System and method for controlling one or more surgical tool

Abstract

Systems and methods are provided for performing a surgical procedure to form a custom-shaped cavity in an anatomical element. The surgical tool may be oriented by the robotic arm in one direction along a first trajectory to remove a first portion of the anatomical element. The surgical tool may be oriented in at least one direction along a second trajectory to remove a second portion of the anatomical element to form a custom-shaped cavity in the anatomical element.

Description

BACKGROUND OF THE DISCLOSURE

[0001] The present disclosure generally relates to controlling one or more surgical tools, and more particularly to controlling one or more surgical tools using a surgical robot.

[0002] A surgical robot can assist a surgeon or other healthcare provider in performing a surgical procedure, or can autonomously perform one or more surgical procedures. Articulated members providing controllable connections allow the surgical robot to reach areas of a patient's anatomy during various medical procedures. SUMMARY OF THE DISCLOSURE

[0003] Example aspects of the present disclosure include:

[0004] A system for performing a minimally invasive surgical procedure according to at least one embodiment of the present disclosure includes: a processor; and a memory that stores data for processing by the processor, the data when processed causing the processor to: receive a surgical tool through an arm guide of a robotic arm; and orient the surgical tool in at least one direction along a trajectory to remove at least a portion of an anatomical element, thereby forming a custom-shaped cavity in the anatomical element.

[0005] In any aspect among the aspects herein, the custom-shaped cavity has a cross-sectional area greater than the cross-sectional area of the surgical tool.

[0006] In any aspect among the aspects herein, the at least one direction includes a lateral direction and a depth direction.

[0007] In any aspect among the aspects herein, further includes the arm guide, wherein the arm guide includes a depth limiter to prevent the surgical tool from moving beyond a predetermined depth, and wherein the depth limiter is adjustable.

[0008] In any aspect among the aspects herein, the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: stop the movement of the surgical tool by the robotic arm at a predetermined depth.

[0009] In any aspect among the aspects herein, the surgical tool is configured to drill and mill the anatomical element.

[0010] Any aspect of the present disclosure, wherein the surgical tool includes a reamer, and wherein the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: receive a drill bit through the arm guide of the robotic arm; and orient the drill bit in one direction along a drill bit trajectory to form an aperture in the anatomical element before removing at least a portion of the anatomical element by the reamer.

[0011] Any aspect of the present disclosure, wherein the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: orient the surgical tool in one direction along a drill bit trajectory to form an aperture in the anatomical element before removing the at least a portion of the anatomical element; measure the depth of the aperture; and drive an implant into the aperture by the robotic arm to the depth.

[0012] Any aspect of the present disclosure, wherein the custom-shaped cavity is shaped to receive the head of a pedicle screw.

[0013] Any aspect of the present disclosure, wherein the custom-shaped cavity is shaped such that the head is tilted relative to the pedicle screw.

[0014] Any aspect of the present disclosure, wherein the surgical tool has a diameter greater than the cutting depth of the surgical tool.

[0015] A system for performing a surgical procedure according to at least one embodiment of the present disclosure includes: a robotic arm configured to orient a surgical tool; a processor; and a memory that stores data for processing by the processor, the data when processed causing the processor to: orient the surgical tool in at least one direction along a trajectory to remove at least a portion of an anatomical element, thereby forming a custom-shaped cavity in the anatomical element.

[0016] Any aspect of the present disclosure, wherein the surgical procedure is a minimally invasive surgical procedure.

[0017] Any aspect of the present disclosure, wherein the custom-shaped cavity has a cross-sectional area greater than the cross-sectional area of the surgical tool.

[0018] Any aspect of the present disclosure, wherein the at least one direction includes a lateral direction and a depth direction.

[0019] Any aspect of the present disclosure also includes an arm guide that includes a depth limiter to prevent the surgical tool from moving beyond a predetermined depth, and wherein the depth limiter is adjustable; and any one of the aspects of the present disclosure, wherein the memory stores additional data for processing by the processor, the additional data when processed causes the processor to: receive the surgical tool through the arm guide.

[0020] A system for performing a surgical procedure according to at least one embodiment of the present disclosure includes: a robotic arm configured to orient a surgical tool; an arm guide coupled to the robotic arm and configured to prevent movement of the surgical tool beyond a predetermined depth; a processor; and a memory that stores data for processing by the processor, the data when processed causes the processor to: receive a first surgical tool through the arm guide; orient the first surgical tool by the robotic arm along a first trajectory in one direction to form an aperture in an anatomical element; receive a second surgical tool through the arm guide; orient the second surgical tool by the robotic arm along a second trajectory in more than one direction to remove a second portion of the anatomical element, thereby forming a custom-shaped cavity in the anatomical element.

[0021] Any aspect of the present disclosure, wherein the first surgical tool includes a drill bit and the second surgical tool includes a reamer.

[0022] Any aspect of the present disclosure, wherein the custom-shaped cavity has a cross-sectional area greater than the cross-sectional area of the surgical tool.

[0023] Any aspect of the present disclosure, wherein at least one direction includes a lateral direction and a depth direction.

[0024] Any one aspect is combined with any one or more other aspects.

[0025] Any one or more of the features disclosed herein.

[0026] Any one or more of the features generally disclosed herein.

[0027] Any one or more of the features generally disclosed herein are combined with any one or more other features generally disclosed herein.

[0028] Any one of an aspect / feature / embodiment is combined with any one or more other aspects / features / embodiments.

[0029] Use any one or more of the aspects or features disclosed herein.

[0030] It should be understood that any feature described herein can be claimed in combination with any other feature described herein, regardless of whether the features are from the same described embodiment.

[0031] Details of one or more aspects of the present disclosure are set forth in the following drawings and the description. Other features, objects, and advantages of the technology described in this disclosure will be apparent from the description, the drawings, and the claims.

[0032] The phrases "at least one", "one or more", and "and / or" are open-ended expressions that are both conjunctive and disjunctive in operation. For example, each of 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" means 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 elements such as X, Y, and Z or element classes such as X1-Xn, Y1-Ym, and Z1-Zo, the phrase is intended to refer to a single element selected from X, Y, and Z, a combination of elements selected from the same class (e.g., X1 and X2), and a combination of elements selected from two or more classes (e.g., Y1 and Zo).

[0033] The term "a" entity means one or more of such entities. Thus, the terms "a", "one or more", and "at least one" may be used interchangeably herein. It should also be noted that the terms "comprising", "including", and "having" may be used interchangeably.

[0034] The foregoing is a simplified overview of the present disclosure to provide an understanding of some aspects of the present disclosure. This summary of the invention is neither an extensive overview nor an exhaustive overview of the present disclosure and its various aspects, embodiments, and configurations. It is neither intended to identify the key or important elements of the present disclosure nor to delineate the scope of the present disclosure, but rather to present selected concepts of the present disclosure in a simplified form as an introduction to the more detailed description presented below. As should be understood, other aspects, embodiments, and configurations of the present disclosure may make use, alone or in combination, of one or more of the features set forth above or described in detail below.

[0035] Many additional features and advantages of the present disclosure will become apparent to those skilled in the art upon consideration of the embodiments described below. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] The accompanying drawings are incorporated in and constitute a part of this specification to illustrate several examples of the present disclosure. These drawings, together with the description, explain the principles of the present disclosure. The drawings merely illustrate how to implement and use the preferred and alternative examples of the present disclosure, and these examples should not be construed as limiting the present disclosure solely to the examples illustrated and described. Additional features and advantages will become apparent from the following more detailed description of various aspects, embodiments, and configurations of the present disclosure, as illustrated by the accompanying drawings referred to below.

[0037] Figure 1 is a block diagram of a system according to at least one embodiment of the present disclosure;

[0038] Figure 2 is a block diagram of a system according to at least one embodiment of the present disclosure;

[0039] Figure 3 is a flowchart according to at least one embodiment of the present disclosure; and

[0040] Figure 4 is a flowchart according to at least one embodiment of the present disclosure. Detailed Description

[0041] It should be understood that the various aspects disclosed herein can be combined in combinations different from those specifically presented in the specification and the accompanying drawings. It should also be understood that, depending on the example or embodiment, certain actions or events of any of the processes or methods described herein can be performed in a different order and / or can be added, combined, or completely omitted (e.g., depending on different embodiments of the present disclosure, not all of the described actions or events may be required to implement the disclosed technology). Additionally, although certain aspects of the present disclosure are described for clarity as being performed by a single module or unit, it should be understood that the technology of the present disclosure can be performed by a combination of units or modules associated with, for example, a computing device and / or a medical device.

[0042] In one or more examples, the methods, processes, and techniques described can be implemented in hardware, software, firmware, or any combination thereof. If implemented in software, the functions can be stored as one or more instructions or code on a computer-readable medium and executed by a hardware-based processing unit. Alternatively or additionally, the functions can be implemented using a machine learning model, a neural network, an artificial neural network, or a combination thereof (either alone or in combination with instructions). The computer-readable medium can 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 the desired program code in the form of instructions or data structures and can be accessed by a computer).

[0043] The 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), graphics processing units (e.g., Nvidia GeForce RTX 2000 series processors, Nvidia GeForce RTX 3000 series processors, AMD Radeon RX 5000 series processors, AMD Radeon RX 6000 series processors, or any other graphics processing unit), application-specific integrated circuits (ASICs), field-programmable logic arrays (FPGAs), or other equivalent integrated or discrete logic circuits. Thus, the term "processor" as used herein can refer to any one of the foregoing structures or any other physical structure suitable for implementing the described techniques. Additionally, these techniques can be implemented entirely in one or more circuits or logic elements.

[0044] Before explaining any embodiments of the present disclosure in detail, it is to be understood that the present disclosure is not limited in its application to the construction details and component arrangements set forth in the following description or illustrated in the drawings. The present disclosure is capable of other embodiments and of being practiced or carried out in various ways. Additionally, it is to be understood that the terminology and phraseology used herein are for the purpose of description and should not be regarded as limiting. The use of "comprising," "including," or "having" and variations thereof herein is intended to cover the items listed thereafter and equivalents thereof, as well as additional items. Furthermore, the present disclosure may use examples to illustrate one or more of its aspects. Unless otherwise expressly stated, the use or listing of one or more examples (which may be indicated by "for example," "by way of example," "such as," or similar language) is not intended and does not limit the scope of the present disclosure.

[0045] The terms proximal and distal are used in their conventional medical meanings in the present disclosure, with proximal being closer to the operator or user of the system and farther from the surgical area of interest within or on the patient's body, while distal is closer to the surgical area of interest within or on the patient's body and farther from the operator or user of the system.

[0046] In minimally invasive surgery (MIS) procedures, since the working space in MIS procedures is much smaller than that in open surgery, users such as surgeons cannot utilize many conventional tools used in open surgery. In addition, the user may have difficulty observing or be unable to observe the surgical space in MIS procedures. In particular, procedures for removing material from anatomical elements, such as decortication, may prove challenging in MIS procedures. Due to the lack of visibility, small incisions, and the increased risk of soft tissue contact, it may be difficult to use MIS procedures to install implants such as pedicle screw implants. There is also another risk in MIS procedures: due to the limitations of the patient's bone anatomy, forced removal may pose an unacceptable risk to the patient, thus potentially leading to implant protrusion.

[0047] According to at least one embodiment of the present disclosure, a robotic surgical system can enable the removal of bone anatomy with higher precision by using a surgical tool such as a reamer (or any other tool capable of removing bone anatomy), while minimizing the risk to the patient. This will allow the user to remove the bone anatomy along a multi-directional trajectory of the screw. Such removal, combined with depth precision (also achieved by the robotic system), allows the user to ream or remove the bone anatomy to a predetermined depth, place depth markers, and then place the pedicle screw at that depth. This will allow for easier and more successful completion of MIS procedures.

[0048] Embodiments of the present disclosure provide technical solutions for one or more of the following problems: (1) removing a portion of an anatomical element in an MIS procedure, (2) forming one or more custom-shaped cavities in one or more anatomical elements in hard-to-reach locations, (3) performing decortication in an MIS procedure, and (4) increasing patient safety.

[0049] Turning first to Figure 1 , a block diagram of a system 100 according to at least one embodiment of the present disclosure is shown. The system 100 can be used to control one or more surgical tools using a robotic system, e.g., to control, pose, and / or otherwise manipulate a surgical robotic system, a surgical robotic arm, and / or a surgical tool attached thereto, and / or to perform one or more other aspects of one or more of the methods disclosed herein. The system 100 includes a computing device 102, one or more imaging devices 112, a robot 114, a navigation system 118, a database 130, and / or a cloud or other network 134. Systems according to other embodiments of the present disclosure may include more or fewer components than the system 100. For example, the system 100 may not include one or more of the imaging device 112, the robot 114, the navigation system 118, the computing device 102, the database 130, and / or the cloud 134.

[0050] The computing device 102 includes a processor 104, a memory 106, a communication interface 108, and a user interface 110. Computing devices according to other embodiments of the present disclosure may include more or fewer components than the computing device 102.

[0051] The processor 104 of the computing device 102 may be any processor described herein or any similar processor. The processor 104 may be configured to execute instructions stored in the memory 106 that may cause the processor 104 to perform one or more computing steps using or based on data received from the imaging device 112, the robot 114, the navigation system 118, the database 130, and / or the cloud 134.

[0052] The memory 106 may be or include RAM, DRAM, SDRAM, other solid-state memory, any memory described herein, or any other tangible non-transitory memory for storing computer-readable data and / or instructions. The memory 106 may store information or data for completing any steps of, for example, the methods 300 and 400 described herein or any other method. The memory 106 may store instructions and / or machine learning models that support one or more functions of the robot 114. For example, the memory 106 may store content (e.g., instructions and / or machine learning models) that, when executed by the processor 104, enables image processing 120 and / or trajectory planning 122. In some embodiments, such content may be organized into one or more applications, modules, packages, layers, or engines if provided as instructions.

[0053] Image processing 120 enables the processor 104 to process image data of an image (received from an imaging device such as the imaging device 112, the navigation system 118, or any imaging device) for, for example, identifying information about anatomical elements such as anatomical element 236 and / or objects such as surgical tool 234 depicted in the image. The information may include, for example, identification of hard tissue and / or soft tissue, the boundary between hard tissue and soft tissue, the boundary of hard tissue and / or soft tissue, identification of a surgical tool such as surgical tool 234, etc. Image processing 120 may identify hard tissue, soft tissue, and / or the boundary of hard tissue and / or soft tissue, for example, by determining the difference or contrast between the colors or grayscales of the image pixels. For example, the boundary between hard tissue and soft tissue may be identified as the contrast between brighter pixels and darker pixels. Image processing 120 may also be used to obtain pose information of the surgical tool 234 and / or the anatomical element 236 in order to, for example, confirm the pose of the surgical tool 234 obtained from the robot 114 when the robot 114 is orienting the surgical tool 234. Image processing 120 may also be used to obtain one or more measurements of the anatomical element 236, such as, for example, the depth of an orifice in the anatomical element.

[0054] Trajectory planning 122 enables the processor 104 to receive information about a desired custom-shaped cavity and generate a trajectory for the surgical tool 234 to remove one or more portions from the anatomical element 236. The one or more portions removed may form an orifice and / or a desired custom-shaped cavity. In at least one embodiment, the orifice and the desired custom-shaped cavity are connected to receive, for example, a pedicle screw implant. The custom-shaped cavity may be shaped to receive and seat the screw head of the pedicle screw implant. The information about the desired custom-shaped cavity may include, for example, the dimensions of the desired custom-shaped cavity, a three-dimensional model of the desired custom-shaped cavity, the dimensions of the implant to be received by the desired custom-shaped cavity, and / or a three-dimensional model of the implant. The trajectory may be directly transmitted to, for example, the robot 114 and / or stored in a database 130, the memory 106, or any memory of any component.

[0055] The memory 106 may also store a surgical plan 124. The surgical plan 124 may include, for example, one or more steps for performing a surgical procedure and / or one or more parameters for during a surgical procedure. In some embodiments, the surgical procedure may be a spinal procedure for correcting spinal deformities (e.g., spinal alignment, implant placement, osteotomy, fusion, and / or any other spinal procedure). For example, the surgical plan 124 may include one or more surgical steps for placing one or more implants, such as preparing an anatomical element 236 (e.g., vertebra), drilling in the anatomical element 236, tapping the anatomical element 236, decorticating the anatomical element 236, and driving the implant into the anatomical element 236. The surgical plan 124 may also be stored in the database 130.

[0056] Alternatively or additionally, the memory 106 may store other types of content or data (e.g., machine learning patterns, artificial neural networks, deep neural networks, etc.) that may be processed by the processor 104 to perform the various methods and features described herein. Thus, although the various contents of the memory 106 may be described as instructions, it should be understood that the functions described herein may be implemented by using instructions, algorithms, and / or machine learning models. The data, algorithms, and / or instructions may cause the processor 104 to manipulate the data stored in the memory 106 and / or data received from or via the imaging device 112, the robot 114, the database 130, and / or the cloud 134.

[0057] The computing device 102 may also include a communication interface 108. The communication interface 108 may be used to receive image data or other information from external sources (such as the imaging device 112, the robot 114, the navigation system 118, the database 130, the cloud 134, and / or any other system or component that is not part of the system 100), and / or to transmit instructions, images, or other information to external systems or devices (e.g., another computing device 102, the imaging device 112, the robot 114, the navigation system 118, the database 130, the cloud 134, and / or any other system or component that is not part of the system 100). The communication interface 108 may include one or more wired interfaces (e.g., USB port, Ethernet port, FireWire port) and / or one or more wireless transceivers or interfaces (configured to transmit and / or receive 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 108 may be used to enable the device 102 to communicate with one or more other processors 104 or computing devices 102, either to reduce the time required to complete computationally intensive tasks or for any other reason.

[0058] The computing device 102 may also include one or more user interfaces 110. The user interface 110 may be or include a keyboard, a mouse, a trackball, a monitor, a television, a screen, a touch screen, and / or any other device for receiving information from a user and / or for providing information to a user. The user interface 110 may be used, for example, to receive user selections or other user input regarding any step of any method described herein. Nevertheless, any required input for any step of any method described herein may be automatically generated by the system 100 (e.g., by the processor 104 or another component of the system 100) or received by the system 100 from a source external to the system 100. In some embodiments, the user interface 110 may be used to allow a surgeon or other user to modify instructions to be executed by the processor 104 according to one or more embodiments of the present disclosure, and / or to modify or adjust settings of other information displayed on or corresponding to the user interface 110.

[0059] Although the user interface 110 is shown as part of the computing device 102, in some embodiments, the computing device 102 may utilize a user interface 110 that is housed separately from one or more of the remaining components of the computing device 102. In some embodiments, the user interface 110 may be located near one or more other components of the computing device 102, while in other embodiments, the user interface 110 may be located remote from one or more other components of the computing device 102.

[0060] The imaging device 112 can be used to image anatomical features (e.g., bones, veins, tissues, etc.) and / or other aspects of the patient's anatomy to generate image data (e.g., image data depicting or corresponding to bones, veins, tissues, etc.). As used herein, "image data" refers to data generated or captured by the imaging device 112, including data in machine-readable form, graphical / visual form, and any other form. In different examples, the image data can include data corresponding to an anatomical feature portion of the patient or a part thereof. The image data can be or include preoperative images, intraoperative images, postoperative images, or images taken independently of any surgical procedure. In some embodiments, the first imaging device 112 can be used to obtain first image data (e.g., a first image) at a first time, and the second imaging device 112 can be used to obtain second image data (e.g., a second image) at a second time after the first time. The imaging device 112 may be capable of taking 2D images or 3D images to generate image data. The imaging device 112 can be or include, for example, an ultrasound scanner (which may include, for example, physically separate transducers and receivers, or a single ultrasound transceiver), an O-arm, a C-arm, a G-arm, or any other device utilizing X-ray-based imaging (e.g., a fluoroscope, a CT scanner, or other X-ray machine), a magnetic resonance imaging (MRI) scanner, an optical coherence tomography (OCT) scanner, an endoscope, a microscope, an optical camera, a thermal imaging camera (e.g., an infrared camera), a radar system (which may include, for example, a transmitter, a receiver, a processor, and one or more antennas), or any other imaging device 112 suitable for obtaining an image of an anatomical feature portion of the patient. The imaging device 112 can be fully contained within a single housing, or can include a transmitter / transmitter and a receiver / detector in separate housings or otherwise physically separated.

[0061] In some embodiments, the imaging device 112 can include more than one imaging device 112. For example, the first imaging device can provide first image data and / or a first image, and the second imaging device can provide second image data and / or a second image. In still other embodiments, the same imaging device can be used to provide both first image data and second image data and / or any other image data described herein. The imaging device 112 can be used to generate an image data stream. For example, the imaging device 112 can be configured to operate using an open shutter, or using a shutter that continuously alternates between open and closed, in order to capture consecutive images. For the purposes of this disclosure, unless otherwise specified, image data can be considered continuous and / or provided as an image data stream if the image data represents two or more frames per second.

[0062] The robot 114 can be any surgical robot or surgical robot system. The robot 114 can be or include, for example, a Mazor XTM Stealth Edition robotic guidance system. The robot 114 can be configured to position the surgical tool 234 at one or more precise positions and orientations (whether guided by the navigation system 118 or not), and / or return the surgical tool 234 to the same position and orientation at a later time point to complete or assist a surgical task. The robot 114 can be configured to hold and / or manipulate anatomical elements, such as the anatomical element 236, during or in conjunction with a surgical procedure. The robot 114 may include one or more robotic arms 116. In some embodiments, the robotic arms 116 may include a first robotic arm and a second robotic arm, but the robot 114 may include more than two robotic arms. In some embodiments, one or more of the robotic arms 116 may be used to hold and / or manipulate the surgical tool 234. Each robotic arm 116 can be positioned independently of the other robotic arms. The robotic arms 116 can be controlled in a single shared coordinate space or in separate coordinate spaces.

[0063] The robot 114 together with the robotic arms 116 can have, for example, one, two, three, four, five, six, seven or more degrees of freedom. Additionally, the robotic arms 116 can be positioned or locatable in any pose, plane, and / or focus. This pose includes position and orientation. Thus, the imaging device 112, the surgical tool 234, or other objects held by the robot 114 (or more specifically, held by the robotic arms 116) can be precisely positioned at one or more desired and specific positions and orientations.

[0064] The robotic arm 116 can include one or more sensors 126 that enable the processor 104 (or the processor of the robot 114) to determine the precise pose of the robotic arm (and any object or element held or fixed to the robotic arm) in space.

[0065] The sensor 126 can be a position sensor, a proximity sensor, a magnetometer, or an accelerometer. In some embodiments, the sensor 126 can be a linear encoder, a rotary encoder, or an incremental encoder. In still other embodiments, the sensor 126 can be an imaging sensor. Other types of sensors can also be used as the sensor 126. For example, the sensor 126 can be a force sensor configured to detect the force applied (e.g., whether via the end effector of the robotic arm 116, a tool held by the end effector of the robotic arm 116, or otherwise) on the robotic arm 116. One or more sensors 126 can be positioned, for example, on the robotic arm 116 or elsewhere.

[0066] Data from sensor 126 can be provided to the processor of robot 114, the processor 104 of computing device 102, and / or navigation system 118. The data can be used to calculate the position of robotic arm 116 in space relative to one or more coordinate systems (e.g., based on coordinate system information stored in memory 116). This calculation can be based not only on the data received from sensor 126, but also on data or information about, for example, robot 114 or a part thereof or any other relevant object (such as, for example, physical dimensions), which can be stored in, for example, memory 116 of computing device 102 or any other memory.

[0067] In some embodiments, reference markers (i.e., navigation markers) can be placed on robot 114 (including, for example, on robotic arm 116), imaging device 112, surgical tool 234, or any other object in the surgical space. The reference markers can be tracked by navigation system 118, and the results of the tracking can be used by robot 114 and / or by an operator of system 100 or any of its components. In some embodiments, navigation system 118 can be used to track other components of the system (e.g., imaging device 112), and the system can operate without using robot 114 (e.g., a surgeon manually manipulates imaging device 112 and / or one or more surgical tools based on, for example, information and / or instructions generated by navigation system 118).

[0068] During operation, navigation system 118 can provide navigation for the surgeon and / or the surgical robot. Navigation system 118 can be any currently known or future-developed navigation system, including, for example, Medtronic StealthStation TMAn S8 surgical navigation system or any successor thereof. The navigation system 118 may include one or more cameras or other sensors for tracking one or more reference markers, navigation trackers, or other objects within an operating room or other room in which part or all of the system 100 is located. The one or more cameras may be optical cameras, infrared cameras, or other cameras. In some embodiments, the navigation system 118 may include one or more electromagnetic sensors. In various embodiments, the navigation system 118 may be used to track the position and orientation (e.g., pose) of the imaging device 112, the robot 114, and / or the robotic arm 116 and / or one or more surgical tools 234 (or more specifically, to track the pose of a navigation tracker directly or indirectly attached in a fixed relationship to one or more of the foregoing). The navigation system 118 may include a display for displaying one or more images from an external source (e.g., the computing device 102, the imaging device 112, or other source) or for displaying images and / or video streams from one or more cameras or other sensors of the navigation system 118. In some embodiments, the system 100 may operate without using the navigation system 118. The navigation system 118 may be configured to provide guidance to a surgeon or other user of the system 100 or its components, to the robot 114, or to any other element of the system 100 regarding, for example, the pose of one or more anatomical elements, whether a tool is in the proper trajectory, and / or how to move the tool into the proper trajectory to perform a surgical task in accordance with a preoperative or other surgical plan.

[0069] The database 130 may store information associating one coordinate system to another (e.g., associating one or more robotic coordinate systems to a patient coordinate system and / or a navigation coordinate system). The database 130 may additionally or alternatively store, for example, one or more surgical plans 124 (including, for example, information about a desired custom-shaped cavity, the trajectory of the surgical tool 234, pose information about a target, and / or image information about the patient's anatomy at and / or near the surgical site) for use by the robot 114, the navigation system 118, and / or the computing device 102 or a user of the system 100; one or more images of a surgery that may be used in conjunction with or assisted by one or more other components of the system 100; and / or any other useful information. The database 130 may be configured to provide any such information to the computing device 102 or any other device of the system 100 or any other device external to the system 100, either directly or via the cloud 134. In some embodiments, the database 130 may be or include part of a hospital image storage system, such as a Picture Archiving and Communication System (PACS), a Health Information System (HIS), and / or another system for collecting, storing, managing, and / or transmitting electronic medical records including image data.

[0070] Cloud 134 may be or represent the Internet or any other wide area network. Computing device 102 may be connected to cloud 134 via communication interface 108 using a wired connection, a wireless connection, or both. In some embodiments, computing device 102 may communicate with database 130 and / or an external device (e.g., a computing device) via cloud 134.

[0071] System 100 or a similar system may be used to, for example, implement one or more aspects of any of the methods 300 and / or 400 described herein. System 100 or a similar system may also be used for other purposes.

[0072] Turning to Figure 2 , a block diagram of a system 200 in accordance with at least one embodiment of the present disclosure is shown. System 200 includes a computing device 202 (which may be the same as or similar to the aforementioned computing device 102), a navigation system 218 (which may be the same as or similar to the aforementioned navigation system 118), and a robot 214 (which may be the same as or similar to the aforementioned robot 114). In some embodiments, system 200 may be used in conjunction with system 100. Systems according to other embodiments of the present disclosure may include more or fewer components than system 200. For example, system 200 may not include navigation system 218.

[0073] As shown, robot 214 includes a robotic arm 216 extending from a base 240 (which may include one or more members 216A connected by one or more joints 216B). Base 240 may be stationary or capable of movement. In some embodiments, robot 214 may include one robotic arm or two or more robotic arms. In embodiments where robot 214 includes more than two robotic arms, the robotic arms may operate in a shared or common coordinate space. By operating in a common coordinate space, the robotic arms avoid colliding with each other during use because the position of each robotic arm is known to the others.

[0074] In some embodiments, an arm guide 232 and a surgical tool 234 may be disposed or supported on the end of robotic arm 216. In other embodiments, arm guide 232 and surgical tool 234 are disposed or fixed to any portion of robotic arm 216. In other embodiments, any one or more tools, instruments, or components may be supported by, fixed to, or disposed on robotic arm 216.

[0075] The arm guide 232 can be attached to the robotic arm 216 and can be configured to receive one or more surgical tools 234. In some embodiments, the arm guide 232 can include an aperture through which the surgical tool 234 is received. The arm guide 232 can also include a step or depth limiter that can interface with the surgical tool 234 to prevent the surgical tool 234 from moving past the depth limiter. The depth limiter can serve as a physical barrier to prevent the surgical tool 234 from moving beyond a predetermined depth. In some embodiments, the depth limiter can be a component separate from the arm guide 232. In such embodiments, the depth limiter can be manually controlled or set by a user (e.g., a surgeon or healthcare provider), or automatically controlled or set by the robot 114 and / or the robotic arm 116. It should also be understood that the robotic arm 216 can also automatically prevent the surgical tool 234 from moving beyond a predetermined threshold. Thus, the surgical tool 234 can be prevented from mechanically and / or using software from moving beyond a predetermined threshold.

[0076] As Figure 2 shown, the surgical tool 234 is supported by the robotic arm 216 and the arm guide 232. The robotic arm 216 is capable of operating to autonomously and / or based on input from a surgeon or user to perform one or more planned movements and / or procedures using the surgical tool 234. In other words, the surgical tool 234 can be used to perform an action or procedure on the patient 210, whether based on instructions from a surgeon and / or in accordance with a surgical plan, such as surgical plan 124. For example, the surgical tool 234 can be used to install an implant in the patient 210 by performing one or more steps such as preparing an anatomical element 236 (e.g., a vertebra), drilling a hole in the anatomical element 236 to form an aperture, tapping the anatomical element 236, decorticating the anatomical element 236, and driving the implant into the anatomical element 236.

[0077] The surgical tool 234 can include, for example, a drill bit, a reamer, a screwdriver, a tap, a combined drill bit-reamer capable of drilling, reaming, and / or milling, and / or any other surgical tool. In an embodiment where the surgical tool 234 includes a reamer, the reamer can be a tool having a flat face. More specifically, the reamer can be a tool having a face with a width greater than the cutting depth. The surgical tool 234 can also be shaped to avoid anatomical structures or hardware. For example, the surgical tool 234 can include a cutter, where a portion of the middle of the cutter body is removed such that after placement of, for example, a pedicle screw shank, the cutter (which can be used to clear bone around the pedicle screw head) and the head can be received inside a pocket formed by the cutter. The pocket, which can be a central pocket and / or a fully cannulated pocket, can be in fluid communication with a fluid source such as, for example, water, saline, or other irrigation fluid, which can be used to irrigate the surgical site and / or aspirate surgical debris. The cutter can also be combined with another surgical tool 234, such as, for example, a drill capable of perforating an anatomical element (which can include, for example, a pedicle), thereby allowing one surgical tool 234 to perform multiple tasks.

[0078] In another example, the surgical tool 234 can include a cutting tool that can be smaller than a desired pocket and can be used to cut a plurality of smaller pockets adjacent to the cavity 238. More specifically, in some embodiments, the laterally fed pockets can overlap such that the overlap forms a pocket larger than the size of the cutting tool. In such embodiments, non-standard or custom-shaped countersinks can be formed with a standard tool by overlapping the cutting portions into a desired shape. More specifically, for example, two overlapping cylindrical countersinks can form an oval pocket, and these overlaps can be combined into a desired or custom shape. In at least one embodiment, the shape of the pocket (which can be the same as or adjacent to or close to the cavity 238) can be customized for a desired implant such that, for example, a long rod can be received in an elongated pocket. Additionally, the customized cavity 238, pocket, or any other custom-shaped bone removal can be programmed automatically (e.g., using artificial algorithms) or manually (e.g., using user input from, for example, a surgeon or other healthcare provider) using software. The software can receive inputs such as, for example, the coordinates of the desired cavity, the desired shape of the bone removal suitable for the implant, and / or to maximize or optimize the strength of the bone (e.g., by measuring bone density or the thickness of the remaining bone after bone removal).

[0079] Decortication of the anatomical element 236 can include using the surgical tool 234 to remove at least a portion of the anatomical element 236 to form a custom-shaped cavity 238. The custom-shaped cavity 238 can include complex spaces and can have multiple portions with different cross-sectional areas. In some embodiments, the robotic arm 216 can be manipulated with the surgical tool 234 attached thereto to create the multi-part custom-shaped cavity 238. In other embodiments, the robotic arm 216 can be stationary during use (e.g., the robotic arm 216 is in a fixed position), and the surgical tool 234 can be used in combination with the robotic arm 216. The uppermost portion of the custom-shaped cavity 238 can have a first shape and a first cross-sectional area, and the middle or lower portion of the custom-shaped cavity 238 can have a second shape and a second cross-sectional area. In some embodiments, the cross-sectional area of the uppermost portion is greater than the cross-sectional area of the middle or lower portion. Providing the multi-part custom-shaped cavity 238 can help accommodate implants having complex shapes and can further prevent such implants from protruding too far (e.g., projecting) outside the anatomical element 236 in which the implant is fixed.

[0080] The custom-shaped cavity 238 can also be formed at an angle relative to the pedicle screw shank such that when the pedicle screw head is attached to the pedicle screw shank, the head interferes with the anatomical element (e.g., bone) and is angled relative to the pedicle screw shank. In such cases, the angled head can be used for additional correction of the patient's spine such that when the rod mates with the head, the head can orient itself perpendicular to the rod, thereby orienting the anatomical element 236 (e.g., vertebral body) therewith. It may also be desirable to angle the head relative to the pedicle screw shank such that the custom-shaped cavity 238 can leave more of the anatomical element 236 (e.g., bone) than a conventional in-line pocket. Such a custom-shaped cavity 238 can potentially result in increased strength in the direction, for example, in which the pedicle screw is pulled out of the anatomical element (e.g., bone). In other cases, the cavity 238 can be shaped to enable, for example, pivoting movement of the head in the medial-lateral direction while restricting pivoting movement of the head in the superior-inferior direction.

[0081] Such a custom-shaped cavity 238 is achieved by the precise manipulation of the surgical tool 234 by the robotic arm 216 within a workspace that is not visually accessible to a user such as a surgeon or other medical personnel. In other words, the robotic arm 216 is capable of orienting and operating the surgical tool 234 in a space that the user cannot specifically observe (e.g., during a MIS procedure). Thus, cavities of complex geometries or shapes can be formed by the robotic arm 216 operating the surgical tool 234 in a workspace where it is typically difficult to work.

[0082] Figure 3Method 300 is depicted that can be used to control, for example, one or more surgical tools (such as surgical tool 234) to form a cavity of a customized shape in an anatomical element (such as anatomical element 236). Although method 300 will be described with respect to installing an implant such as a pedicle screw implant, it should be understood that method 300 can be used to form a cavity of a customized shape for any purpose, reason, or use.

[0083] Method 300 (and / or one or more of its steps) can be implemented or otherwise executed, for example, by at least one processor. The at least one processor can be the same as or similar to processor 104 of computing device 102 described above. The at least one processor can be part of a robot (such as robot 114) or part of a navigation system (such as navigation system 118). Processors other than any processors described herein can also be used to execute method 300. The at least one processor can execute method 300 by executing elements stored in a memory (such as memory 106). The elements stored in the memory and executed by the processor can cause the processor to execute one or more steps of the functions as shown in method 300. One or more parts of method 300 can be executed by a processor that executes any of the content of the memory (such as image processing 120 and / or trajectory planning 122).

[0084] Method 300 includes receiving a first surgical tool (step 304). The first surgical tool can be the same as or similar to surgical tool 234. In some embodiments, the first surgical tool includes a drill bit. In other embodiments, the first surgical tool includes a combined drill-bit reamer or any tool capable of drilling, reaming, and / or milling. The first surgical tool can be received by a robotic arm (such as robotic arms 116, 216) of a robot (such as robots 114, 214) and coupled to the robotic arm. In some embodiments, an arm guide (such as arm guide 232) can be attached to the robotic arm and the first surgical tool can be received through the arm guide. In such embodiments, the arm guide can be configured to receive the first surgical tool (or any surgical tool) and prevent the surgical tool from moving beyond a predetermined depth. Whether the first surgical tool is received by the arm guide or otherwise coupled to the robotic arm, the first surgical tool is supported, oriented, and operated by the robotic arm. As described above, the robotic arm is capable of precisely positioning and orienting a surgical tool such as the first surgical tool and is configured to orient the surgical tool along a trajectory.

[0085] Method 300 also includes orienting a robotic arm to a first surgical tool to remove a first portion of an anatomical element (step 308). Orienting the robotic arm to the first surgical tool can include orienting the robotic arm along a first trajectory in one direction to remove the first portion of the anatomical element, which can be the same as or similar to anatomical element 236. In some embodiments, the first portion forms an aperture in the anatomical element. In such embodiments, the first trajectory can include the depth at which the first surgical tool drills into the anatomical element. For example, the first trajectory can be obtained from a memory (such as memory 106) of a computing device (such as computing device 102), a surgical plan (such as surgical plan 124), and / or a database (such as database 130). In other cases, the first trajectory can be obtained from a processor performing trajectory planning (such as trajectory planning 122). As previously described, trajectory planning enables the processor to receive information about a desired custom-shaped cavity and / or a desired aperture and generate a trajectory for the surgical tool to remove one or more portions from the anatomical element. The one or more portions can form an aperture, a custom-shaped cavity, or any other shape, space, or combination of shapes.

[0086] Method 300 also includes receiving a second surgical tool (step 312). Step 312 can be the same as or similar to step 304 described above. The second surgical tool can include a reamer. In some embodiments, the second surgical tool can be the same as the first surgical tool. In some embodiments, method 300 can exclude step 312. In other words, the robotic arm (or arm guide) can receive the surgical tool and perform both step 308 and step 316 below.

[0087] Method 300 also includes orienting the robotic arm in at least one direction to a second surgical tool to remove a second portion of the anatomical element (step 316). Step 316 can be the same as or similar to step 308. The at least one direction can include a lateral direction and a depth direction. It should be understood that the at least one direction can include any direction. The second portion removed from the anatomical element can form a custom-shaped cavity, such as custom-shaped cavity 238 in the anatomical element. In some cases, the custom-shaped cavity can have a cross-sectional area larger than the cross-sectional area of the second surgical tool (or any surgical tool). In some embodiments, the custom-shaped cavity can be shaped to receive the head of a pedicle screw implant such that the head can be seated flush against the anatomical element. The custom-shaped cavity enables the pedicle screw implant to have a lower profile relative to the anatomical element. In the absence of such a custom-shaped cavity, the head and the pedicle screw may protrude and be exposed relative to the anatomical element.

[0088] In some embodiments, step 316 may be referred to as a decortication step. Decortication of an anatomical element may include removing at least a portion of the anatomical element using a surgical tool to form a cavity of a customized shape. Such decortication is achieved by precisely manipulating the surgical tool within a workspace that is not visually accessible to a user, such as a surgeon or other medical personnel, by a robotic arm. In other words, the robotic arm is capable of orienting and operating the surgical tool within a space that the user cannot specifically observe (e.g., during a MIS procedure). Thus, a cavity of a complex geometry or shape can be formed by operating the surgical tool within a workspace where it is typically difficult to work by the robotic arm.

[0089] Method 300 further includes stopping the movement of the first surgical tool and / or the second surgical tool at a predetermined depth (step 320). The predetermined depth may be received from, for example, a surgical plan, a memory, a database, or any other component of a system such as system 100. In embodiments where an arm guide is attached to the robotic arm and a surgical tool, whether it is the first surgical tool, the second surgical tool, or any surgical tool, is received by the arm guide, the arm guide may be configured to stop the movement of the surgical tool at a predetermined depth. More specifically, the arm guide may include a step or depth limiter that may interface with the surgical tool to prevent the surgical tool from moving past the depth limiter. Thus, the depth limiter acts as a physical barrier to prevent the surgical tool from moving beyond the predetermined depth. The depth limiter may be adjustable such that a user, such as a surgeon or other medical provider, can adjust the depth limiter as needed. In other embodiments, the robotic arm 216 may also automatically prevent the surgical tool from moving past the predetermined depth. In such embodiments, the robotic arm may receive the predetermined depth and automatically stop the movement of the surgical tool past the predetermined depth.

[0090] Method 300 further includes measuring the depth of the orifice (step 324). The depth of the orifice may be measured using image data from an imaging device, such as imaging device 112, and / or using the robotic arm to measure the depth. In embodiments where imaging is used to measure the depth, the image data from the imaging device may be processed by a processor using image processing, such as image processing 120, to process the image data to identify the orifice and measure the depth of the orifice. In embodiments where the robotic arm is used to measure the depth, a sensor, such as sensor 126 of the robotic arm, may be used to measure the depth. For example, the pose of the robotic arm may be measured when the first surgical tool starts drilling, and the pose of the robotic arm may be measured when the first surgical tool has drilled to the desired depth. In another example, the pose of the robotic arm may be measured when the first surgical tool is at the desired depth.

[0091] Depth may also be received from a surgical plan or determined when the processor performs trajectory planning. The depth received from a surgical plan, trajectory planning, or any software may be used to confirm or compare with the depth measured by the robotic arm and / or imaging device. Such comparison may be used to determine the accuracy of the depth.

[0092] Method 300 further includes causing the robotic arm to drive the implant into the aperture to the depth (step 328). The depth may be obtained from, for example, step 324. In other embodiments, a depth marker and a navigation system (such as navigation system 118 configured to track the pose of the depth marker) may be used to mark the depth. In other embodiments, the depth may be received from a surgical plan, a memory, a database, or any other component.

[0093] Causing the robotic arm to drive an implant (such as a pedicle screw implant) into the aperture may include the robotic arm using a surgical tool (such as a screwdriver) to drive the implant. It should be understood that steps 308, 316, and / or 328 (e.g., drilling, forming a custom-shaped cavity, and driving the implant) may be performed with the same surgical tool. It should also be understood that method 300 may include other steps, such as, for example, preparing an anatomical element and tapping the anatomical element, and in such cases, any combination of steps may be performed using the same surgical tool.

[0094] The present disclosure encompasses embodiments of method 300 that include more or fewer steps and / or one or more steps different from those described above.

[0095] Figure 4 Method 400 is depicted that may be used to control, for example, one or more surgical tools (such as surgical tool 234) to form a prepared anatomical element (such as anatomical element 236) for receiving an implant (such as implant 238). Although method 400 will be described with respect to installing an implant such as a pedicle screw implant, it should be understood that method 400 may be used to form a custom-shaped cavity for any purpose, reason, or use.

[0096] Method 400 (and / or one or more of its steps) may be implemented or otherwise performed, for example, by at least one processor. The at least one processor may be the same as or similar to processor 104 of computing device 102 described above. The at least one processor may be part of a robot (such as robot 114) or part of a navigation system (such as navigation system 118). Processors other than any of the processors described herein may also be used to perform method 400. The at least one processor may perform method 400 by executing elements stored in a memory (such as memory 106). The elements stored in the memory and executed by the processor may cause the processor to perform one or more steps of the functions shown in method 400. One or more portions of method 400 may be performed by a processor that executes any of the contents of the memory (such as image processing 120 and / or trajectory planning 122).

[0097] Method 400 includes preparing an anatomical element (step 404). The anatomical element may be the same as or similar to anatomical element 236 and may include, for example, vertebrae. The anatomical element may be prepared to receive, for example, an implant (such as implant 238). The implant may be a pedicle screw, although in other cases the implant may be, for example, a rod, cage, etc. Preparing the anatomical element may include scraping, polishing, marking, forming guide holes, or a combination thereof on the surface of the anatomical element. A surgical tool (such as surgical tool 234) may be used to prepare the anatomical element. The anatomical element may be manually prepared by a user operating the surgical tool or prepared by a robotic arm 116, 216 of a robot (such as robots 114, 214) to assist the user or to automatically orient and operate the surgical tool. In some embodiments, an arm guide (such as arm guide 232) may be attached to the robotic arm and the surgical tool may be received through the arm guide. In such embodiments, the arm guide may be configured to receive the surgical tool (or any surgical tool) and prevent the surgical tool from moving beyond a predetermined depth. Whether the surgical tool is received by the arm guide or otherwise coupled to the robotic arm, the surgical tool is supported, oriented, and operated by the robotic arm. As previously described, the robotic arm is capable of precisely positioning and orienting a surgical tool such as the surgical tool and is configured to orient the surgical tool along a trajectory.

[0098] Method 400 further includes orienting a robotic arm to direct a surgical tool to drill in an anatomical element (step 408). The surgical tool can be the same as or similar to the surgical tool used to prepare the anatomical element in step 404. In other cases, the surgical tool can be a surgical tool different from the surgical tool used in step 404. Orienting the robotic arm to direct the surgical tool can include orienting the robotic arm to direct the surgical tool in one direction along a first trajectory to remove a first portion of the anatomical element (e.g., drill). In some embodiments, the first portion forms an orifice in the anatomical element. In such embodiments, the first trajectory can include the depth at which the surgical tool drills in the anatomical element. As previously described, the first trajectory can be obtained from a memory (such as memory 106) of a computing device (such as computing device 102), a surgical plan (such as surgical plan 124), and / or a database (such as database 130). In other cases, the first trajectory can be obtained from a processor that performs trajectory planning (such as trajectory planning 122). As previously described, trajectory planning enables the processor to receive information regarding a desired custom-shaped cavity and / or a desired orifice, and generate a trajectory for the surgical tool to remove one or more portions from the anatomical element. The one or more portions can form an orifice, a custom-shaped cavity, or any other shape, space, or combination of shapes.

[0099] Method 400 further includes orienting a robotic arm to direct a surgical tool to tap the orifice (step 412). The surgical tool can be the same as or similar to the surgical tool used in step 404 and / or 408 to prepare the anatomical element and / or drill in the anatomical element. In other cases, the surgical tool can be a surgical tool different from the surgical tool used in step 404 and / or 408. Orienting the robotic arm to direct the surgical tool can include orienting the robotic arm to direct the surgical tool in one direction along a first trajectory to tap the orifice formed in step 408.

[0100] Method 400 also includes orienting a robotic arm to position a surgical tool to perform a decortication on an anatomical element (step 416). Step 416 may be the same as or similar to step 316 of method 300 described above. The surgical tool may be the same as or similar to the surgical tool used in steps 404, 408, and / or 412 to prepare the anatomical element, drill a hole in the anatomical element, and / or tap the orifice. In other cases, the surgical tool may be a surgical tool different from the surgical tool used in steps 404, 408, and / or 412. Orienting the surgical tool to perform the decortication may include orienting the surgical tool in at least one direction to remove a second portion of the anatomical element. It should be understood that the at least one direction may include any direction. The second portion removed from the anatomical element may form a custom-shaped cavity, such as custom-shaped cavity 238 in the anatomical element. In some cases, the custom-shaped cavity may have a cross-sectional area larger than the cross-sectional area of the second surgical tool (or any surgical tool). In some embodiments, the custom-shaped cavity may be shaped to receive the head of a pedicle screw implant such that the head may be seated flush against the anatomical element. The custom-shaped cavity allows the pedicle screw implant to have a lower profile relative to the anatomical element. In the absence of such a custom-shaped cavity, the head and the pedicle screw may protrude and be exposed relative to the anatomical element.

[0101] As previously described, decortication of the anatomical element may include using a surgical tool to remove at least a portion of the anatomical element to form a custom-shaped cavity. Such decortication is achieved by the robotic arm precisely manipulating the surgical tool within a workspace that is not visually accessible to a user, such as a surgeon or other medical personnel. In other words, the robotic arm is capable of orienting and operating the surgical tool in a space that the user cannot specifically observe (e.g., during a MIS procedure). Thus, a cavity of a complex geometry or shape may be formed by the robotic arm operating the surgical tool within a workspace where it is typically difficult to work.

[0102] Method 400 also includes causing a robotic arm to drive an implant into the aperture (step 420). Step 420 may be the same as or similar to step 328 of method 300 described above. Causing a robotic arm to drive an implant (such as a pedicle screw implant) into the aperture may include the robotic arm using a surgical tool (such as a screwdriver) to drive the implant. It should be understood that the same surgical tool may be used to perform steps 404, 408, 412, 416, and / or 420 (e.g., preparing the anatomical element, drilling in the anatomical element, tapping the aperture, forming a custom-shaped cavity (e.g., decortication), and driving the implant). It should also be understood that method 400 may include other steps, such as, for example, preparing the anatomical element and tapping the anatomical element, and in such cases, any combination of steps may be performed using the same surgical tool.

[0103] The present disclosure encompasses embodiments of method 400 that include more or fewer steps than those described above and / or one or more steps different from those described above.

[0104] As described above, the present disclosure encompasses methods having fewer steps than all of the steps identified in Figure 3 and Figure 4 (and the corresponding descriptions of methods 300 and 400), as well as methods that include additional steps beyond the steps identified in Figure 3 and Figure 4 (and the corresponding descriptions of methods 300 and 400). The present disclosure also encompasses methods that include one or more steps from one of the methods described herein and one or more steps from another of the methods described herein. Any correlation described herein may be or include registration or any other correlation.

[0105] The foregoing is not intended to limit the present disclosure to one or more forms disclosed herein. In the foregoing detailed description, for example, for purposes of simplifying the present disclosure, various features of the present disclosure are grouped together in one or more aspects, embodiments, and / or configurations. The features of the aspects, embodiments, and / or configurations of the present disclosure may be combined in alternative aspects, embodiments, and / or configurations other than those discussed above. The methods of the present disclosure should not be construed as reflecting an intention that the claims require more features than those expressly recited in each claim. Rather, as reflected in the following claims, the inventive aspects lie in less than all of the features of a single foregoing disclosed aspect, embodiment, and / or configuration. Accordingly, the following claims are hereby incorporated into this detailed description, where each claim stands on its own as a separate preferred embodiment of the present disclosure.

[0106] In addition, although the foregoing has included a description of one or more aspects, embodiments, and / or configurations, as well as certain variations and modifications, other variations, combinations, and modifications are within the scope of the present disclosure, for example, within the skill and knowledge of those skilled in the art. It is intended to obtain rights to include alternative aspects, embodiments, and / or configurations within the scope of what is permitted, including alternative, interchangeable, and / or equivalent structures, functions, scopes, or steps of those claimed, whether or not such alternative, interchangeable, and / or equivalent structures, functions, scopes, or steps are disclosed herein, and it is not intended to disclose any patentable subject matter.

Claims

1. A system for performing a minimally invasive surgical procedure, the system comprising: Processor; and a memory storing data for processing by the processor, the data when processed causing the processor to: receive a surgical tool via an arm guide of a robotic arm; and orient the surgical tool in at least one direction along a trajectory by the robotic arm to remove at least a portion of an anatomical element, thereby forming a custom-shaped cavity in the anatomical element.

2. The system according to claim 1, wherein the custom-shaped cavity has a cross-sectional area larger than the cross-sectional area of the surgical tool.

3. The system according to claim 1, wherein the at least one direction includes a lateral direction and a depth direction.

4. The system according to claim 1, the system further comprising the arm guide, wherein the arm guide includes a depth limiter to prevent the surgical tool from moving beyond a predetermined depth, and wherein the depth limiter is adjustable.

5. The system according to claim 1, wherein the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: Cause the robotic arm to stop the movement of the surgical tool at a predetermined depth.

6. The system according to claim 1, wherein the surgical tool is configured to drill and mill the anatomical element.

7. The system according to claim 1, wherein the surgical tool includes a reamer, and wherein the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: Receive the drill bit through the arm guide of the robotic arm; and Cause the robotic arm to orient the drill bit in one direction along a drill bit trajectory to form an orifice in the anatomical element before removing at least a portion of the anatomical element by the reamer.

8. The system according to claim 1, wherein the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: Cause the robotic arm to orient the surgical tool in one direction along a drill bit trajectory to form an orifice in the anatomical element before removing at least a portion of the anatomical element; measure a depth of the orifice; and cause the robotic arm to drive an implant into the orifice to the depth.

9. The system according to claim 1, wherein the custom-shaped cavity is shaped to receive the head of a pedicle screw.

10. The system according to claim 9, wherein the custom-shaped cavity is shaped such that the head is inclined relative to the pedicle screw.

11. The system according to claim 1, wherein the surgical tool has a diameter greater than the cutting depth of the surgical tool.

12. A system for performing a surgical procedure, the system comprising: A first robotic arm configured to orient a surgical tool; Processor; and a memory storing data for processing by the processor, the data when processed causing the processor to: orient the surgical tool in at least one direction along a trajectory by the robotic arm to remove at least a portion of an anatomical element, thereby forming a custom-shaped cavity in the anatomical element.

13. The system according to claim 12, wherein the surgical procedure is a minimally invasive surgical procedure.

14. The system according to claim 12, wherein the custom-shaped cavity has a cross-sectional area larger than the cross-sectional area of the surgical tool.

15. The system according to claim 12, wherein the at least one direction includes a lateral direction and a depth direction.

16. The system according to claim 12, the system further comprising an arm guide including a depth limiter to prevent the surgical tool from moving beyond a predetermined depth, and wherein the depth limiter is adjustable; and wherein the memory stores additional data for processing by the processor, the additional data when processed causing the processor to: Receive the surgical tool through the arm guide.

17. A system for performing a surgical procedure, the system comprising: A first robotic arm configured to orient a surgical tool; An arm guide coupled to the robotic arm and configured to prevent movement of the surgical tool beyond a predetermined depth; Processor; and a memory storing data for processing by the processor, the data when processed causing the processor to: receive a first surgical tool via the arm guide; orient the first surgical tool in one direction along a first trajectory to form an orifice in the anatomical element; receive a second surgical tool via the arm guide; orient the second surgical tool in more than one direction along a second trajectory by the robotic arm to remove a second portion of the anatomical element, thereby forming a custom-shaped cavity in the anatomical element.

18. The system according to claim 17, wherein the first surgical tool includes a drill bit and the second surgical tool includes a reamer.

19. The system according to claim 17, wherein the cavity having the customized shape has a cross-sectional area larger than the cross-sectional area of the surgical tool.

20. The system according to claim 17, wherein the at least one direction includes a lateral direction and a depth direction.

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