigation system 406. In other embodiments, the system 400 may not include the fluid source 420 and / or the vacuum source 422.

[0077] The computing device 402 according to embodiments of the present disclosure may include a processor 408, a memory 410, a communication interface 412, and a user interface 414. In some embodiments, the computing device (such as computing device 402) may have a higher... Figure 4 The computing device 402 shown has more or fewer components.

[0078] The processor 408 of the computing device 402 may be any processor described herein or any similar processor. The processor 408 may be configured to execute instructions stored in the memory 410, which may enable the processor 408 to perform one or more computational steps using or based on data received from: a user interface 414; one or more sensors included in, attached to or otherwise monitoring the operation of the tool 100; a robot 404; and / or a navigation system 406.

[0079] Memory 410 may be or include RAM, DRAM, SDRAM, other solid-state memory, any memory described herein, or any other tangible non-transitory memory used to store computer-readable data and / or instructions. Memory 410 may store information or data that can be used to perform any step of the methods 500 described herein. Memory 410 may store, for example, one or more tool instructions 416 and / or one or more surgical plans 418. In some embodiments, such instructions 416 may be organized into one or more applications, modules, packages, layers, or engines. Instructions 416 may cause processor 408 to manipulate data stored in memory 410 and / or received from navigation system 406.

[0080] The computing device 402 may also include a communication interface 412. The communication interface 412 may be used to receive information from external sources (such as tool 100, robot 404, and / or navigation system 406), and / or to transmit instructions, data, or other information to external systems or devices (e.g., tool 100, robot 404, and / or navigation system 406). The communication interface 412 may include one or more wired interfaces (e.g., USB port, Ethernet port, FireWire port) and / or one or more wireless interfaces (e.g., configured to transmit information via one or more wireless communication protocols such as 802.11a / b / g / n, Bluetooth, NFC, ZigBee, etc.). In some embodiments, the communication interface 412 may be used to enable the computing device 402 to communicate with one or more other processors 408 or computing devices 402, whether to reduce the time required to complete computationally intensive tasks or for any other reason.

[0081] The computing device 402 may also include one or more user interfaces 414. User interfaces 414 may be or include a keyboard, mouse, trackball, monitor, television, touchscreen, joystick, switch, button, and / or any other means for receiving information from and / or providing information to a user. User interfaces 414 may be used, for example, to receive user selections or other user input regarding surgical plans; to receive user input that can be used in conjunction with tool instructions 416 and / or surgical plans 418; to receive user selections or other user input regarding the operation of robot 404, manipulation of robotic arm 424, and / or use of tool 100; and / or to display instructions 416 and / or surgical plans 418. In some embodiments, user interfaces 414 may be used to allow surgeons or other users to modify instructions 416, plans 418, or other displayed information, but it should be understood that each of the aforementioned inputs may be automatically generated by system 400 (e.g., by processor 408 or another component of system 400) or received by system 400 from a source external to system 400. In some implementations, user inputs such as those described above may be optional or unnecessary for the operation of the systems, apparatus and methods described herein.

[0082] Although user interface 414 is shown as part of computing device 402, in some embodiments, computing device 402 may utilize user interface 414, which may be housed separately from one or more other components of computing device 402. In some embodiments, user interface 414 may be located close to one or more other components of computing device 402, but in other embodiments, user interface 414 may be located away from one or more other components of computing device 402.

[0083] Robot 404 can be any surgical robot or surgical robot system. Robot 404 can be, or includes, for example, Mazor X. ™ The Stealth Edition robot guidance system. Robot 404 may include one or more robot arms 424. In some embodiments, robot arm 424 may include one robot arm, but in other embodiments, robot arm 424 may include two or more robot arms. Tool 100 may be disposed on the end of robot arm 424. In other examples, tool 100 may be disposed on any part of robot arm 424 and / or robot 404.

[0084] Reference markers (i.e., navigation markers) may be placed on robot 404, robotic arm 424, tool 100, or any other object in the surgical space. The reference markers may be tracked by navigation system 406, and the results of the tracking may be used by the operator of robot 404 and / or system 400 or any of its components. In some embodiments, navigation system 406 may be used to track other components of the system (e.g., tool 100), and system 400 may be operated without the use of robot 404 (e.g., a surgeon manually manipulating tool 100).

[0085] In some embodiments, system 400 may include navigation system 406, but in other embodiments, system 400 may not include navigation system 406. During operation, navigation system 406 can provide navigation for the surgeon and / or surgical robot. Navigation system 406 can be any navigation system now known or developed in the future, including, for example, Medtronic StealthStation. ™ S8 Surgical Navigation System. In various embodiments, navigation system 406 can be used to track the position of robotic arm 424 (or more specifically, a navigation tracker attached to robotic arm 424). Navigation system 406 may include cameras or other sensors for tracking one or more reference markers, navigation trackers, or other objects within the operating room. Navigation system 406 may include a display for displaying one or more images from an external source (e.g., computing device 402, camera, or other source), or a video stream from the camera or other sensors of navigation system 406. In some embodiments, navigation system 406 may provide computing device 402 with position, movement, and / or other information for controlling tool 100 and / or any other aspect of system 400. In some embodiments, system 400 may operate without the use of navigation system 406.

[0086] System 400 may also include a fluid source 420 and / or a vacuum source 422. In some embodiments, system 400 may not include fluid source 420 and / or vacuum source 422, and may include only fluid source 420, or only vacuum source 422. In other embodiments, fluid source 420 and / or vacuum source 422 may be used with tool 100 independently of system 400. Each of fluid source 420 and / or vacuum source 422 may be formed as part of tool 100 or may be separate from tool 100. A hose (not shown) may extend from each of fluid source 420 and vacuum source 422 to tool 100. Fluid source 420 may be configured to supply fluid to brush 106 and / or at least one retractable drill 108. The fluid may be a gas (e.g., oxygen, air, carbon dioxide, helium-oxygen mixture) or a liquid (water, brine, etc.). Fluid can cool drill 108 and / or flush loose dissecting particles from drill 108, brush 106, and / or dissecting element 112 during use. Vacuum source 422 can remove fluid when used with fluid source 420, and / or remove loose dissecting particles when used with or without fluid source 420. Fluid can be delivered to and / or removed from dissecting element 112 through a cannula in at least one drill 108. In other embodiments, fluid can be delivered to or removed from dissecting element 112 through any cannula, ring, or hose formed on, disposed on, or attached to tool 100.

[0087] Turn now Figure 5 The method 500 for performing surgical procedures can be performed wholly or partially by a robot (e.g., robot 404 controlled by computing device 402) and / or a surgeon. The method 500 can use, for example, the tool 100 described above with respect to Figures 1-3 and / or the tool described above with respect to... Figure 4 The system described is 400 to be executed.

[0088] Method 500 includes using a cutter (e.g., cutter 104) of a surgical instrument (e.g., surgical instrument 100) to cut the patient's soft tissue (e.g., tissue 110) (step 502). (See also: Regarding...) Figures 1A to 2B The cutter can create incisions in soft tissue to form openings (e.g., opening 124), and thus allow access to anatomical elements (such as anatomical element 112).

[0089] Method 500 also includes expanding the soft tissue with an expander (e.g., expander 102) of the tool (step 504). As previously discussed... Figures 2A to 2B The expander widens the opening to form a larger opening through which other parts of the tool can be inserted. During the expansion step, in which the expander moves from a non-expanded position to an expanded position, the cutter can simultaneously move from a cutting position to a non-cutting position, such as... Figure 2B As shown.

[0090] Method 500 further includes having a brush (e.g., brush 106) of the tool brush the surface (e.g., surface 128) of the anatomical element (step 506). As previously discussed... Figure 3A The brush is described as brushing and / or cleaning the surface by removing any remaining soft tissue from the surface of the anatomical element to prepare the surface for drilling (e.g., by a first drill 130 or a grinding drill).

[0091] Method 500 further includes cutting a flat portion or shallow recess on the surface of the anatomical element (step 508). The flat portion or shallow recess can be cut using a grinding drill such as a first drill 130 or a rotary file. The flat portion or shallow recess can serve as a guide for the drill bit used to drill into the anatomical element, and / or can advantageously help prevent scraping during drilling. The flat portion or shallow recess can have a circular shape and can have a diameter at least as large as the diameter of the drill bit used to drill into the anatomical element.

[0092] Method 500 further includes drilling at least one drill (which may be the same as or similar to the second drill 132 or a component thereof) into the dissecting element (step 512). As previously discussed... Figure 3B and Figure 3C The at least one drill may be, for example, a second drill 132, and may include a drill bit configured for drilling into bone or other hard tissue. The at least one drill may begin drilling from a flat or shallow recessed portion of the surface of the anatomical element produced in step 508.

[0093] In some embodiments, method 500 may include receiving a surgical plan, which may be the same as or similar to surgical plan 418. The surgical plan may be received via a user interface and / or communication interface of a computing device (such as computing device 402) and may be stored in memory (such as memory 410 of computing device 402). The surgical plan may include information about one or more planned movements of the instrument during the surgical procedure. This information may also include a timeline or schedule of one or more planned movements. One or more planned movements may include one or more of the following: timestamps, movement type (e.g., translational and / or rotational movement), movement duration, and / or location information (e.g., coordinates).

[0094] In some embodiments, method 500 may include determining information regarding one or more required movements of an instrument during a surgical procedure outlined in or otherwise described in the surgical plan. In such embodiments, the surgical plan may not include any such information received via a computing device (e.g., computing device 402), but a processor (e.g., processor 408) executing instructions stored in a storage device (e.g., memory 410) may generate such information based on the surgical plan.

[0095] In some embodiments, method 500 may include generating tool instructions (such as tool instructions 416 for causing a tool (e.g., tool 100) to perform one or more surgical steps (such as those described in conjunction with steps 502 to 512). The instructions may also be based on a surgical plan. However, in some embodiments, the tool may be automatically actuated based on instructions stored in memory, which are not based on a surgical plan.

[0096] Instruction 416 may include one or more instructions that cause an alarm or other indication to be issued to the surgeon before each movement of the tool and / or before performing one of one or more planned surgical steps (e.g., via a user interface, such as user interface 414). In some embodiments, such an alarm may suspend the execution of the surgical plan for approval by the surgeon or other operator. In other embodiments, the alarm may simply notify the surgeon of a planned movement and / or a planned increase or decrease in volume, and automatically execute the planned movement. The alarm and / or notification may be displayed on the user interface and / or may include audible and / or visual displays.

[0097] In some embodiments, method 500 may include positioning the tool using a robotic arm. Method 500 may also be performed automatically by a robotic arm that holds the tool (e.g., it may be, for example, robotic arm 424). In other embodiments, the tool may be used manually by a surgeon, who may be assisted in some embodiments by a robot (e.g., robot 404) and / or a navigation system (e.g., navigation system 406).

[0098] As should be understood based on the foregoing disclosure, this disclosure covers companies with fewer than [number missing] [units missing]. Figure 5 The methods for all steps identified in the code (and the corresponding description of method 500), and including all steps except... Figure 5 The method for additional steps beyond those steps identified in the diagram (and the corresponding description of method 500).

[0099] The methods and systems described herein provide a tool that can make and expand incisions to access anatomical elements, prepare the anatomical elements for drilling, and drill the anatomical elements using a single multi-functional tool. This tool advantageously reduces at least four components to a single device, thereby eliminating the need for surgeons or surgical robots to switch tools during the procedure and reducing operation time. Furthermore, the absence of tool switching reduces the potential risk of accidental impact during tool removal or insertion into the surgical site. The tool can also automate each surgical step and can be easily removed from the surgical site as a single unit. Furthermore, the tool remains in the same or similar position during use, ensuring that the drill bit is adequately positioned on the prepared surface.

[0100] The foregoing discussion has been presented for purposes of illustration and description. The foregoing is not intended to limit this disclosure to the one or more forms disclosed herein. In the foregoing specific embodiments, for the purpose of simplifying this disclosure, various features of this disclosure are grouped together in one or more aspects, embodiments, and / or configurations. Features of aspects, embodiments, and / or configurations of this disclosure may be combined in alternative aspects, embodiments, and / or configurations other than those discussed above. The approach of this disclosure should not be construed as reflecting an intention that the claims require more features than expressly recited in each claim. Rather, as reflected in the following claims, aspects of the invention lie in fewer than all the features of a single foregoing aspect, embodiment, and / or configuration. Therefore, the following claims are hereby incorporated into this specific embodiment, wherein each claim exists independently as a separate preferred embodiment of this disclosure.

[0101] Furthermore, although the description has included descriptions of one or more aspects, embodiments, and / or configurations, as well as certain variations and modifications, other variations, combinations, and modifications are also within the scope of this disclosure upon understanding it, for example, as may be within the skill and knowledge of one skilled in the art. It is intended to obtain the right to include alternative aspects, embodiments, and / or configurations to the permissible extent, including claimed alternatives, replacements, and / or equivalent structures, functions, scopes, or steps, regardless of whether such alternatives, replacements, and / or equivalent structures, functions, scopes, or steps are disclosed herein, and it is not intended for use with any patentable subject matter.

Claims

1. A surgical tool, the surgical tool comprising: An expander configured to expand a patient’s tissue, the expander having a plurality of arms, each arm having a distal end, the expander having an unexpanded configuration and an expanded configuration, wherein the distal ends of the plurality of arms are positioned closer to each other when the expander is in the unexpanded configuration than when the expander is in the expanded configuration; A cutter configured to cut the tissue, the cutter being disposed at the distal end of one of the plurality of arms and configured to move between a cutting position when the expander is in the unexpanded configuration and a non-cutting position when the expander is in the expanded configuration; A retractable brush, configured to brush the surface of the patient's anatomical elements to remove material from the surface; and At least one retractable drill bit is configured to drill into the anatomical element. When the at least one retractable drill extends, the retractable brush automatically retracts.

2. The surgical tool of claim 1, wherein the dilator is biased to the undilated configuration.

3. The surgical tool of claim 1, wherein extending the retractable brush from the retracted position to the extended position moves the dilator from the unexpanded configuration to the expanded configuration.

4. The surgical tool of claim 1, wherein when the expander moves from the unexpanded configuration to the expanded configuration, the cutter moves from the cutting position to the non-cutting position.

5. The surgical instrument of claim 1, wherein the at least one retractable drill comprises a first drill and a second drill, the second drill being disposed in the cannula of the first drill.

6. The surgical tool of claim 5, wherein when the second drill is in operation, the retractable brush and the first drill automatically retract.

7. The surgical tool of claim 5, wherein the second drill is capable of extending and retracting independently of the first drill.

8. The surgical instrument of claim 5, wherein the first drill is a grinding drill configured to create a flat portion or a shallow recess on the surface of the anatomical element, and the second drill is a drill bit configured to drill a hole through the flat portion or the shallow recess.

9. The surgical tool according to claim 1, further comprising a first housing and a second housing disposed inside the first housing.

10. The surgical tool of claim 9, wherein each of the plurality of arms is rotatably connected to the first housing.

11. The surgical tool of claim 9, wherein the retractable brush extends from an end of the second housing, and the second housing is rotatable within the first housing.

12. The surgical tool of claim 9, wherein the at least one retractable drill is disposed inside the second housing when retracted.

13. The surgical instrument of claim 9, wherein each of the first housing and the second housing is a tube.

14. The surgical tool of claim 1, wherein the cutter is selectively rotated from the cutting position to the non-cutting position.

15. The surgical tool of claim 14, wherein the cutter is configured to rotate from the cutting position to the non-cutting position as the expander engages with the tissue during the movement from the unexpanded configuration to the expanded configuration.

16. A surgical instrument, said surgical instrument comprising: An expander configured to expand a patient’s tissue, the expander having a plurality of arms, each arm having a distal end, the expander having an unexpanded configuration and an expanded configuration, wherein the distal ends of the plurality of arms are positioned closer to each other when the expander is in the unexpanded configuration than when the expander is in the expanded configuration; A cutter configured to cut the tissue, the cutter being disposed at the distal end of one of the plurality of arms and configured to move between a cutting position when the expander is in the unexpanded configuration and a non-cutting position when the expander is in the expanded configuration; A retractable brush, configured to brush the surface of the patient's anatomical elements to remove material from the surface; and At least one retractable drill bit is configured to drill into the anatomical element. The at least one retractable drill includes a first drill and a second drill, wherein the second drill is disposed in the cannula of the first drill.

17. A surgical instrument, the surgical instrument comprising: An expander configured to expand a patient’s tissue, the expander having a plurality of arms, each arm having a distal end, the expander having an unexpanded configuration and an expanded configuration, wherein the distal ends of the plurality of arms are positioned closer to each other when the expander is in the unexpanded configuration than when the expander is in the expanded configuration; A cutter configured to cut the tissue, the cutter being disposed at the distal end of one of the plurality of arms and configured to move between a cutting position when the expander is in the unexpanded configuration and a non-cutting position when the expander is in the expanded configuration; A retractable brush, configured to brush the surface of the patient's anatomical elements to remove material from the surface; and At least one retractable drill bit is configured to drill into the anatomical element. A first housing and a second housing disposed inside the first housing. The retractable brush extends from the end of the second housing, and the second housing is rotatable within the first housing.

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