Surgical tools and systems including the same

Abstract

This disclosure provides a surgical tool, system, and method for cleaning an anatomical space. At least one brush is disposed on a shaft extending through a tube. The tube includes corresponding brush grooves for each brush. A motor is operable to rotate the shaft to move at least one brush from a closed position to a cleaning position. The at least one brush is fully positioned inside the tube in the closed position and at least partially positioned outside the tube in the cleaning position. A fluid source is operable to supply fluid to at least one brush as it passes through the brush groove.

Description

Technical Field

[0001] This technology relates generally to surgical tools, and more specifically to tools used for preparing anatomical surfaces. Background Technology

[0002] During surgical procedures, particularly spinal interbody fusion, surgical cleaning tools (such as brushes) can be used to prepare the surfaces of anatomical elements for the procedure or for specific steps within it. Surgical robots can be used to assist or autonomously perform one or more steps of a surgical procedure. Summary of the Invention

[0003] Exemplary aspects of this disclosure include:

[0004] A surgical tool according to at least one embodiment of the present disclosure includes: at least one brush disposed on a shaft extending through a tube having a corresponding brush groove for each brush; a motor operable to rotate the shaft to move at least one brush from a closed position to a cleaning position, the at least one brush being fully positioned inside the tube in the closed position and at least partially positioned outside the tube in the cleaning position; and a fluid source operable to supply fluid to at least one brush as the at least one brush passes through the brush groove.

[0005] In any aspect of this article, fluid is supplied through a conduit on the shaft.

[0006] In any aspect of this article, at least one brush defines a substantially circular shape having a brush axis parallel to and offset from the axis of the shaft, and rotation of the shaft causes at least one brush axis to move about the axis.

[0007] In any aspect of this document, the tube includes a first conduit parallel to the second conduit, and each of at least one brush axis and axes is parallel to and offset from the axis of the second conduit.

[0008] Any aspect of this article also includes a suction conduit for draining fluid.

[0009] Any aspect of this article also includes at least one discharge slot disposed near at least one brush slot, the at least one discharge slot being in communication with a suction conduit.

[0010] In any aspect of this article, fluid and a corresponding discharge channel are discharged from at least one brush as at least one brush moves from a cleaning position through a corresponding brush groove to a closed position.

[0011] In any aspect of this article, at least one brush comprises a plurality of steel bristles of different lengths.

[0012] In any aspect of this article, multiple steel bristles form a circle.

[0013] In any aspect of this article, at least one brush comprises three brushes.

[0014] Any aspect of this article also includes a lifting motor configured to move the tool vertically during operation.

[0015] A method for scrubbing anatomical elements according to at least one embodiment of the present disclosure includes: alternatingly rotating at least one brush of a surgical instrument between a clean position and a closed position, the at least one brush being fully positioned within the periphery of a tube of the surgical instrument in the closed position, the tube having a corresponding groove for each brush; supplying fluid from a fluid source of the surgical instrument to the at least one brush as the at least one brush rotates through the closed position; and discharging fluid from the at least one brush through a suction conduit of the surgical instrument, the suction conduit being in fluid communication with a discharge groove disposed near the groove.

[0016] In any aspect of this article, a brush is disposed on a shaft extending through a tube, the shaft including a borehole and at least one fluid orifice positioned near at least one brush, through which fluid is supplied to at least one brush.

[0017] Any aspect of this article also includes: using a motor to move the tool vertically during tool operation.

[0018] In any aspect of this article, at least one brush comprises a plurality of steel bristles of different lengths.

[0019] A system for cleaning an anatomical space according to at least one embodiment of the present disclosure includes: at least one surgical tool including at least one brush, a corresponding groove for each brush, and a fluid source; a processor; and a memory storing instructions executed by the processor, which, when executed, cause the processor to: rotate at least one brush of the surgical tool between a cleaning position and a closed position, the at least one brush contacting an anatomical element when in the cleaning position; supply fluid from the fluid source to the at least one brush, wherein when the at least one brush moves from the cleaning position through the corresponding brush groove to the closed position, fluid and the corresponding brush groove discharge loose anatomical elements from the at least one brush; and discharge fluid and loose anatomical elements from the at least one brush.

[0020] In any aspect of this article, at least one brush comprises a plurality of steel bristles of different lengths.

[0021] In any aspect of this article, instructions for execution by a processor, when executed, further cause the processor to move the tool vertically by a motor during the operation of the tool.

[0022] In any aspect of this article, the surgical tool includes a shaft on which at least one brush is disposed.

[0023] In any aspect of this article, at least one brush defines a substantially circular shape having a brush axis parallel to and offset from the axis of the shaft, and rotation of the shaft causes at least one brush axis to move about the axis.

[0024] 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.

[0025] 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); or elements selected from two or more classes (e.g., Y1 and Z). o () combination.

[0026] 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.

[0027] 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.

[0028] 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

[0029] 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.

[0030] Figure 1A A surgical cleaning tool according to at least one embodiment of the present disclosure is described;

[0031] Figure 1B At least one embodiment according to this disclosure is described. Figure 1A A close-up view of the far side;

[0032] Figure 2A At least one embodiment according to this disclosure is described. Figure 1A A perspective view of a portion of the tool;

[0033] Figure 2B At least one embodiment according to this disclosure is described. Figure 2A A close-up view of a portion of the tool;

[0034] Figure 2C At least one embodiment according to this disclosure is described. Figure 2A A close-up view of the far side of a portion of the tool;

[0035] Figure 3A At least one embodiment according to this disclosure is described. Figure 1A The tools, a portion of which are shown in a close-up view;

[0036] Figure 3BAt least one embodiment according to this disclosure is described. Figure 1A The tool, another part of which is shown in a close-up view;

[0037] Figure 4A The first configuration according to at least one embodiment of the present disclosure is depicted. Figure 1A A perspective view of a portion of the tool;

[0038] Figure 4B The first configuration according to at least one embodiment of the present disclosure is depicted. Figure 1A A top view of a portion of the tools;

[0039] Figure 4C A second configuration according to at least one embodiment of the present disclosure is depicted. Figure 1A A perspective view of a portion of the tool;

[0040] Figure 4D A second configuration according to at least one embodiment of the present disclosure is depicted. Figure 1A A top view of a portion of the tools;

[0041] Figure 4E A third configuration is depicted according to at least one embodiment of the present disclosure. Figure 1A A perspective view of a portion of the tool;

[0042] Figure 4F A third configuration is depicted according to at least one embodiment of the present disclosure. Figure 1A A top view of a portion of the tools;

[0043] Figure 5 This is a block diagram of a system according to at least one embodiment of the present disclosure; and

[0044] Figure 6 This is a flowchart of a method according to at least one embodiment of the present disclosure. Detailed Implementation

[0045] 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).

[0046] 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).

[0047] 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.

[0048] 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 items listed thereafter and their equivalents and additional items. Furthermore, this disclosure may use examples to illustrate one or more aspects thereof. Unless expressly stated otherwise, 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. Similarly, the term “exemplary” as used herein means “example.” Moreover, unless expressly stated otherwise, terms such as “about” and “approximately”, when used in conjunction with stated values, mean within ten percent of the stated values.

[0049] Discectomy is a crucial step in interbody fusion of the spine. Some of the challenges of discectomy include the fact that it currently takes a significant amount of time and is often incomplete (e.g., not all disc remnants are completely removed from the intervertebral space), leading to a risk of nonfusion. The nucleus pulposus, or the inner core of the disc, is a sticky material that is difficult to remove. Forceps can be used for some volume reduction (e.g., removing larger segments of the disc), but they cannot adequately clean the endplate. Brushes are commonly used for endplate preparation, but each brush can only be used once because cleaning the brush (e.g., removing sticky nucleus pulposus material from the brush bristles) is impractical. Therefore, discectomy may require the use of multiple brushes. When using forceps and / or brushes, the resection and cleaning process is lengthy and incomplete. Furthermore, numerous in-and-out operations are required, endangering neutral tissue. Attempted mechanical solutions for discectomy have failed, at least in part, due to the inability to overcome problems such as the stickiness of the resected material, clogging of the suction cannula, and smoothing of the deburred surface.

[0050] The solution described herein includes a rotating brush for removing intervertebral disc material, coupled to an integrated cleaning mechanism. The eccentric brush, in its closed configuration, is in the form of a tube to allow clean access to the intervertebral disc. The eccentric brush rotates and cleans the endplate, then passes through fine grooves in a cleaning tool for wiping the brush, thus cleaning the brush with each rotation. To remove solid material forcibly removed from the endplate and the brush, the cleaning tool includes a rinsing and vacuum system.

[0051] The embodiments disclosed herein can be particularly useful, for example, during surface preparation associated with spinal interbody fusion.

[0052] Including the trough, rinsing system, and vacuum system, the brush's lifespan is extended and the need for multiple brushes in a single surgery is reduced. This also reduces and / or eliminates the time associated with brush replacements and minimizes or eliminates multiple entries and exits of cleaning tools to the surgical site, thus better protecting neutral tissue from unnecessary damage. The brushes can also be sterilized and are therefore reusable.

[0053] Embodiments of this disclosure also provide a brush contained within a tube during positioning of the brush for cleaning, thereby protecting the brush (and neutral tissue along the insertion path) from damage. The tool according to embodiments of this disclosure is also advantageously small and non-invasive, and can be adapted for minimally invasive procedures.

[0054] As described more fully below, a cleaning tool according to at least some embodiments of the present disclosure can be designed to clean anatomical elements by utilizing a brush that moves between a cleaning position and a closed position, a fluid supply source that supplies fluid to the brush to clean the brush, and a discharge conduit for discharging fluid and loose anatomical particles from the anatomical element and / or its vicinity.

[0055] First refer to Figure 1A and Figure 1B A cleaning tool 100 according to at least one embodiment of the present disclosure includes a tube 102, a brush assembly 104, a brush motor 106, a lifting motor 108, and a fluid source 520. Figure 5 (shown in the image) and vacuum source 522 ( Figure 5 (As shown in the diagram). In some embodiments, tool 100 may have fewer or more components. For example, tool 100 may not include lifting motor 108, fluid source 520, and / or vacuum source 522 (as shown in the diagram). Figure 5 (As shown in the diagram). Tool 100 can be used to prepare the surface of an anatomical element (which may be, for example, a vertebral endplate) using a single, reusable brush or a set of brushes. Tool 100 includes a proximal portion 110 and a distal portion 112. Tool 100 can be made of, as shown in the diagram. Figure 5 The robot 504 described herein is held by a passive tool holder or by a surgeon or other person and can perform each step described herein automatically (e.g., under the control of the robot 504) or manually (e.g., under the control of the surgeon).

[0056] In the illustrated embodiment, tool 100 includes tube 102. Tube 102 includes a first conduit 114, the first axis of which is parallel to the second axis of a second conduit 116, and also includes a first end 118 opposite to a second end 120. The diameter of the first conduit 114 may be less than, greater than, or equal to the diameter of the second conduit 116. Tube 102 may be any solid material, including but not limited to metal, steel, plastic, or any combination thereof, and may be biocompatible. In some embodiments, tube 102 may have a diameter shaped for insertion into a small incision for minimally invasive surgery. For example, the diameter of tube 102 may be 8 mm, although in other examples, tube 102 may have a diameter less than or greater than 8 mm. In other embodiments, tube 102 may have a larger diameter.

[0057] Brush assembly 104 may include one, two, or more brushes. Tube 102 may include a brush groove assembly 122. Brush groove assembly 122 may include one, two, or more grooves, the number of grooves corresponding to the number of brushes in brush assembly 104. In the illustrated embodiment, brush groove assembly 122 includes three grooves positioned near a first end 118. In other embodiments, brush groove assembly 122 may be positioned anywhere on tube 102, for example, at or near a second end 120 of tube 102 or near the middle portion 124 of tube, depending on the specific anatomy being cleaned and the anatomy particles being discharged therefrom. In the illustrated embodiment, each groove of brush groove assembly 122 has a height approximately similar to or slightly larger than the height of each brush in brush assembly 104, such that loose anatomy particles that may adhere to each brush in brush assembly 104 are forcibly removed by contact with the edge of the corresponding groove in brush groove assembly 122. In other embodiments, each slot of the brush slot group 122 may have a greater height than the corresponding brush of the brush group 104.

[0058] The tube 102 may also include one or more discharge channels 126. In the illustrated example, the tube 102 includes a first discharge channel disposed above the brush channel assembly 122 and a second discharge channel disposed below the brush channel assembly 122. In other embodiments, the tube 102 may include one or more discharge channels. In further embodiments, one or more discharge channels may be disposed anywhere on the tube 102, for example, at or near the second end 120 of the tube 102 or near the middle portion 124 of the tube, depending on the specific anatomical structure being cleaned and the anatomical particles being discharged therefrom. In the illustrated embodiment, one or more discharge channels 126 extend partially around the circumference of the tube 102 and have a height greater than the height of the channels of the brush channel assembly 122. In other examples, one or more discharge channels 126 may extend completely around the circumference of the tube and / or may have a height greater or less than the height of the channels of the brush channel assembly 122. One or more discharge channels 126 may be sized to facilitate the entry of dissecting particles forcibly removed by the brush assembly 104 during operation of the cleaning tool 100, and may also be configured to reduce the likelihood of blockage by multiple dissecting particles being simultaneously drawn into the second conduit 116.

[0059] Brush motor 106 is located near proximal portion 110 and is operable to rotate shaft 128 to rotate brush assembly 104 from a closed position to a cleaning position and back to a closed position. The closed position is the position where the largest portion of brush assembly 104 is enclosed within the periphery of tube 102, while the cleaning position is any rotational position of brush assembly 104 other than the closed position. In other words, the cleaning position includes any angular offset of brush assembly 104 from the closed position (e.g., between 1 degree and 359 degrees). In embodiments where brush assembly 104 is fully contained within the periphery of tube 102 when in the closed position, the cleaning position encompasses any position of brush assembly 104 where any portion of brush assembly 104 extends beyond the periphery of tube 102.

[0060] In the illustrated embodiment, brush motor 106 is positioned on motor bracket 130 and coupled to shaft 128. Lifting motor 108 is also disposed near proximal portion 110 and configured to vertically move tool 100 before, during, or after operation of tool 100. In the illustrated embodiment, lifting cam 132 extends through cam groove 134 in motor bracket 130 and slides along cam groove 134 as lifting motor 108 rotates. Cam 132 and cam groove 134 convert the rotational motion of lifting motor 108 into translational motion (e.g., vertical motion) of tool 100. Operation of lifting motor 108 during operation of cleaning tool 100 advantageously enables brush assembly 104 to clean the entire (or at least most) intervertebral disc space, despite having a substantially flat profile.

[0061] The brush motor 106 and the lifting motor 108 may have the same or different motor types. In some embodiments, one or more gears, gearboxes, clutches, transmissions, and / or other mechanical elements may be used to enable a single motor to simultaneously rotate the shaft 128 and thus the brush assembly 104, as well as adjust the height of the tool 100. The brush motor 106 and / or the lifting motor 108 may be an electric motor, a pneumatic motor, a hydraulic motor, or other types of motor. In some embodiments, the brush motor 106 and the lifting motor 108 each include a geared motor. In other embodiments, each of the brush motor 106 and the lifting motor 108 includes any type of motor, including but not limited to AC brushless motors, DC brushed motors, DC brushless motors, servo motors, etc.

[0062] Figures 2A to 2C The brush assembly 104 is shown in detail. The brush assembly 104 is positioned on a shaft 128 near its distal portion 112. The shaft 128 extends through a first conduit 114 of the tube 102 and has an axis S parallel to (and in some embodiments coaxial with) the axis of the first conduit. Figure 2B As shown, brush assembly 104 has a brush axis B at its center, which is parallel to and offset from axis S and the first conduit axis. Brush axis B is parallel to the second conduit axis of the second conduit 116. Rotation of shaft 128 causes at least one brush axis B to orbit about axis S, resulting in eccentric rotation of brush assembly 104.

[0063] The brush assembly 104 and the shaft 128 can be an integral part (e.g., integrally formed) or separate parts. In embodiments where the brush assembly 104 is separate from the shaft 128, the brush assembly 104, as a whole or as individual brushes within the brush assembly, can be removed from the shaft 128 for replacement and / or cleaning. In other embodiments, the brush assembly 104 is attached to the shaft 128, and the shaft 128 can be removed from the tool 100 for cleaning and / or replacement. In yet another embodiment, the brush assembly 104 may be attached to a portion of the shaft 128, and that portion can be removed from the shaft 128 for cleaning and / or replacement.

[0064] In the example shown, brush group 104 includes three brushes spaced apart from each other. In other examples, brush group 104 includes one brush, two brushes, or more than three brushes. In examples where brush group 104 includes two or more brushes, each brush may be spaced apart from or adjacent to another brush. Brush group 104 may have a height substantially similar to the height of a spinal disc, although brush group 104 may have a height smaller or larger than the height of a spinal disc.

[0065] In some embodiments, the brush assembly 104 includes multiple steel bristles of varying lengths. In other embodiments, the brush assembly 104 may include bristles of any type of material, including but not limited to plastics, metals, synthetic fibers, and natural fibers. Figure 2B As shown, when viewed from the top or bottom, the brush assembly 104 defines a substantially circular shape. More specifically, multiple bristles form a circle. In other embodiments, the brush assembly 104 can define any shape, including but not limited to squares, triangles, ovals, rectangles, stars, etc. In such embodiments, the tube 102 can be provided with the same or similar shape, such that the brush assembly 104 can be rotated to a closed position in which the brush assembly 104 is fitted within the periphery of the tube 102.

[0066] As previously mentioned, brush assembly 104 can move from the closed position to the cleaning position. Figure 4A As shown, when brush assembly 104 is in the closed position, brush assembly 104 is fully positioned within tube 102. When brush assembly 104 is in the cleaning position (or in any position other than the closed position), brush assembly 104 is at least partially located outside tube 102. During use, as each brush of brush assembly 104 passes through the corresponding brush slot of brush slot assembly 122 and rotates into or through the closed position, fluid (if used, from fluid source 520) and the corresponding brush slot of brush slot assembly 122 help to forcibly remove and expel loose anatomical particles and / or fluid from each brush of brush assembly 104 and the intervertebral space, with distal portion 112 extending into the intervertebral space.

[0067] Fluid is supplied from fluid source 520 through a conduit via shaft 128. For example... Figure 2A and Figure 2C As shown, fluid enters the shaft 128 through one or more first fluid orifices 140 near the proximal portion 110 and exits the shaft 128 through one or more second fluid orifices 138 near the distal portion 112. In the illustrated embodiment, the one or more first fluid orifices 140 comprise a plurality of first fluid orifices positioned at or near the tip or tip portion of the shaft 128. In other embodiments, the one or more first fluid orifices 140 comprise a single orifice. The one or more first fluid orifices may be positioned anywhere on the shaft 128, although positioning the one or more first fluid orifices closer to the distal portion 110 may facilitate the supply of fluid from the fluid source 520 to that distal portion.

[0068] As shown in the example, one or more second fluid holes 138 include a plurality of second fluid holes positioned at the bottom end or bottom portion of the shaft 128 and adjacent to the brush assembly 104. In the illustrated embodiment, the shaft 128 includes a first set of second fluid holes 138 positioned proximally to each brush of the brush assembly 104 and a second set of second fluid holes 138 positioned distally to each brush of the brush assembly 104. This positioning of the second fluid holes 138 advantageously allows fluid to be sprayed or otherwise discharged to both sides of each brush of the brush assembly 104. However, in other embodiments, the second fluid holes 138 may be positioned only proximally to each brush, or only distally to each brush, or at the same height as each brush. In other embodiments, one or more second fluid holes 138 may be positioned anywhere on the shaft 128.

[0069] Figure 3A and Figure 3B Further details of the tool 100 for supplying fluid to the brush assembly 104 are shown. Fluid is supplied to one or more first fluid orifices 140 via a fluid conduit 142 and a fluid ring 141. The ring 141 advantageously supplies fluid to the shaft 128 while also allowing the shaft 128 to rotate within the ring 141. As shown and as described above, second fluid orifices 138 are positioned on the proximal and distal sides of each brush in the brush assembly 104 to allow fluid to be jetted or otherwise discharged to both sides of each brush in the brush assembly 104. In some embodiments, the conduit 102 may include one or more first fluid conduits corresponding to one or more first fluid orifices 140 (e.g., in embodiments where the conduit 102 extends along a larger portion of the shaft 128, or in embodiments where the fluid conduit 142 and the fluid ring 141 are positioned closer to the distal portion 112 of the tool 100), and one or more second fluid conduits corresponding to one or more second fluid orifices 138.

[0070] Turning Figures 4A to 4C Brush assembly 104 is shown moving from a closed position to a cleaning position during use. Brush assembly 104 can rotate continuously between the cleaning and closed positions (e.g., via continuous rotation of shaft 128) to clean the dissecting element by alternately brushing it (when in the cleaning position) and by a combination of fluid jetting and suction to clean the dissecting particles (when in the closed position). As previously described, when in the closed position, brush assembly 104 is positioned inside tube 102, as... Figure 4AAs shown in the diagram. In other words, when in the closed position, the brush assembly 104 is fully positioned within the periphery of the tube 102, in which position the brush assembly 104 can advantageously discharge fluid through the second fluid hole 138 thereon and perform cleaning through suction within the second conduit or suction conduit 116. When the brush assembly 104 is oriented toward the cleaning position (e.g., ... Figure 4A and Figure 4B As shown (cleaning location, for example, in) Figures 4C to 4F As shown in the diagram, the brush assembly 104 rotates through the brush groove assembly 122 and exits the tube 102 during movement. As the brush assembly 104 rotates out of the tube 102 and completes a full rotation, the brush assembly 104 scrapes or brushes the anatomical particles from the anatomical element to clean the surface of the anatomical element from the anatomical particles (e.g., the intervertebral disc being removed).

[0071] When brush assembly 104 moves from the cleaning position back to the closed position to complete a full rotation, as Figure 4F As shown, brush assembly 104 moves through brush slot assembly 122. Fluid can also be supplied to brush assembly 104 (e.g., via second fluid orifice 138) either throughout the rotation or only when brush assembly 104 rotates through the closed position to loosen and / or forcefully remove anatomical particles that may adhere to brush assembly 104, and / or prevent loose anatomical particles from becoming stuck or adhering to brush assembly 104. In some embodiments, when brush assembly 104 is not in or near the closed position, tube 102 blocks second fluid orifice 138, thus advantageously preventing fluid from being sprayed or discharged into the intervertebral space being cleaned. Furthermore, as brush assembly 104 moves through brush slot assembly 122, loose anatomical particles that may adhere to each brush of brush assembly 122 can be removed from each brush when they contact the edge of the corresponding brush slot of brush slot assembly 104 or tube 102.

[0072] As shown in the figure and as previously described, one or more discharge slots 126 are disposed near the brush slot assembly 122 and communicate with the second conduit 116 (also referred to as the suction conduit). A vacuum source 522 generates suction in the second conduit 116 or the suction conduit, and as loose dissecting particles are forcibly removed, the suction draws the loose dissecting particles (and the surrounding fluid) through the discharge slots 126 and through the second conduit 116 or the suction conduit.

[0073] In the illustrated embodiment and as previously described, a first discharge channel 126 may be positioned above the brush slot assembly 122 (e.g., proximal to the brush slot assembly 122) and a second discharge channel 126 may be positioned below the brush slot assembly 122 (e.g., distal to the brush slot assembly 122). Including two discharge channels 126 advantageously facilitates the drainage of loose anatomical particles and fluid from the intervertebral space. Furthermore, as the tool 100 moves upward or away from the anatomical element, loose anatomical particles (and surrounding fluid) can be more easily drained through the second discharge channel 126, while as the tool 100 moves downward or toward the anatomical element, loose anatomical particles (and surrounding fluid) can be more easily drained through the first discharge channel 126. Moreover, as shown in the illustrated embodiment, a second conduit 116 or a suction conduit is connected to… Figure 1A and Figure 1B The vacuum tube 144 shown is used to draw in loose dissected particles. Although not shown, the vacuum tube 144 can be connected to a container or waste treatment device to receive and / or process loose dissected particles and / or fluids.

[0074] 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.

[0075] As mentioned above regarding Figure 1 to... Figure 4F The described tool 100 can be used as follows Figure 5 In the system 500 shown, however it should be understood that tool 100 can be used independently of system 500. System 500 includes a computing device 502, a robot 504 (which may include or hold tool 100), a fluid source 520, a vacuum source 522, and / or a navigation system 506. In some embodiments of this disclosure, the system (such as...) Figure 5 System 500 may not include one or more of the components shown, but may include... Figure 5 Other components not shown, and / or may include those related to Figure 5The system 500 shown may include one or more components that are similar but not identical. For example, in some embodiments, the system 500 may not include the navigation system 506. In other embodiments, the system 500 may not include the fluid source 520 and / or the vacuum source 522.

[0076] The computing device 502 according to embodiments of the present disclosure may include a processor 508, a memory 510, a communication interface 512, and a user interface 514. In some embodiments, the computing device (such as computing device 502) may have more than Figure 5 The computing device 502 shown has more or fewer components.

[0077] The processor 508 of the computing device 502 may be any processor described herein or any similar processor. The processor 508 may be configured to execute instructions stored in the memory 510, which may enable the processor 508 to perform one or more computational steps using or based on data received from: a user interface 514; one or more sensors included in, attached to or otherwise monitoring the operation of the tool 100; a robot 502; and / or a navigation system 506.

[0078] Memory 510 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 510 may store information or data that can be used to perform any step of the method 600 described herein. Memory 510 may store, for example, one or more instructions 516 and / or one or more surgical plans 518. In some embodiments, such instructions 516 may be organized into one or more applications, modules, packages, layers, or engines. Instructions 516 may be configured to be executed by processor 508 to perform any of the methods described herein (including method 600) or portions thereof, and / or to operate one or more of robot 504, navigation system 506, tool 100, fluid source 520, and / or vacuum source 522. Instructions 516 may cause processor 508 to manipulate data stored in memory 510 and / or received from navigation system 506.

[0079] The computing device 502 may also include a communication interface 512. The communication interface 512 may be used to receive information from external sources (such as tool 100, robot 504, and / or navigation system 506), and / or to transmit instructions, data, or other information to external systems or devices (e.g., tool 100, robot 504, and / or navigation system 506). The communication interface 512 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 512 may be used to enable the computing device 502 to communicate with one or more other processors 508 or the computing device 502, whether to reduce the time required to complete computationally intensive tasks or for any other reason.

[0080] The computing device 502 may also include one or more user interfaces 514. The user interface 514 may be or include a keyboard, mouse, trackball, monitor, television, touch screen, joystick, switch, button, headset and / or any other device for receiving information from the user and / or providing information to the user. User interface 514 can be used, for example, to receive user selections or other user input regarding controlling the robot to position tool 100 within the intervertebral space; user selections or other user input regarding rotating brush assembly 104 alternately between a cleaning position and a closed position; user selections or other user input regarding supplying fluid to brush assembly 104 from a fluid source; user selections or other user input regarding draining fluid from brush assembly 104 through suction conduit 116; user selections or other user input regarding adjusting the height of the distal portion 112 of tool 100; receiving useful user input related to instruction 516 and / or surgical plan 518; receiving user selections or other user input regarding the operation of robot 504, manipulation of robotic arm 524, and / or use of tool 100; and / or displaying instruction 516 and / or surgical plan 518. In some embodiments, the user interface 514 may be used to allow surgeons or other users to modify instructions 516, plans 518, or other displayed information. However, it should be understood that each of the aforementioned inputs may be automatically generated by system 500 (e.g., by processor 508 or another component of system 500) or received by system 500 from a source external to system 500. In some embodiments, user inputs such as those described above may be optional or unnecessary for the operation of the systems, apparatus, and methods described herein.

[0081] Although the user interface 514 is shown as part of the computing device 502, in some embodiments, the computing device 502 may utilize a user interface 514 that is housed separately from one or more other components of the computing device 502. In some embodiments, the user interface 514 may be located close to one or more other components of the computing device 502, but in other embodiments, the user interface 514 may be located away from one or more other components of the computing device 502.

[0082] Robot 504 can be any surgical robot or surgical robot system. Robot 504 can be, or includes, for example, Mazor X. ™ Stealth robot guidance system. Robot 504 may include one or more robot arms 524. In some embodiments, robot arm 524 may include one robot arm, but in other embodiments, robot arm 524 may include two or more robot arms. Tool 100 may be disposed on the end of robot arm 524. In other examples, tool 100 may be disposed on any part of robot arm 524 and / or robot 504.

[0083] In some embodiments, system 500 may include navigation system 506, but in other embodiments, system 500 may not include navigation system 506. During operation, navigation system 506 can provide navigation for the surgeon and / or surgical robot. Navigation system 506 can be any navigation system now known or developed in the future, including, for example, Medtronic StealthStation. TM S8 Surgical Navigation System. In various embodiments, navigation system 506 can be used to track the position of robotic arm 524 (or more specifically, a navigation tracker attached to robotic arm 524). Navigation system 506 may include cameras or other sensors for tracking one or more reference markers, navigation trackers, or other objects within the operating room. Navigation system 506 may include a display for displaying one or more images from an external source (e.g., a camera or other source), or a video stream from the camera or other sensors of navigation system 506. In some embodiments, navigation system 506 may provide robot 504 with position, movement, and / or other information for controlling tool 100 and / or any other aspect of system 500. In some embodiments, system 500 does not include navigation system 506 and can operate without using a navigation system.

[0084] Reference markers (i.e., navigation markers) may be placed on robot 504, robotic arm 524, tool 100, or any other object in the surgical space. The reference markers may be tracked by navigation system 506, and the results of the tracking may be used by computing device 502 and / or by the operator of system 500 or any component thereof. In some embodiments, navigation system 506 may be used to track other components of the system (e.g., tool 100), and system 500 may operate without the use of robot 504 (e.g., a surgeon manually manipulating tool 100).

[0085] System 500 may also include a fluid source 520 and / or a vacuum source 522. In some embodiments, system 500 may not include fluid source 520 and / or vacuum source 522, and may include only fluid source 520, or only vacuum source 522. In other embodiments, fluid source 520 and / or vacuum source 522 may be used with tool 100 independently of system 500. Each of fluid source 520 and / or vacuum source 522 may be formed as part of tool 100 or may be separate from tool 100. Hoses (not shown) may extend from each of fluid source 520 and vacuum source 522 to fluid tube 142 and vacuum tube 144, respectively. Fluid source 520 may be configured to supply fluid to brush assembly 104. The fluid may be a gas (e.g., oxygen, air, carbon dioxide, helium-oxygen mixture) or a liquid (e.g., water, saline, or another rinsing agent). The fluid may rinse loose dissecting particles from brush assembly 104 and / or dissecting elements. Fluid source 520 may be configured with a pressurized fluid storage container, or may otherwise include a pressurized fluid source to allow fluid to be discharged onto brush assembly 104 under pressure. In such embodiments, the pressure may be selectable (whether by a surgeon or other human operator of tool 100, by computing device 502, or otherwise). When used with fluid source 520, vacuum source 522 may remove fluid, and / or, when used with or without fluid source 520, may remove loose anatomical particles. Fluid may be delivered to or removed from anatomical elements via fluid conduit 142 and shaft 128, and / or removed from anatomical elements via vacuum conduit 144. In other embodiments, fluid may be delivered to or removed from anatomical elements 112 through or via any cannulas, rings, or hoses formed on, disposed on, or attached to tool 100.

[0086] Turn now Figure 6 Method 600 for performing surgical procedures can be performed wholly or partially by a robot (e.g., robot 504 controlled by computing device 502) and / or a surgeon. Method 600 can utilize, for example, the techniques described above... Figures 1A to 4C The described tool 100 and / or the above about Figure 5The system described is 500 to be executed.

[0087] Method 600 includes controlling a robot (such as robot 504) to position a cleaning tool (such as tool 100) within the intervertebral space (step 602). The cleaning tool may be attached to a robotic arm (such as robotic arm 524). Control may include sending instructions to the robot to manipulate the robotic arm to insert the cleaning tool into the intervertebral space, and may be based on one or more images, such as a surgical plan (such as surgical plan 518), the patient's anatomy (in which the cleaning tool is inserted), user input, and / or other information. Instructions may include a predetermined position and orientation of the cleaning tool. Control may include providing a trajectory or movement path from the surgical plan to the robot, or using a processor (such as processor 508) to determine a trajectory or movement path for the robot that will correctly position the cleaning tool within the intervertebral space; and then providing the determined trajectory or movement path to the robot. In some cases, the tool may be used manually by a surgeon, who may be assisted by a robot and / or navigation system (e.g., navigation system 506) in some embodiments.

[0088] Method 600 also includes rotating the tool's brush assembly (e.g., brush assembly 104) alternately between a cleaning position and a closed position (step 604). (See also: Regarding...) Figure 2B and Figures 4A to 4C When in the closed position, the brush assembly is fully positioned within the periphery of the tool's tube (e.g., tube 102). The tube may have corresponding brush grooves for the brush assembly, through which each brush passes during each rotation. The brush assembly can forcefully remove or remove dissecting particles from the dissecting element to clean the surface of the dissecting element.

[0089] Method 600 also includes supplying fluid to the brush assembly via a fluid source of the tool (e.g., fluid source 520) (step 606). As previously discussed... Figures 2A to 3B As described, fluid is supplied to each brush in the brush assembly as each brush rotates through the closed position. In some embodiments, fluid is supplied to the brush assembly continuously. The fluid can prevent loose dissecting particles from sticking to the brush assembly and / or can loosen dissecting particles stuck to the brush assembly.

[0090] Method 600 also includes draining fluid (and any anatomical particles entrained therein) from the brush assembly through a suction cannula of the tool (e.g., a second cannula 116) (step 608). As previously discussed... Figures 1A to 1BAs described, fluid and / or loose dissecting particles can be discharged from the site via a drain channel located near the brush slot assembly. Discharge may not result in complete removal of all fluid provided in step 606. Furthermore, loose dissecting particles can be forcibly removed as the brush assembly passes through the corresponding brush slot assembly to the closed position, and these particles can be discharged through the drain channel and suction conduit. The rotation of the brush assembly between the clean position and the closed position can be repeated continuously until the surface of the dissecting element is sufficiently cleaned.

[0091] Method 600 also includes adjusting the height of the distal portion of the cleaning tool (e.g., distal portion 112) (step 610). The height of the cleaning tool can be adjusted via a lifting motor (such as lifting motor 108). The height can be adjusted independently or continuously under the guidance of a surgeon, or in discrete increments. By continuously adjusting the height of the distal portion, the height of the brush assembly is continuously adjusted during use to create a vibratory motion, thereby aiding in the thorough cleaning of the intervertebral space.

[0092] In some embodiments, method 600 may include receiving a surgical plan (e.g., surgical plan 518). The surgical plan may be received via a user interface (such as user interface 514) and / or a communication interface (such as communication interface 512 of a computing device (such as computing device 502)) and may be stored in memory (such as memory 510 of the computing device). The surgical plan may include information about one or more planned movements of an instrument (and / or a robot holding the instrument) during surgery. 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).

[0093] In some embodiments, method 600 may include determining information regarding one or more required movements of instruments 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, but such information may be generated based on the surgical plan by a processor executing instructions stored in memory.

[0094] In some embodiments, method 600 may include generating instructions (such as instruction 516) for causing a tool (e.g., tool 100) to perform one or more surgical steps (such as those described in combination with steps 602 through 610). 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.

[0095] Instruction 516 may include one or more instructions that cause an alert or other instruction to be issued to the surgeon before each movement of the tool and / or before the execution of one of the planned surgical steps in one or more planned surgical steps (e.g., via a user interface, such as user interface 514). In some embodiments, such an alert may suspend the execution of the surgical plan for approval by the surgeon or other operator. In other embodiments, the alert may simply notify the surgeon of the planned movement and / or the planned increase or decrease in volume, and automatically execute the planned movement. The alert and / or notification may be displayed on the user interface and / or may include audible and / or visual displays.

[0096] As can be understood based on the foregoing disclosure, this disclosure covers companies with fewer than Figure 6 The method for all steps identified in the code (and the corresponding description of method 600), and including all steps except... Figure 6 Methods involving additional or other steps beyond those identified in the diagram (and the corresponding description of method 600).

[0097] The methods and systems described herein provide a tool for preparing the surface of anatomical elements for fusion or other surgical procedures. This tool is self-cleaning and reusable, eliminating the need for surgeons or surgical robots to switch brushes during cleaning, resulting in shorter operation times and less trauma to the patient's neutral tissues along the insertion / removal path. Furthermore, the absence of brush switching or tool switching reduces the potential risk of accidental impact during tool removal or insertion into the surgical site. The brush is also protected during positioning, reducing the risk of brush damage before cleaning the anatomical element.

[0098] 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.

[0099] 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 instrument comprising: At least one brush, the at least one brush being disposed on a shaft extending through a tube, the tube having a corresponding brush groove for each brush; A motor operable to rotate the shaft to move the at least one brush through the brush slot from a closed position to a cleaning position, wherein the at least one brush is fully positioned inside the tube in the closed position and at least partially positioned outside the tube in the cleaning position; and A fluid source operable to supply fluid to the at least one brush as it passes through the brush groove. The at least one brush defines a substantially circular shape having a brush axis parallel to and offset from the axis of the shaft, and rotation of the shaft causes the at least one brush axis to move around the axis.

2. The surgical instrument of claim 1, wherein the fluid is supplied through a conduit of the shaft.

3. The surgical instrument of claim 1, wherein the tube comprises a first catheter parallel to the second catheter, and wherein the at least one brush axis and each of the axes are parallel to and offset from the axis of the second catheter.

4. The surgical instrument of claim 1 further includes an aspiration catheter for draining the fluid.

5. The surgical tool according to claim 4 further includes at least one discharge groove disposed near the at least one brush groove, the at least one discharge groove being in communication with the aspiration catheter.

6. The surgical tool of claim 5, wherein the fluid is discharged from the at least one brush as the at least one brush passes through the corresponding brush groove from the cleaning position to the closed position.

7. The surgical tool of claim 1, wherein the at least one brush comprises a plurality of steel bristles of different lengths.

8. The surgical tool of claim 7, wherein the plurality of steel bristles are formed in a circle.

9. The surgical tool of claim 1, wherein the at least one brush comprises three brushes.

10. The surgical instrument of claim 9 further includes a lifting motor configured to vertically move the surgical instrument during operation.

11. A system for cleaning an anatomical space, comprising: At least one surgical instrument according to any one of claims 1-10; processor; and A memory that stores instructions for execution by the processor, which, when executed, cause the processor to: The surgical instrument is rotated between a cleaning position and a closed position, wherein the at least one brush contacts the anatomical element when in the cleaning position; The fluid source supplies fluid to the at least one brush, wherein when the at least one brush moves from the cleaning position through the corresponding brush groove to the closed position, the fluid and loose dissecting elements are discharged from the at least one brush.

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