Multi-arm surgical robot system

Abstract

The invention relates to a multi-arm surgical robot system, and devices, systems, and methods for robot-assisted surgery. A surgical robotic system with integrated navigation and multiple surgical arms may assist a user in performing one or more surgical procedures. In addition to the plurality of surgical arms, the robotic system may have a peripheral arm to position a navigation camera and a surgeon display. The robotic system is collaborative to allow for easy integration into a procedure workflow, e.g., to install pedicle screws, intervertebral implants, or other surgical devices.

Description

Technical Field

[0001] The present disclosure relates to medical devices, and more particularly to robotic surgical systems and related devices and methods. Background Art

[0002] Computer-assisted techniques can be used during surgical procedures, for example, to improve accuracy, reduce surgical operative time, and lower potential radiation exposure. Typically, navigation provides surgeons with better visualization during minimally invasive procedures, while surgical robots assist with trajectory alignment and implant positioning. The combination of robotics and navigation enhances computer-assisted techniques because the robot automates navigational positioning. Furthermore, robotic arms can be used to precisely align and maintain the surgeon's desired trajectory during the procedure.

[0003] However, current robotic navigation systems have several limitations. For example, the systems may be limited by navigation adjustment factors, such as inaccurate registration or poor line of sight of the robot's camera; passive guidance issues, such as possible patient movement, the inability to actively move the system during the procedure, and difficulty working with long surgical structures; having only a single robotic arm, which limits the approach to one surgical maneuver at a time; the inability of the surgeon or assistant to see a monitor to oversee the procedure; and the hindered movement of the entire system during surgery and / or during transport.

[0004] Therefore, there remains a need for improved systems and methods for robotic-assisted surgery, in which the robotic navigation system acts as a tool and true assistant to the surgeon throughout the surgical procedure, which improved systems and methods have the flexibility and adaptability for a variety of clinical applications and procedures. Summary of the Invention

[0005] To meet this need and other needs, devices, systems and methods for robotic-assisted surgery are provided. A surgical robotic system with integrated navigation and multiple surgical arms can assist a user in performing one or more surgical procedures. An end effector can be attached to each surgical arm to engage instruments and perform the desired surgical procedure. In addition to the surgical arms, the robotic system can also have peripheral arms to position a navigation camera and surgeon display. The robotic system is collaborative so that the motorized subsystems can be controlled both by system software and manually by the user. These collaborative subsystems can include all robotic arms, base motion and base locking / stabilization. The collaborative design enables easy integration into the procedural workflow, for example, to install pedicle screws, interbody implants or other surgical devices.

[0006] According to one embodiment, a multi-arm surgical robotic system includes: a movable base station including an onboard computer; a display electrically coupled to the computer; a camera electrically coupled to the computer and configured to detect one or more tracking markers; a pair of surgical arms electrically coupled to the computer and capable of moving based on commands processed by the computer; and an end effector electrically coupled to each surgical arm. The surgical arms can be configured to be synchronized relative to each other. The surgical arms can be configured to perform independent surgical tasks simultaneously. The surgical arms can be configured to perform independent surgical tasks sequentially. Each of the surgical arms can be configured to be controlled by a different user. One of the surgical arms can be configured to perform one type of task, while another surgical arm can be configured to perform a different type of task. One of the surgical arms can control the other surgical arm during a zoom mode. The surgical arms can automatically execute verification procedures.

[0007] According to one embodiment, a multi-arm surgical robotic system includes: a movable base station including an onboard computer; an arm positioner attached to the base station; a monitor arm attached to the arm positioner, the monitor arm supporting a display electrically connected to the computer; a camera arm attached to the arm positioner, the camera arm supporting a camera electrically connected to the computer and configured to detect one or more tracking markers; and a pair of surgical arms attached to the arm positioner and electrically connected to the computer and capable of moving based on commands processed by the computer.

[0008] A multi-arm surgical robotic system may include one or more of the following features. The monitor arm and the camera arm may be motorized and controlled by a computer for automatic positioning of the display and the camera, respectively. The arm positioner may include a vertical column that provides telescopic movement. Each of the surgical arms may include a plurality of arm segments interconnected by joints to provide movement with seven degrees of freedom. The monitor arm may be connected to the arm positioner at a rotary joint, and the arm segments of the monitor arm may be interconnected by double hinge joints. The camera arm may be connected to the arm positioner at a rotary joint, the arm segments of the camera arm may be interconnected by double hinge joints, and the camera may be connected to the free end of the camera arm with a tilt joint. The free end of each surgical arm may include an end effector interface for securing an end effector to precisely position an instrument.

[0009] According to one embodiment, a robotic navigation method may include: (a) providing a multi-arm surgical robotic system comprising a pair of surgical arms, a display, and a navigation camera supported on a single mobile cart; (b) positioning the surgical robotic system near an operating room table; and (c) performing a surgical procedure with the assistance of the surgical arms of the multi-arm surgical robotic system, such that the two surgical arms are synchronized relative to each other to perform independent tasks simultaneously or sequentially. The procedure may include using one or both of the surgical arms to install one or more pedicle screws (such as bilateral pedicle screws) in corresponding vertebrae. The procedure may include using one or both of the surgical arms to install an intervertebral implant using an anterior cervical discectomy and fusion (ACDF), a posterior cervical fusion (PCF), anterior lumbar interbody fusion (ALIF), a transforaminal lumbar interbody fusion (TLIF), a posterior lumbar interbody fusion (PLIF), or a lateral lumbar interbody fusion (LLIF) procedure. The multi-arm surgical robotic system may have a deployed configuration for use and a docked configuration for transport or storage.

[0010] According to one embodiment, a multi-arm surgical robot system includes: a movable base station including an onboard computer; two or more motorized surgical arms attached to the base station and electrically connected to and controlled by the computer. Each surgical arm has seven arm links interconnected by seven joints, thereby providing movement with seven degrees of freedom. These seven joints may each have a single axis of rotation. Each subsequent joint may have an orthogonal axis of rotation compared to the previous joint. These seven joints may be revolute joints. Starting from the base station, the seven arm links may include a first link, a second link, a third link, a fourth link, a fifth link, a sixth link, and a seventh link, which are interconnected by seven joints including a first joint, a second joint, a third joint, a fourth joint, a fifth joint, a sixth joint, and a seventh joint. The axes of rotation of the fifth joint, the sixth joint, and the seventh joint may all intersect at a single point. The coordinate system origins of the second to seventh links may all be coplanar. The third link may be offset so that the third joint axis and the fifth joint axis remain coplanar. Each surgical arm may have a docked position such that the fifth link, the sixth link, and the seventh link are aligned proximate the first link and the second link.

[0011] According to one embodiment, a multi-arm surgical robotic system includes: a movable base station including an onboard computer; a monitor arm attached to the base station, the monitor arm supporting a display electrically coupled to the computer; a camera arm attached to the base station, the camera arm supporting a camera electrically coupled to the computer and configured to detect one or more tracking markers; and a pair of surgical arms attached to the base station and electrically coupled to the computer and capable of moving based on commands processed by the computer. The surgical arms have seven arm links interconnected by seven joints, providing movement with seven degrees of freedom.

[0012] The multi-arm surgical robotic system may include one or more of the following features. The surgical arm, monitor arm, and camera arm may be motorized and controlled by a computer for automatic positioning. The surgical arm may have closed inverse kinematics. Each joint of the surgical arm may include a motor, a gearbox, a load encoder, and a motor encoder. The load encoder may include a load encoder sensor for measuring the rotational position, speed, or direction of the load and a load encoder scale for quantifying the load. A microscope camera may be incorporated into the surgical robotic system to magnify the surgical site. The microscope camera may be mounted to the underside of the monitor arm below the display.

[0013] According to one embodiment, a robotic navigation method may include: (a) providing a multi-arm surgical robotic system comprising a pair of surgical arms having seven arm links interconnected by seven joints, thereby providing movement with seven degrees of freedom; (b) positioning the surgical robotic system near an operating room table with the surgical arms in a right-angle posture; and (c) performing a surgical procedure with the assistance of one or two of the surgical arms of the multi-arm surgical robotic system. The method may include moving the surgical arms to a preset covering position in which both surgical arms are extended upward for sterile covering before performing the surgical procedure. The multi-arm surgical robotic system may have an expanded configuration and a docked configuration in which the surgical arms are folded out of the surgical field. During the surgical procedure, one of the surgical arms may be expanded while the other surgical arm remains docked to perform a single-arm procedure.

[0014] Kits are also available that include different types and sizes of implants, instruments, and other components for performing the procedure. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] A more complete understanding of the present invention, together with their attendant advantages and features, will be more readily appreciated by reference to the following detailed description when considered in conjunction with the accompanying drawings, in which:

[0016] Figure 1 A surgical robotic system having two surgical arms is shown according to one embodiment;

[0017] Figures 2A to 2B Shown are the deployed and docked system configurations. Figure 1 surgical robotic systems;

[0018] Figures 3A to 3B showing a side view and a front view, respectively, of a docking system according to one embodiment;

[0019] Figure 4 shows a deployed surgical robotic system positioned proximate an operating room table;

[0020] Figures 5A to 5B Demonstrates surgical arm movement types and capabilities, including point, vector, and rotational constraints controlled by force input from the user;

[0021] Figure 6 An example of simultaneous active approach of the surgical arms of a surgical robotic system is shown;

[0022] Figure 7 An example of two surgeon workspaces with two active users during a procedure is shown;

[0023] Figures 8A to 8D An example of pedicle screw placement using multiple surgical arms is shown;

[0024] Figure 9 An example of using a surgical robotic system in zoom mode to magnify the working volume and scale for fine-tuning is shown;

[0025] Figure 10 An example of using a surgical robotic system is shown, where a pantograph is registered with an augmented reality object (here only the patient's spine is shown);

[0026] Figure 11 Automated dual-arm instrument verification for confirming instrument tip position is shown according to one embodiment;

[0027] FIG. 12A to FIG. 12B Alternative arm configurations of a surgical robotic system are shown with a vertical column and bifurcated arm positions above and below the upper arm, respectively;

[0028] Figure 13 A surgical robotic system having a positioner with a revolute joint for five degrees of freedom is shown according to one embodiment;

[0029] Figure 14shows a pedestal robot with a surgical arm starting at a base cabinet according to one embodiment;

[0030] FIG. 15A to FIG. 15B A surgical robotic system is shown with a parallelogram positioner in extended and docked positions, respectively, according to one embodiment;

[0031] Figure 16 A surgical robotic system having a parallelogram positioner with floating columns is shown according to one embodiment;

[0032] 17A to 17B Examples of stacked columns with two and three surgical arms, respectively, are shown;

[0033] Figure 18 A surgical robotic system with an independent base arm is shown according to one embodiment;

[0034] Figure 19 A surgical robotic system with a decoupled surgical arm having ten degrees of freedom is shown according to one embodiment;

[0035] Figure 20 A surgical robotic system having a curved gantry for positioning dual surgical arms around a patient is shown according to one embodiment;

[0036] 21A to 21D An example of a decoupled single cart system without a camera is shown;

[0037] Figure 22 shows a surgical robotic system in a docked position ready for installation;

[0038] FIG. 23A to FIG. 23B Examples of pre-set positions for overriding the robot in a single-arm protocol and a multi-arm protocol are shown, respectively;

[0039] FIG. 24A to FIG. 24B An example of an arrangement for positioning a navigation camera for optimal line of sight while avoiding operating room lights is shown;

[0040] FIG. 25A to FIG. 25B Examples of positioning a dual-display monitor with opposing displays and side-by-side displays are shown, respectively;

[0041] Figure 26 One example of diametrically opposed displays is shown, with multiple surgeons working on opposite sides of an operating room table;

[0042] Figure 27shows a surgical robotic system configured with opposing displays in microscope mode having a microscope oriented toward a surgical site for magnified visualization, according to one embodiment;

[0043] Figure 28 shows a surgical robotic system with side-by-side displays in microscope mode, allowing one display to provide a magnified image while another display provides surgical workflow, according to one embodiment;

[0044] Figure 29 An example of a port is shown in which fiducial markers are etched into the port to assist with dynamic camera positioning and focusing;

[0045] Figure 30 An example of a dual configuration for two surgeons working simultaneously in microscope mode is shown;

[0046] Figure 31 A surgical robotic system is shown having dual load sensors at the base of each arm and at the end effector interface to detect and safely recover from collisions;

[0047] FIG. 32A to FIG. 32B An example of two robotically controlled navigation cameras providing redundancy and reducing line-of-sight issues is shown in docked and deployed configurations, respectively;

[0048] Figures 33A to 33B An example of a navigation camera and surgical display mounted to a selectively compliant articulated robotic arm (SCARA) is shown in a docked configuration and a deployed configuration, respectively;

[0049] Figures 34A to 34B shows a closed inverse kinematics surgical arm configuration in a docked position and an extended position, respectively, according to one embodiment;

[0050] Figure 35 shows a surgical robot in a right-angle pose at an operating room table, according to one embodiment;

[0051] Figure 36 A schematic diagram illustrating a joint of a surgical arm according to one embodiment is shown;

[0052] Figure 37 shows a joint coordinate system of a surgical arm according to one embodiment;

[0053] Figures 38A to 38B Examples of optimized and inefficient docking of surgical arms are shown, respectively;

[0054] Figures 39A to 39DA comparison of right-angle crossover postures of different surgical arm configurations is shown;

[0055] FIG. 40A to FIG. 40B shows a load encoder at the output of a gearbox according to one embodiment;

[0056] Figures 41A to 41B shows a load encoder preceding a motor according to one embodiment;

[0057] Figure 42 shows a cable management system including a slip ring passing through a rolling joint of a surgical arm according to one embodiment;

[0058] Figure 43 An embodiment of a machined datum for integral arm tracking is shown; and

[0059] Figures 44A to 44B Examples of information rings positioned on surgical arms and / or end effectors to visually convey status information of each respective arm are shown. DETAILED DESCRIPTION

[0060] Embodiments of the present disclosure generally relate to surgical robotic systems and related devices and methods. In particular, a surgical robotic system may include integrated real-time surgical navigation with multiple surgical arms that are configured to assist a user in performing one or more surgical tasks. An end effector may be attached to each surgical arm to guide the trajectory of a dedicated surgical instrument and perform the desired surgical procedure. For example, a robotic system may include a pair of surgical arms that guide the instrument to follow a trajectory specified by a user. Multi-arm systems can provide opportunities to greatly expand the capabilities of computer-assisted technology in surgery. Multiple surgical arms allow the robotic system to assist with more surgical procedures and improve the accuracy of the procedures. Advanced multi-arm highly automated platforms can allow one or more surgeons, technicians, and patients to interact simultaneously.

[0061] The surgical robotic system can be configured for complete navigation and accurate alignment during spinal surgery. The surgical robotic system can allow for positioning of anatomical structures and real-time navigation of surgical instruments and devices in open or minimally invasive surgical (MIS) procedures. For example, a surgical arm and an attached end effector can be used to position and install pedicle screws, intervertebral implants, or perform other surgical techniques during spinal surgery. Although generally described herein with reference to performing spinal surgery, it should be understood that the systems and methods described herein can be applied to other orthopedic locations in the body and other medical procedures, such as trauma applications, cranial procedures, and tumor applications.

[0062] It should be understood that the present disclosure is not limited in its application to the construction details and component arrangements shown in the description herein or shown in the accompanying drawings. The teachings of the present disclosure can be used and practiced in other embodiments and practiced or implemented in various ways. In addition, it should be understood that the words and terms used herein are for descriptive purposes and should not be considered limiting. The use of "comprising," "including," or "having" and variations thereof herein is meant to include the items listed thereafter and their equivalents as well as additional items. Unless otherwise specified or limited, the terms "mounted," "connected," "supported," and "coupled," and variations thereof, are used broadly and include direct and indirect mounting, connection, support, and coupling. In addition, "connected" and "coupled" are not limited to physical or mechanical connections or couplings.

[0063] The following discussion is provided to enable those skilled in the art to implement and use the embodiments of the present disclosure. Various modifications to the illustrated embodiments will be apparent to those skilled in the art, and the principles herein may be applied to other embodiments and applications without departing from the disclosed embodiments. Therefore, the embodiments are not intended to be limited to the embodiments shown, but should have the broadest scope consistent with the principles and features disclosed herein. The following detailed description will be read with reference to the accompanying drawings, in which similar elements may have similar reference numerals. The accompanying drawings are not necessarily drawn to scale, depicting selected embodiments and are not intended to limit the scope of the embodiments. Those skilled in the art will recognize that the examples provided herein have many useful alternatives and fall within the scope of the embodiments.

[0064] Multi-arm surgical robot system

[0065] Now turning to the accompanying drawings, Figure 1 A multi-arm surgical robotic system or platform 10 according to one embodiment is shown. The multi-arm surgical robotic system 10 is configured to complete multiple surgical tasks simultaneously or sequentially, which can improve the accuracy of the entire procedure and reduce surgical time. The surgical robotic system 10 may include, for example, a robotic base station 12, an arm positioner 14 attached to the base station 12, and multiple arms 16, 18, 22 attached to the positioner 14. Two or more surgical arms 16 can help guide instruments or perform surgical tasks, such as using an end effector 26. The monitor arm 18 is configured to support one or more displays or monitors 20. The camera arm 22 is configured to support one or more navigation cameras 24, for example, for detecting and tracking markers, such as active markers and passive markers. Unlike other robotic systems that may utilize separate observation / control stations or separate camera supports / stations, all system components are integrated into a single mobile unit of the robotic system 10. Integrating all components into one mobile platform can improve the usability and accuracy of the system 10 while also reducing the overall footprint in the operating room.

[0066] The robotic base station 12 may comprise, for example, a mobile cabinet or portable frame on casters or wheels 30. The base station 12 houses an onboard computer or computing unit for controlling all functions of the robotic system 10. The onboard computer may include a central processing unit (CPU), memory, and input / output interfaces. The CPU executes the instructions of a computer program or software by performing the arithmetic, logic, control, and input / output (I / O) operations specified by the instructions. The memory may include volatile and non-volatile memory, which temporarily or permanently stores data and instructions currently in use or to be needed by the CPU. This may include, for example, random access memory (RAM), read-only memory (ROM), and storage devices such as hard drives. The input / output interfaces allow the computer system to interact with a user, acquire information, and deliver results, and may include devices such as a monitor, keyboard, mouse, and a network interface for internet connection.

[0067] like Figure 1 As shown in the embodiment of the present invention, the multi-arm surgical robot system 10 may include one or more user interfaces, such as a display or monitor 20, 32 including a touch screen display, which can be operated by one or more surgeons or other users. Before or during a medical procedure, a two-dimensional (2D) and / or three-dimensional (3D) image, such as a computed tomography (CT) scan, of the desired surgical area of ​​the patient 62 can be taken and provided to an onboard computer. The surgeon can use the image to program the desired insertion point and trajectory for one or more surgical instruments 28 to reach the desired anatomical target in or on the patient 62. The desired insertion point and trajectory can be planned on the image, which can be displayed on the monitor 20, 32. The system 10 includes 2D and 3D imaging software that allows preoperative planning, navigation, and guidance throughout the surgical procedure. More details of the surgical robot and navigation system can be found in, for example, U.S. Patent Publication No. 2019 / 0021795 and U.S. Patent Publication No. 2017 / 0239007, which are incorporated herein by reference in their entirety for all purposes.

[0068] In one embodiment, a pair of monitors 20 can be attached to the monitor arm 18, which is part of the sterile field. Before or during the procedure, relevant information can be displayed and manipulated by the surgeon on the touch screen monitor 20. Unlike systems where the surgeon can only see a single monitor, the dual monitor display provides access for the assistant surgeon or assistant and allows each surgical arm in each surgical arm 16 to be controlled individually. The monitors 20 can be arranged side by side, back to back, or arranged in another suitable configuration that is accessible and visible to the user. The base station 12 can also include a terminal or touch screen control display 32 mounted on the cabinet. When the system 10 is docked, during transportation, or during the procedure, the user can access the touch screen display 32 mounted on the cabinet. During surgery, the cabinet display 32 can be used for non-sterile user control or observation, such as by an assistant. It should be understood that one or more of the displays 30, 32 can be supplemented or replaced with an optional wireless tablet or other suitable device.

[0069] The surgical robotic system 10 may also utilize, for example, a camera 24 attached to a camera arm 22. The camera arm 22 is configured to move, orient, and support a camera 30 in a desired position. The camera 24 may include any suitable camera or cameras, such as one or more infrared cameras (e.g., bifocal or stereophotogrammetric cameras), capable of identifying active and passive tracking markers in a given measurement volume visible, for example, from the perspective of the camera 24. For example, the tracking markers may be arranged in a particular array or pattern, which may help identify the instrument. In an exemplary embodiment, the camera 24 is a machine vision navigation camera configured to capture visual data from tracking markers, which may be present on the system 10, on the instrument 28, attached to the patient, or in any other suitable location for tracking and navigating surgical procedures. The camera 24 may scan the given measurement volume and detect light from the markers in order to identify and determine the position of the markers in three dimensions. For example, active markers may include infrared emitting markers (e.g., infrared light emitting diodes (LEDs)) that are activated by electrical signals, and passive markers may include fiducials, retroreflective markers (e.g., balls or disks) that reflect infrared light, such as emitted by an illuminator on the camera 24, or other suitable device (e.g., they reflect incident IR radiation in the direction of the incident light). In one embodiment, tracking markers may include machined fiducials, reflective disks, reflective balls, and / or active LEDs that are visible directly or through a surgical drape. The position, orientation, and location of structures with these types of markers may be provided to an onboard computer, which may be displayed to a user on a display 20, 32. The navigation camera 24 tracks the position in real time and provides an image on the monitor 20, 32 along with, for example, an image of the patient to provide guidance to the surgeon during the operation.

[0070] The base station 12 may also include a connector panel 34 that includes external connection ports for various devices, such as an equipotential terminal, a foot pedal connector, a camera connector port, an HDMI connector, an Ethernet connector, dual USB 3.0 ports, etc. It should be understood that any suitable hardware, software, or combination thereof may be implemented to perform the operations and functions of the robotic system 10.

[0071] The robotic base station 12 may include a motorized propulsion and positioning system to transport the robotic system 10. In this manner, one or more base wheels 30 can be powered and steered by the user before or during a procedure. The motorized propulsion and positioning system may include two primary modes. In a first configuration, the user can transport and position the robotic system 10 via one or more handles 36. Powered base motion can be controlled by user input of force on the handles 36. For example, force feedback can be measured at the handles 36 to adjust the direction and speed of movement. In a second configuration, the user can utilize smart positioning in the operating room for position callbacks and accessibility adjustments. Smart positioning can be achieved via encoders on the wheels 30 and relative position tracking using the navigation camera 24. Relative tracking using the camera 24 can be achieved, for example, using patient reference tracking, simultaneous localization and mapping (SLAM), and / or machine vision. Smart positioning allows for intraoperative positioning of the system 10, for example, to accommodate long implant structures or complex procedures. The base station 12 may include a braking and / or stabilizer system 38 to secure the base 12. Stabilizer system 38 can be rigidly fixed to stabilize system 10 in the operating room and lock base 12 to the ground during surgery. Stabilizer can be engaged and retracted manually by the user via motor power. In this way, the braking system can also be used to assist in transportation when system 10 is powered off.

[0072] The arm positioner 14 is attached to the base station 12 and can be controlled via an onboard computer. In one embodiment, the arm positioner 14 can include a vertical column that provides telescopic movement along the z-axis 40, thereby acting as a sliding joint. Thus, the arm positioner 14 can extend or retract in a vertical direction, thereby moving one or more arms 16, 18, 22 of the system 10. As shown in this embodiment, the surgical arm 16 can be coupled to the arm positioner 14 near the base station 12, and the monitor arm 18 and camera arm 22 can be positioned toward the distal end of the arm positioner 14. In this way, vertical movement of the arm positioner 14 can provide movement of the monitor 20 and camera 24 along the z-axis 40. It should be understood that other suitable configurations can be used to position the respective robotic arms 16, 18, 22.

[0073] One or more surgical arms 16 may be provided to perform a wide range of motions and adjustments, for example, to mimic the movements of a human arm, hand, and / or finger and to closely replicate the dexterity and precision of a skilled surgeon. In one embodiment, the surgical arms 16 include a pair of left and right surgical arms arranged around the base of the arm positioner 14. Each surgical arm 16 may include multiple arm segments or links interconnected by various types of joints, such as for Figures 34A to 34B More detailed description. Each joint can allow a specific type of movement or provide specialized motion. The joints can include rotary joints, sliding joints, spherical joints, universal joints, cylindrical joints, planar joints, or other suitable joints that contribute to the range of motion, flexibility, and reach of the arm. In the illustrated embodiment, the system 10 includes a left surgical arm and a right surgical arm 16, each of which allows movement with seven degrees of freedom (7DoF). For example, the movement can include three translational movements (along the x-axis, y-axis, and z-axis), three rotational movements (around the x-axis, y-axis, and z-axis), and additional rotations or translations for imparting high precision and dexterity. It should be understood that the surgical arm 16 can be configured to have any suitable orientation or movement, thereby allowing each arm 16 to move forward / backward, move left / right, move up / down, yaw left / right, pitch up / down, roll around its own axis, or otherwise translate or rotate to perform complex movements. The surgical arm 16 may be configured to have zero backlash to ensure that movements are highly precise, accurate, and directly reflect the surgeon's commands without any delay.

[0074] The distal end of each surgical arm 16 includes an end effector interface 42 for securing an end effector 26 to the end of the surgical arm 16. The end effector 26 is a device or tool that is attached to the end of the robotic surgical arm 16 to interact with the surgical site. In some cases, the end effector 26 may include a guide tube to provide precise positioning of an instrument 28 placed therethrough. In other cases, the end effector 26 may include an active or workable instrument, such as a retractor for retracting soft tissue, which is controlled by the system 10 or manually. The end effector 26 may be provided as a separate component that is sterilized prior to use. The end effector interface 42 may include a mechanical and / or electrical connection of the end effector 26 to the distal end of the surgical arm 16. The end effector interface 42 includes a power supply and communication interface for the end effector 26. The end effector interface 42 allows the end effector 26 to be rigidly connected to the surgical arm 16 via a sterile drape.

[0075] The end effector 26 can be configured to guide or hold an integrated or separate navigated instrument 28. For example, the end effector 26 may include a tubular element or guide tube aligned along the planned trajectory. A separate navigated instrument 28 can be passed through the guide tube and positioned along the planned trajectory to perform a given function. For example, the navigated instrument 28 may include, for example, a drill bit, a tap, a screwdriver, or other instruments for inserting screws. For example, the navigated instrument 28 may also include expanders, intervertebral disc preparation instruments (e.g., curettes, Cobb elevators, osteotomes, files, scrapers, etc.), trial pieces, retractors / tractors, inserters, and other instruments for installing intervertebral implants. It should be understood that any suitable instrument can be used for a specified surgical procedure.

[0076] Each surgical arm 16 may include one or more load sensors 44, 46 configured to monitor and measure the forces applied to the surgical arm 16. A distal load sensor 44 may be provided near the free end of each surgical arm 16. For example, a 6-axis load sensor 44 may be located at the end effector interface 42 to provide a collaborative, specialized movement mode when a user moves the arm 16 by applying force directly to the end of the arm 16 or the end effector 26. A base load sensor 46, such as a 6-axis load sensor 46, may also be provided in each arm 16 near the connection to the arm positioner 14 to provide real-time feedback to the control system of the robot 10.

[0077] Each surgical arm 16 may include an information ring (ROI) 48 for status indication. Each information ring 48 may provide independent information about the status of each corresponding arm 16. For example, the information ring 48 may provide a separate color, such as green for system ready, red for error, yellow for user action, etc., to convey information to the user. The information ring 48 may also flash or provide other visual indicators to the user. The information ring 48 may be located anywhere along each arm 16 or at another suitable location.

[0078] The monitor arm 18 is attached to the positioner 14, for example, near the top of the positioner 14. The monitor arm 18 comprises a motorized arm having a plurality of arm segments interconnected by various types of joints 50. The motorized monitor arm 18 can be controlled by the system 10 and / or the user to achieve optimal visibility of the monitor 20. FIG. 25A to FIG. 25BIn one embodiment shown, the monitor arm 18 is connected to the positioner 14 at a rotation joint 52, the arm segments are interconnected by a double hinge joint 54, and the monitor 20 is coupled to the free end of the monitor arm 18 via two rotation joints 56 and 58, respectively. As shown, the monitor arm 18 can allow movement with four degrees of freedom (4DoF). For example, movement can include x, y, z, and yaw, with the folding butterfly providing angular control. It should be understood that the monitor arm 18 can be configured to have any suitable orientation or movement, thereby allowing the arm 18 to be supported and positioned in the monitor 20 for optimal visibility.

[0079] The camera arm 22 is attached to the positioner 14, for example, at its distal end. The camera arm 22 comprises a motorized arm having multiple arm segments interconnected by various joints. The motorized camera arm 22 can be controlled by the system 10 and / or the user to achieve the best line of sight for the camera 24 throughout the procedure. In one embodiment, the camera arm 22 is connected to the positioner 14 at a rotational joint, the arm segments are interconnected by double hinge joints, and the camera 24 is connected to the free ends of the arm segments with pivot or tilt joints. As shown, the camera arm 22 can allow for movement with six degrees of freedom (6DoF). For example, movement can include x, y, z, yaw, pitch, and tilt. In one embodiment, the navigation camera 24 is mounted to the arm 22 in a SCARA configuration (selective compliance articulated robotic arm), with a sliding vertical joint for height adjustment, followed by two in-plane swivel joints for xy positioning. The camera itself can have three-axis orientation control (pan, tilt, roll), for a total of six axes of camera positioning. All joints can be motorized and use absolute single-turn encoder feedback, allowing the system 10 to know the camera position immediately when the system is powered on, without the need for a homing routine. The camera arm 22 can be bimodal, active and passive, meaning it can be positioned either robotically or through manual surgeon interaction, enabling the collaborative approach of the system 10. Unlike systems that provide cameras on separate supports, the system 10 incorporates the camera 24 into a single cart solution. This can help improve the line of sight of the camera 24, as the camera can only navigate if it can see patient references and instruments of interest. The motorized camera arm 22 also allows the camera 24 to be adjusted during a procedure, which minimizes possible line of sight interruptions and eliminates the need for any manual positioning of the camera.

[0080] Now go to Figures 2A to 2B and Figures 3A to 3B , the multi-arm surgical robot system 10 can have an extended position and a docked position. Figure 2AIn the deployed position shown, one or more of the robot's arms 16, 18, 22 are extended and positioned for active participation in a surgical procedure. In the deployed configuration, the surgical arm 16 can be arranged to provide optimal access to the surgical site, the camera arm 22 can be extended to provide optimal line of sight for the machine vision navigation camera 24, and the monitor arm 18 can be extended to enable optimal viewing and participation with the touch screen monitor 20. Figure 2B In the docked position shown, all arms 16, 18, 22 are folded so that the surgical robot 10 is in a compact configuration, such as for transport or storage. The cabinet touch screen display 32 remains accessible when the system 10 is docked. Figures 3A to 3B In the docking system 10 shown, all of the robotic arms 16, 18, 22 are docked in a compact form factor for ease of transport and to enable selective deployment of individual arms 16, 18, 22. This arrangement allows all four arms 16, 18, 22 in the system 10 to dock in a compact form factor and allows the user to selectively deploy a subset of the arms 16, 18, 22 depending on a particular use case. For example, a use case requiring one surgical arm 16 and video output to be sent to a large operating room (OR) monitor rather than using an integrated monitor 20 may require the monitor 20 to remain retracted while one surgical arm 16 is deployed. Deployment and docking can be motorized and automated, which enables a simple and elegant setup that would otherwise be large or complex.

[0081] Now go to Figure 4 , the positioning of the system at the operating room table 60 is flexible and can be based on the surgeon's preference for a given procedure. The multi-arm surgical robotic system 10 can be positioned beside or across from the surgeon, and can also be positioned toward the feet or head of the patient 62. In all of these combinations, the surgical arms 16 have a large working volume on both sides of the table 60 without moving the system base 12, and the monitor 20 and camera 24 can be positioned along the midline of the table 60. This camera position limits line of sight issues, and the monitor position is more ergonomic for the surgeon than other systems. Figure 4 In the illustrated embodiment, the two surgical arms 16 are identical in length and configuration. Alternatively, the surgical arms 16 may be different. The length of one arm 16 may be increased, for example, by attachments at the end between the end of the arm 16 and the end effector 26, or two different arm configurations may be provided. Such differences in length and / or type may create a primary arm and a secondary arm when positioned in the OR and deployed for a procedure.

[0082] Now go to Figures 5A to 5B, the surgical arm 16 may have improvements in accuracy, articulation, and enhanced motion capabilities while interacting directly with the patient 62. The enhanced surgical arm motion 70 may be categorized into four movement mode categories: passive guidance 72, active guidance 74, active assistance 76, and active control 78. During passive guidance 72, the system 10 moves the surgical arm 16 to a position and maintains that position. Once in position, the system 10 is static and passively guides the instrument 28 controlled by the surgeon. During active guidance 74, the system 10 moves the surgical arm 16 to a position and servoes in place, dynamically adjusting as the anatomy moves to maintain relative position to the patient 62. During active assistance 76, the surgical arm 16 is controlled by force input from the user, allowing motion within a specified set of constraints. As Figure 5B As shown, the constraints may include point constraints 80, vector constraints 82, and rotation constraints 84. Point constraints 80 may include free, finite, on a vector, on a plane, and / or within a volume. Vector constraints 82 may include free, finite, parallel to a vector, and / or perpendicular to a plane. Rotation constraints 84 may include free and / or finite. During active control 78, planned robot motion may be achieved by continuously activating a safety switch. Some examples may include drilling, tapping, screw placement, disc removal, cage placement, and bone removal.

[0083] Active modes 74, 76, 78 enable tissue volume removal, such as facetectomy, laminectomy, discectomy, etc., in addition to milling, drilling, tapping, screwdriving, and other functions. All active movement modes 74, 76, 78 can be enabled by a monitor safety control system. The monitor is a redundant control system in parallel with the main motion control system. It monitors all feedback devices (encoders, switches, force sensors), motor current, and joint speed and compares these readings with the main motion control system. It also compares the readings with the expected values ​​for a given commanded motion. If there is any difference between the monitor and the main motion control system or between the expected values ​​and the monitor readings, the monitor control safely stops all motion.

[0084] Active movement and multiple surgical arms 16 allow the system 10 to assist with more surgical procedures, such as active milling, placement of longer instruments, and simultaneous robotic motion (e.g., holding a retractor and assisting with disc preparation). This can help improve the accuracy of the entire procedure and reduce the surgeon's cognitive load. The dual surgical arms 16 and dual monitors 20 also enable multiple surgeons to actively participate in the surgical procedure simultaneously, thereby reducing the total time of the procedure. The non-sterile monitor 32 allows non-sterile personnel to actively assist without interfering with the surgical monitor 20. Integrating all components into a single mobile platform reduces the total footprint of computer-assisted technology in the OR. The reduced footprint also improves the usability of the system 10 for personnel because it does not disrupt their standard layout. The overall coordinated motion of the automated peripheral arms 18, 22 and the system 10 streamlines setup and reduces navigation adjustment factors during the procedure. Automatic camera adjustment ensures that the patient / robot is within the field of view of the camera 24, so there are no interruptions in active navigation. The enhanced line of sight reduces wasted time by eliminating manual adjustments and improves the accuracy and overall usability of the system.

[0085] Now go to Figures 6 to 10 According to some embodiments, the multi-arm surgical robotic system 10 is configured to perform multiple surgical tasks simultaneously or sequentially. For example, in a dual-arm system, each surgical arm 16 is integrated into a single system 10, thereby allowing for coordinated procedural use cases and methods. Each surgical arm 16 can be capable of performing independent operations while working together in a synchronized manner. Depending on the type of procedure, each surgical arm 16 can work simultaneously or can be coordinated continuously.

[0086] During spinal procedures, surgical arm 16 can be configured to install implants, such as pedicle screws and interbody implants, to optimize the workflow of the operation and reduce surgical time. For example, surgical arm 16 can be positioned to simultaneously install bilateral pedicle screws in the same vertebra. Surgical arm 16 can be positioned to simultaneously install pedicle screws for the same spinal rod unilaterally. Surgical arm 16 can be coordinated to progressively install multiple pedicle screws along a series of vertebrae. One or two surgical arms in surgical arm 16 can be configured to, for example, install interbody implants by anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), anterior lumbar interbody fusion (ALIF), transforaminal lumbar interbody fusion (TLIF), posterior lumbar interbody fusion (PLIF) and lateral lumbar interbody fusion (LLIF) procedures. For example, surgical arm 16 can be positioned to simultaneously or progressively coordinately install two interbody implants at multiple levels. Each surgical arm 16 can be aligned along a different surgical path, for example, one level positioned via a transforaminal path and another level positioned via a posterior path. One surgical arm 16 can be configured to perform one type of task while another arm 16 performs a different surgical task. For example, one surgical arm 16 can install a pedicle screw while a second surgical arm 16 installs an interbody implant. It is contemplated that the system 10 can be configured to install any suitable implant or perform other surgical tasks in any suitable order to optimize the surgical workflow. These procedures are merely exemplary, and other suitable functions and workflows can be used based on a given procedure.

[0087] During other orthopedic procedures, the surgical arms 16 can be configured to install implants, such as plates, screws, and intramedullary nails, to optimize the workflow of the operation and reduce surgical time. For example, the surgical arms 16 can be aligned along different trajectories to secure screws or anchors into a fracture plate or intramedullary nail for treating traumatic fractures. The surgical arms 16 can be configured to guide or position one or more components of a knee or hip reconstruction. The surgical arms 16 can be used individually or together for cranial procedures. Each of the surgical arms 16 can independently perform different operations while also operating in unison in a coordinated manner according to the specific requirements of the surgical procedure.

[0088] Although the robots and associated systems described herein are generally described with reference to spinal and orthopedic applications, it is also contemplated that the robotic systems may be configured for other surgical applications, including but not limited to trauma surgery or other orthopedic applications, cranial, neurological, cardiothoracic, vascular, colorectal, oncological, dental, and other surgical operations and procedures.

[0089] Further emphasize Figure 6, according to one embodiment, simultaneous active approach of two surgical arms 16 is shown. During simultaneous active approach, each surgical arm 16 works together to actively and independently perform multiple surgical tasks. In this embodiment, the surgical arms 16 can simultaneously align the end effectors 26 along different corresponding trajectories, or can be mirrored across the patient's midline. For example, the patient 62 can be positioned prone on the OR table 60 so that the end effectors 26 can be aligned along a trajectory suitable for installing bilateral pedicle screws. Simultaneous approach can improve the efficiency of single-position surgery, for example, having both lateral and downward access to vertebral levels. By moving the surgical arms 16 in a coordinated manner, the system 10 also facilitates alignment and mating to implants that require an in situ secondary actuation stage, such as highly articulated expandable cages, or cross pins / cross screws, such as plates or threaded spacers. Examples of other active applications may include simultaneous electrode placement in cranial procedures or simultaneous targeting in trauma applications.

[0090] According to another embodiment, one or more of the surgical arms 16 can be configured to hold a retractor, retractor, cannula, or other access tool, for example, for minimally invasive surgical procedures. For example, where multiple surgical arms 16 are available, one surgical arm 16 can be dedicated to positioning and holding a retractor. Because both the surgical arms 16 and the patient 62 are tracked, one surgical arm 16 can be used to dynamically adjust the retractor position as the patient moves. Additionally, force sensing in the surgical arms 16 can be used to monitor the forces applied to the patient. While one surgical arm 16 is dedicated to dynamically positioning the retractor, the remaining arms 16 can work through the opening provided by the retractor to perform surgical tasks, such as removing volume, drilling, screwing, etc. Because the surgical arms 16 are controlled by the same system 10, the surgical arms 16 can move in sync to follow any adjustments made by the retractor arms 16.

[0091] In addition to positioning manually actuated retractors, the system 10 can also be used to position robotically actuated retractors. In other words, the end effector 26 can be replaced with a specialized robotic retractor end effector that is configured to provide better visibility and access to the surgical site. The surgical arm 16 provides hard-wired power and communication to the flexible end effector interface 42 through a sterile barrier. The end effector interface 42 can be used to power and control the robotically actuated retractor. The robotic retractor may include two, three, or more retractor blades that can be adjusted and controlled robotically and / or manually. Further details of the retractor can be found, for example, in U.S. Patent No. 11,234,788, which is incorporated herein by reference in its entirety for all purposes. Force sensors can also be integrated into the retractor to characterize and monitor the retraction forces induced on the patient.

[0092] Further emphasize Figure 7 According to one embodiment, multi-user mode allows each surgical arm 16 to be controlled by a different user. In dual-user mode, the two users can have separate workspaces 86 and 88 for controlling each respective surgical arm 16. When two surgeons are present, the first surgeon can have a first workspace 86, and the second surgeon can have a second workspace 88. For example, the surgeons can be positioned on either side of the OR table 60, with each surgical arm 16 assigned to a single surgeon. In this dual-user mode, the system software enables dual-user mode, where the system 10 understands that there are two active users during the procedure. Each surgeon can have a customized viewport and can independently activate their surgical arm 16. The non-sterile monitor 32 can also have a customized viewport, including a mirror image of either surgical viewport. The system software can be configured to detect and avoid any collisions between the two participants and / or surgical arms 16. This dual-user configuration enables simultaneous work, increasing efficiency and reducing surgical time for the patient 62. An example scenario for this mode might involve placing pedicle screws simultaneously on both sides of the patient 62. In large deformity cases where many screws are used in the construct, simultaneous placement of the screws may be valuable, streamlining the procedure and reducing surgical time. It will be appreciated that other surgical procedures may also benefit from a dual user configuration.

[0093] Further emphasize Figures 8A to 8D , an active fixation workflow is shown according to one embodiment. Compared to a single-arm robotic system, having multiple integrated surgical arms 16 allows for a multi-part workflow, for example, for complex deformity cases. For example, in one workflow, a patient 62 can be positioned prone on an OR table 60 for posterior pedicle screw fixation, with the surgical arms 16 located on opposite sides of the patient 62. The surgical arms 16 can be configured to rigidly attach to the pedicle screws in an alternating manner to act as anchor points, thereby improving the accuracy of the entire procedure. This specific use case of pedicle screws can be generalized to any situation where the bony anatomy is mobile and can benefit from fixation. Some non-limiting examples may include attaching one or more vertebrae while correcting a deformity (such as scoliosis), attaching vertebrae while performing bone removal, attaching vertebrae while clearing adjacent disc spaces, attaching vertebrae while placing an intervertebral spacer, attaching a femur or tibia while performing a total or partial knee arthroplasty, attaching one or more bones for treatment of orthopedic trauma, and other orthopedic procedures.

[0094] exist Figure 8AIn the embodiment, the first surgical arm 16A holds an end effector 26 having a guide tube aligned along the planned trajectory. An instrument 28, such as a first drill bit, is passed through the guide tube with minimal disruption to the anatomy. After drilling, a first tap or screw may be placed. Figure 8B As shown, the first robotic arm 16A remains rigidly attached to the patient while the free surgical arm 16B drills the hole on the opposite side. The first arm 16A provides a fixed anchor point for the vertebral body, thereby significantly reducing motion and providing spatial information about the position of the vertebral body through kinematics. The second arm 16B then places its tap or screw and again remains rigidly attached while the first arm 16A is removed and advanced to the next level. Figure 8C As shown, the free arm 16A moves to the next level to install the next pedicle screw. Figure 8D As shown, the process is repeated until all the screws of the construct have been placed. The system switches from anchor point to anchor point allowing the last screw to be as accurate as the first screw. For situations where the anatomical structure is highly mobile (such as in the cervical spine), it is particularly important to maintain accuracy during long procedures. After one or more pedicle screws are installed, a spinal rod may be connected to the pedicle screws to prevent movement and stabilize the spinal column segment.

[0095] A surgical method for placing pedicle screws may include the following steps: (1) drilling, tapping, and inserting a first screw, and rigidly attaching the surgical arm 16 to the patient 62 (e.g., Figure 8A (2) Drill, tap, and screw in the contralateral screw while the system remains rigidly attached to the first screw (as shown). Figure 8B As shown). Since the vertebral body is held in place by the first screw, the placement accuracy of the second screw is improved. Always keep at least one surgical arm 16 rigidly attached to the patient. (3) With the free arm 16, move to the next level to drill, tap, and insert the next screw (as shown). Figure 8C As shown). Since the system rigidly holds adjacent levels, the accuracy of this third screw is also improved. (4) This process is repeated until all screws of the construct are placed (as shown). Figure 8D shown).

[0096] Further emphasize Figures 9 and 10, a sterile robotic pantograph or master-slave workflow is shown according to one embodiment. A pantograph is a mechanical linkage mechanism used to replicate a tool path identically or using a scaling factor based on the ratio of the link lengths. Utilizing two or more surgical arms 16, the system 10 is configured to robotically simulate pantograph functions in 3D space, giving the surgeon a magnified working volume and scaling their movements down to the fine-tuning within the patient 62. In zoom mode, one surgical arm 16 controls another surgical arm 16 performing the surgical task. As Figure 9 As shown, a patient 62 can be positioned prone on an OR table 60, for example, with the robotic system 10 positioned to the side near the head of the patient 62. In this mode, the surgeon can choose to stand beside or opposite the system 10. This allows an unobstructed view of the camera 24 and easy viewing of the display 20, which can show a magnified visualization of the surgical site. Each surgical arm 26 has a 6-axis load cell 44 at its distal end.

[0097] In the aseptic zoom mode system arrangement, the first surgical arm 16A may include a powered end effector 26 having a tool 28 for performing surgical tasks. For example, the first arm 16A may be equipped with a typical instrument 28 (e.g., a bone drill) that interacts directly with the patient 62. The second arm 16B is equipped with a tool for the surgeon to interface with, such as a stylus 90. The surgeon inputs the stylus 90 and can be directly held or manipulated by the surgeon to control the first surgical arm 16A. The stylus arm 16B positions the stylus 90 in the space above the surgical site in a manner that maintains the surgeon's direct line of sight. The load sensor 44 at the end of the stylus arm 16B reads the force input from the surgeon and moves accordingly. Inverse kinematics from the stylus arm 16B is used to control instrument position and orientation, replicating the stylus path but scaling down for fine-tuning. The scaling factor is flexible and can be selected by the user. When the surgeon manipulates the stylus 90 in space, the working surgical arm 16A executes a given procedure in real time.

[0098] Other noteworthy attributes of the pantograph mode of use may include one or more of the following: (1) The system may provide tactile feedback to the surgeon at the stylus 90 of the second arm 16B based on the forces sensed at the load sensor 44 of the first arm, thereby maintaining the surgeon's sense of touch. (2) The force input from the surgeon may be decoupled from any reaction forces from the patient 62 through the instrument 28. This decoupling allows the load sensor 44 at the instrument arm 16A to use its full dynamic range, sensing forces applied to the patient 62 and the implant. (3) The stylus 90 may be integrated into the sterile end effector 26, allowing the surgeon to enter and exit the pantograph mode without compromising sterility while maintaining a natural line of sight to the anatomy. (4) The system may be combined with an endoscope or exoscope to provide magnified visualization of the surgical site and improved visual feedback. (5) As Figure 10 As shown, the system can be combined with an augmented reality solution (such as a headset with an anatomical overlay). The input motion is registered with the magnified surgical volume, where the magnified input motion is scaled to the same magnification as the virtual object 92. For example, the augmented virtual object 92 can be a magnified portion of the patient's spine 94. (6) The system can be combined with an additional monitor that shows a magnified view of the surgical anatomical 3D volume (CT / MRI) or a cartoon of the anatomical structure, with which the surgeon interacts using a stylus 90.

[0099] Now go to Figure 11 , dual-arm instrument verification is shown according to one embodiment. During the verification procedure, the tip of any instrument 28 can be placed in a precise recess of another instrument or end effector for software verification. Software verification ensures that the instrument 28 is visible and registered with the robot software. As the tip is placed, the navigation camera 24 tracks both arrays, confirming the instrument tip position. Figure 11As shown, using two or more surgical arms 16, the procedure can be automated by robotic motion. One surgical arm 16 positions the tip of an instrument 28 into a recess in the rear portion of an end effector 26 held by another surgical arm 16. As the instrument 28 moves to the verification position, the navigation camera 24 tracks the instrument, and the camera 24 can continue to be used to verify the tip position. Compared to the manual process, the repeatability of dual-arm verification is significantly increased. Alternatively, the process can improve verification accuracy by combining cameras and kinematic feedback. In another embodiment, the system implements only kinematic verification, which does not require a camera but relies on precise encoder feedback in the surgical arm 16. In another embodiment, the system introduces the ability to bend the tip or wander verification by robotically rotating the instrument 28 in known increments and rechecking the tip position. In yet another embodiment, the system can move the instrument 28 to the camera's field of view (FOV) for automatic machine vision recognition, verification, and calibration. It should be understood that the dual-arm system 10 can use any suitable method for automatic instrument verification.

[0100] Alternative Robotic System

[0101] Now go to Figures 12A to 17B , the arrangement of the robotic system components can be modified into different configurations, thereby providing different movements and positioning of the components. FIG. 12A to FIG. 12B According to another embodiment, multi-arm surgical robot system 100A, 100B is shown as having bifurcated arms. Robotic system 100A, 100B is similar to multi-arm surgical robot system 10, but vertical arm positioner 14 is replaced by 3-axis positioner 104. In this embodiment, all surgical arms, peripheral arms and non-sterile components are integrated into a single mobile cart. The integrated cart configuration minimizes the total footprint required in the operating room while simplifying setup, decomposition and storage. During use, the mobile cart is positioned at the operating room table 60 to assist in operation as described herein.

[0102] The 3-axis positioner 104 may include a vertical positioner link or arm 108 and a horizontal positioner link or arm 110. The vertical arm 108 provides a sliding vertical joint that allows linear movement along a single vertical axis. The sliding vertical joint is followed by two parallel swivel joints or rotary joints that allow rotation. The sliding joint allows the 3-axis positioner 104 to reach a higher or lower position, thereby adjusting the vertical position, while the two parallel swivel joints enable the surgical arm 16 to be extended and optimally positioned in the operating room. For example, the positioner 104 may position the common rotation point at the approximate midline of the OR table. The surgical arm 16 may be attached to the free end of the horizontal arm 110 by a corresponding swivel mount. Figure 12A In FIG, system 100A includes a surgical arm 16 mounted below a horizontal positioner link 110. Figure 12B , system 100B includes a surgical arm 16 mounted above a horizontal locator link 110. The surgical arm 16 may be similar to the arms described for system 10, wherein the left and right surgical arms 16 each allow movement with seven degrees of freedom (7DoF). For example, a 7DoF arm arrangement may include roll × pitch × roll × pitch × roll × pitch × roll. The monitor 20 and navigation camera 24 may be mounted to the free end of the horizontal locator arm 110, for example using a vertical column. The monitor 20 and camera 24 may be fixed or coupled via an auxiliary arm to position the respective components. As shown, the monitor 20 may be positioned back to back so that an assistant can observe the procedure from outside the surgical space. Similar to system 10, the multi-arm surgical robot systems 100A, 100B may have a deployed system configuration and a docked system configuration.

[0103] refer to Figure 13 , a multi-arm surgical robotic system 120 is shown according to one embodiment. In the robotic system 120, the vertical arm positioner 14 is replaced by a five degree of freedom positioner 124. The robotic system 120 has a base configuration in which the positioner 124 is located on top of the system 120. Unlike the vertical axis on the system 10, the positioner 124 is located on top of the base 12 and does not extend into the body of the system. This allows the overall size of the cabinet 12 to be reduced compared to the system 10. In this embodiment, a single monitor 20 and navigation camera 24 can be mounted to the free end of the positioner 124, with the surgical arm 16 located below the monitor 20.

[0104] The positioner 124 may include a plurality of positioner links or arms 128 with revolute joints therebetween. In one embodiment, the positioner 124 includes a five-degree-of-freedom (5DoF) arrangement. For example, a 5DoF arm arrangement may include roll x pitch x pitch x pitch x roll. The clevis 126 may be attached to the base 12 around a first roll joint, which allows the clevis 126 to rotate about the base 12. The first positioner arm 128 is attached to the clevis 126 at the first pitch joint, which enables the positioner 124 to tilt forward and backward. The second positioner arm 128 is attached to the first positioner arm 128 around a second pitch joint, which provides an additional degree of up and down tilt. The third positioner arm 128 is attached to the second positioner arm 128 around a third pitch joint, which provides further ability to adjust its angle forward and backward. The third positioner arm 128 terminates at the surgical arm 16 at a second roll joint, which allows rotation of the corresponding surgical arm 16. The surgical arms 16 can be attached to the free ends of the positioner 124 by respective rotational mounts. Similar to the other surgical arms 16, the system 120 can include left and right surgical arms 16, each allowing movement with seven degrees of freedom (7DoF), namely, roll x pitch x roll x pitch x roll x pitch x roll. The positioner 124 can be extended and optimally positioned in the operating room for performing the procedure. For example, the positioner 124 can position the common rotation point at the approximate midline of the OR table. The system 120 also includes a docking configuration to minimize the system's footprint.

[0105] Further emphasize Figure 14 , a multi-arm surgical robot system 130 is shown according to one embodiment. The robot system 130 is a pedestal robot having dual surgical arms 16 starting at a base cabinet 12. A dual-arm pedestal robot may include only a single degree of freedom. For example, a vertical arm positioner 134 may include a rotary mount mounted to the base cabinet 12 to provide one degree of freedom (1 DoF). The rotary mount may allow rotational movement around the axis of the vertical arm 134. As shown, the monitor 20 may be positioned back-to-back on top of the vertical arm 134 so that an assistant can observe the procedure from outside the surgical space. The camera 24 may be located above the monitor 20. The rotary positioner 134 may be shared by both surgical arms 16. Similar to the other surgical arms 16, the system 130 may include a left surgical arm and a right surgical arm 16, each of which allows movement with seven degrees of freedom (7 DoF). Limiting the robot's movement to one degree of freedom simplifies the design and focuses the robot's capabilities on its specific tasks.

[0106] Further emphasize FIG. 15A to FIG. 15B, a multi-arm surgical robot system 140A is shown according to one embodiment. In the robotic system 140A, the arm positioner 144 includes a parallelogram positioner configured to extend the surgical arm 16 into the surgical space. The parallelogram positioner 144 includes a first positioner link 146 and a second positioner link 148 that support the surgical arm 16. The first positioner link 146 can be a single-axis positioner, in which the two pitch joints are tied together with a timing belt or chain to synchronize the movement of the pitch joints. The second positioner link 148 can always be parallel to the ground, in which the mechanism is controlled by a single motor. The parallelogram linkage mechanism ensures that the second positioner link 148 remains parallel to the ground when the mechanism is articulated. Using a single motor simplifies the control system and can improve reliability and reduce maintenance requirements. Alternatively, the two positioner joints can be decoupled and controlled by independent motors, allowing the second positioner link 148 to achieve any angle relative to the ground. When in use, the positioner 144 can position the two surgical arms 16 approximately at the midline of the OR table. Similar to the other surgical arms 16, the system 140A can include a left surgical arm and a right surgical arm 16, each of which allows movement with seven degrees of freedom (7DoF). The surgical arms 16 can be located on top of the second positioner link 148. The monitor 20 and camera 24 can also be mounted to the second positioner link 148 and positioned above the surgical arms 16. Similar to the system 10, the multi-arm surgical robot system 140A can have an expanded system configuration and a docked system configuration. Figure 15A The surgical robotic system 140A is shown in a deployed position, and Figure 15B The surgical robotic system 140A is shown in a compact docked position.

[0107] Further emphasize Figure 16 , a multi-arm surgical robotic system 140B is shown according to one embodiment. The robotic system 140B is similar to the system 140A, but the surgical arms 16 are attached below the second positioner link 148 so that the arms 16 hang downward. The monitor 20 and camera 24 can still be mounted to the top of the second positioner link 148. In this embodiment, the surgical arms 16 are mounted from the bottom of the second positioner link 148, and the first link of each surgical arm 16 is mounted in series to form a suspension column. The parallelogram positioner 144 serves as an overhead support for a pair of surgical arms 16. During the procedure, the positioner 144 is configured to position the two 7DoF surgical arms 16 approximately at the midline of the OR table. This allows the surgical arms 16 to be suspended above the workspace without obstructing the area below, thereby maximizing space efficiency. The parallelogram configuration also allows for compact docking of the system 140B.

[0108] Further emphasize 17A to 17B, a multi-arm surgical robot system 150A, 150B is shown according to another embodiment. In these embodiments, the surgical arm 16 can be directly mounted to the base 12 without a positioner, thereby forming a stacked column 154. The first link 156 of each surgical arm 16 can be mounted in series on the base 12, thereby forming a column. The first link 156 of each arm 16 can define a swivel joint or a rotary joint that allows rotation around a single axis. The links 156 can be coaxial so that all links 156 rotate around the same vertical axis. Similar to other surgical arms 16, systems 150A, 150B can provide a surgical arm 16 whose movement has seven degrees of freedom (7DoF). The surgical arm 16 can extend laterally from the first link 156. Figure 17A A system 150A is shown having two stacked links 156 supporting two surgical arms 16, and Figure 17B A system 150B is shown having three stacking links 156 supporting three surgical arms 16. By vertically stacking more arms 16, the stacking links 156 can have "n" number of surgical arms 16, thereby increasing the overall column height. The monitor 20 and camera 24 can be mounted to the top of the stacked arm column 154, for example, using one or more positioners 158. The positioners 158 can include any suitable joints for positioning the monitor 20 and camera 24, which can be offset relative to the axis of the stacking column 154. Similar to the other systems, the multi-arm surgical robotic systems 150A, 150B can have a deployed system configuration and a docked system configuration.

[0109] Now go to Figures 18 to 21D , a distributed system can be provided so that the main system components (surgical arms, navigation cameras, and surgeon displays) are completely decoupled or decoupled into different subset arrangements. For the completely decoupled option, each element can be positioned to optimize its own individual task. In particular, the surgical arms 16 can be arranged to be located on their own mobile platform. The exact number of surgical arms 16 required for a given portion of the surgical procedure can be dynamically adjusted by positioning additional surgical arms 16 or by removing excess surgical arms 16. A separate observation station with one or more monitors 20 can be positioned for the surgeon's use, or an external monitor in the OR suite can receive a video output signal from the system. The navigation camera 24 can also be positioned to obtain the best line of sight. In one embodiment, the subset system can be arranged so that the surgical arm 16 is decoupled when used in conjunction with a separate complete navigation and control system. In another embodiment, the subset system can integrate the surgical arm 16 into the complete navigation and control system, while the camera is separated from the system for line of sight optimization. It should be understood that different components can be coupled together or decoupled to optimize the results.

[0110] Further emphasize Figure 18 , an independent base arm system 160 is shown according to one embodiment. In this embodiment, a single surgical arm 16 is attached to the top of the base 12. The surgical arm 16 can be attached to the base 12, for example, using a swivel mount to allow the arm 16 to move around the rotation of the base 12. The surgical arm 16 can work alone or in conjunction with another independent base arm system 160 or other systems. As shown, the navigation camera 24 and surgeon displays 20, 32 are not present in this decoupled system 160. Therefore, additional stations with these components can be combined to complete the distributed system.

[0111] Further emphasize Figure 19 , a distributed subsystem 170 is shown according to one embodiment. Subsystem 170 is similar to system 100A, but subsystem 170 has only a single surgical arm 16 and the navigation camera 24 is omitted from system 170. The single surgical arm 16 can be used alone or in combination with another robotic system with an arm. The navigation camera 24 can be provided on a separate stand, permanently mounted in the operating room, or otherwise provided within another robotic or navigation system to provide optimal line of sight.

[0112] Further emphasize Figure 20 , a dual-arm subsystem 180 is shown according to one embodiment. The dual-arm subsystem 180 can utilize a curved arm positioner 184 (such as a C-shaped table) to position the surgical arm 16. Similar to other surgical arms 16, the subsystem 180 may include a pair of surgical arms 16, each allowing movement with seven degrees of freedom (7DoF). In this embodiment, the arm positioner 184 can bend or bend along a nonlinear path. The arm positioner 184 may include one or more curved tracks 186 configured to position the surgical arm 16 around the patient. A pair of parallel curved tracks 186 can be offset to guide each of the corresponding arms 16. Alternatively, the tracks 186 can take different paths to guide the arms 16 to different positions. In the embodiment shown, the tracks 186 allow the attached surgical arm 16 to move along a semicircular or open curve of the curved arm positioner 184. The center of rotation of the arm positioner 184 can be approximately coaxial with the long axis of the OR table, thereby providing a large clinically relevant working volume with a relatively simple mechanism.

[0113] Further emphasize 21A to 21D , according to another embodiment, multi-arm surgical robot subsystems 100C, 100D, 130A, and 120A are shown. Each of these subsystems is not provided with a navigation camera 24. Figure 21AShown is a multi-arm surgical robotic subsystem 100C, which is identical to the multi-arm robotic system 100A, with the navigation camera 24 omitted. Figure 21B A multi-arm surgical robotic subsystem 100D is shown, which is identical to the multi-arm robotic system 100B, without the navigation camera 24 . Figure 21C Shown is a multi-arm surgical robotic subsystem 130A, which is identical to the multi-arm robotic system 130 , with the navigation camera 24 omitted. Figure 21D A multi-arm surgical robot subsystem 120A is shown that is identical to the multi-arm robotic system 120, omitting the monitor 20 and navigation camera 24. The navigation camera 24 may be provided on a separate stand, permanently mounted in the operating room, or otherwise provided in another robot or navigation system to provide optimal line of sight. When desired, the surgeon display 20 may be provided on a separate observation station, wireless tablet, or other external monitor. The distributed subsystems may be combined in any suitable combination to optimize surgical procedures. It is also foreseeable that any of the systems, subsystems, or components described herein may have a permanent installation. For example, one or more surgical arms 16 may be integrated and mounted into an OR ceiling or floor or integrated into an OR table.

[0114] Smart arm positioning

[0115] The multi-arm surgical robotic system 10 can be configured with advanced and automated adjustment of the surgical arm 16, monitor arm 18, and / or camera arm 22. Intelligent positioning can allow the arms 16, 18, 22 to automatically adjust to predefined positions or to adjust proactively. For example, the surgical arm 16 can automatically adjust to achieve optimal access to the surgical site, avoid collisions, and / or achieve ergonomic support. The monitor arm 18 can be automated to achieve an optimal viewing position or synchronized with the surgical stage. The camera arm 22 can automatically adjust at various stages of the procedure to achieve an optimal viewing angle.

[0116] Now go to Figure 22 and FIG. 23A to FIG. 23B , showing an example of a predefined draping technique. Surgical draping is a safe operation to ensure the sterility of the surgical field. This operation is often complex due to the geometry of the drape and the drape itself. The process requires both sterile and non-sterile personnel to perform. The surgical robotic platform 10 can utilize the dexterity of the surgical arm 16 to facilitate draping and embedded controls at the non-sterile terminal 32. In this embodiment, the surgical arm 16 can be draped in the same manner as a surgeon puts on a surgical gown and gloves. Figure 22The surgical robotic system 10 is shown in a docked position, which is how the system 10 may enter an operating room for subsequent setup.

[0117] Once in position in the surgical space, the system 10 can be deployed for surgical draping. From the non-sterile display or terminal 32, the technician or assistant can deploy the system 10 for draping, for example, by simply pressing a button. The surgical arm 16 can be moved to a preset draping position, for example, FIG. 23A to FIG. 23B As shown, this position mimics where a surgeon places their gown and gloves. Figure 23A The cover is shown for a single arm procedure, with the single arm 16A extending upward for coverage and the additional arm 16B remaining docked. Figure 23B Draping is shown for a multi-arm procedure, in which case both surgical arms 16 are extended vertically upward for draping. For example, the arms 16 can be bent at the elbows and then extended straight upward with the arms 16 aligned parallel. From this position, a sterile technician can apply a surgical drape to the arms 16. The position of the arms 16 facilitates the stability of the drape during the procedure, preventing the drape from falling to the floor and compromising sterility. From this position, a non-sterile technician can complete the installation of the drape to the rear of the system 10. If the upcoming procedure requires a single arm 16, the unused arm 16 can remain uncovered and in the docked position, as shown. Figure 23A The preset positions allow for easy and sterile application of the drape, thereby ensuring that the drape encloses the system 10 without contaminating the sterile field.

[0118] Similarly, by simply pressing a button, the monitor arm 18 and camera arm 22 can be deployed to the covering position. The system 10 can provide guidance to the user on the steps to take to cover each element, while providing flexibility if the situation requires the use of only a subset of the robotic arms 16. Because all four arms 16, 18, 22 are robotically controlled, the system 10 knows the position of each arm and can ensure that there are no collisions between arms or movements that would compromise the sterility of the newly covered arm.

[0119] The draping strategy that mimics the surgeon's orientation during draping greatly facilitates the application of the drape to the sterile portion of the robot 10. It also reduces the number of people required to complete the draping, which streamlines the setup. The vertical position of the arm 16 maintains the stability of the drape during the procedure so that the drape does not fall off the arm 16 before a non-sterile technician can complete the securing of the drape to the back of the system 10. The ability to deploy a single arm 16 or any number of arms 16 to complete a procedure represents an efficiency for the hospital by avoiding the time and cost associated with draping unused components. The ability of the additional arm 16 to remain off-site during a procedure also makes the most efficient use of space in an environment where space is at a premium.

[0120] Now go to FIG. 24A to FIG. 24B , shows an example of positioning the navigation camera 24 with an optimal line of sight while avoiding the operating room lights 64. The camera arm 22 is configured to position the camera 24 above the OR table 60 and track the procedure from top to bottom. This advantageous position provides a direct field of view to the surgical site and minimizes obstruction from personnel or equipment in the operating room. The challenge of this tracking method is to ensure that the camera 24 does not interfere with the OR lights 64 above the table 60 while still achieving the necessary line of sight. By placing the camera 24 adjacent to the OR lights 64 (e.g. Figure 24A as shown) or placed between the OR lamps 64 (if there are two sets of lamps at station 60 (as shown) Figure 24B As shown), the arm arrangement allows the camera 24 to avoid the illumination space of the OR lamp. In all cases, positioning the camera 24 above the patient table 60 ensures the best line of sight to capture a clear, unobstructed view of the operating area.

[0121] The motorized camera positioning arm 20 can be configured to dynamically and automatically optimize tracking throughout a procedure. Because camera position control is integrated with the program application, the system 10 knows the complete set of objects to be tracked during the procedure. As the procedure progresses, the system 10 predicts when objects enter and exit the scene and knows the importance level of a given object in the scene based on the program steps. Using this contextual knowledge, the system 10 can track all objects of interest in the scene and center the field of view on the relevant objects by physically moving the camera 24. Centering of the field of view can be performed upon request from the user, on an automatic periodic basis, or on a completely continuous basis.

[0122] In addition, the camera positioners 14, 22 can use the complete system kinematics and program context to predict when the monitor 20 and surgical arm 16 will be in the camera's field of view. The camera 24 can be actively positioned to minimize self-occlusion from the monitor 20 or surgical arm 16 while optimizing the scene for the tracked object.

[0123] One step that typically requires extensive camera manipulation is intraoperative image registration. Fluoroscopic or computed tomography (CT) fluoroscopic images can be taken while tracking both the patient and the imaging system as a preliminary step to achieving navigation. In practice, this requires that the camera 24 must be moved from its position centered on the surgical site to a position where both the patient tracking reference and the tracking array on the imaging device are in the field of view. After registration is complete, the camera 24 is moved back to a position centered on the surgical site. Utilizing mobile robotic camera positioners 14, 22, this entire process can be automated, including large-scale movements as well as field of view centering and optimization.

[0124] The camera positioning can be controlled by the user, for example, via one of the touch screen displays 20. The camera positioning can also be controlled from a non-sterile user terminal 32 at the rear of the system 10. The camera view can be displayed directly on the monitor or control panel 20, 32, where the user can visually aim the camera 24 at the area of ​​interest via, for example, touch screen controls or micro-moving discrete buttons. Automatic and improved navigation continuity provides enhanced navigation and saves the user from tedious camera adjustments. For the sake of user experience, the navigation camera 24 begins to fade out of people's sight, and the technology is integrated into a comfortable workflow that focuses on procedures rather than systems, which is a big step towards removing navigation technology.

[0125] Now go to FIG. 25A to FIG. 25B and Figure 26 , one or more smart monitors 20 may be used to improve visibility for one or more users of the system 10. Dual smart displays 20 allow workflow, tracking, and system status to be viewed from one or both sides of the surgical table 60. The displays 20 may be mounted on high performance arms 14, 18, which enable extended reach and highly dexterous positioning. The display arm architecture may include a number of joints 50, such as dual hinges 54 and swivels 52, 56, 58. The swivel 52 may connect the arm 18 to the vertical positioner 14. The dual hinge 54 allows the display 20 to be positioned in the surgeon's preferred position. Display-specific concentric swivels 56, 58 may control the angular positioning of each display 18 relative to each other. A first display swivel 56 may connect one display 20 to the free end of the arm 18, and a second display swivel 58 may connect another display 20 to the free end of the arm 18. For example, Figure 25A As shown, the display posture may include completely opposite displays 20, and Figure 25B In the embodiment of the present invention, the display posture may include adjacent displays 20 in butterfly mode. It should be understood that the positioning between the displays 20 can be any angle between 0° and 180°.

[0126] like Figure 26As shown, diametrically opposed displays 20 can be useful when multiple surgeons are working simultaneously on opposite sides of a surgical table 60. Butterfly mode provides an enhanced user interface for single-surgeon procedures by making both screens 20 available for surgeons to use and reference. Dual displays 20 can be mounted on a bimodal active / passive arm with coded motorized joints, allowing the system 10 to know the arm position at all times. Specifically, all joints can use absolute single-turn encoders, allowing the system 10 to know the arm position immediately upon system power-up, eliminating the need for a homing routine. This provides a unique opportunity for intelligent positioning of the display 20 to coordinate with the portion of the procedure being performed. The system 10 can have preset and customizable configurations for the monitor arm 18, allowing the display 20 to be moved toward the surgeon during planning and review, and away from the surgeon during navigation, ensuring optimal and ergonomic viewing. If the surgeon has a given preference for different display positions, the position can be manually manipulated to the preferred orientation, while the position is tracked for future automated movement.

[0127] From a user experience perspective, dual monitors 20 represent improved workflow efficiency. Dual monitors 20 allow a single surgeon greater visibility into the procedure and workflow. It also allows multiple surgeons to utilize the robot 10 without competing for resources or compromising visibility during navigation. Automating the display movement reduces the surgeon's mental burden of having to continually adjust the display 20 during different parts of the procedure. The second monitor 20 also enables additional functionality, such as microscope mode.

[0128] Now go to Figures 27 to 30 , magnified visualization can be incorporated into the surgical robotic platform 10, simulating the functionality of a traditional orthopedic microscope. In this embodiment, a magnified video feed of the surgical site can be captured via one or more magnification devices 66, such as an endoscope, an exoscope, a port-mounted camera, or other camera mounted to the robotic system 10. The magnification device 66 can provide variable magnification levels, allowing the surgeon to see fine details of the surgical site, such as bones, nerves, and soft tissue, which may not be visible to the naked eye. This integrated magnification functionality can completely eliminate the need for a microscope. The magnification device 66 can have integrated lighting, such as LED-based lighting, to provide bright and focused light directly on the surgical field. The magnification device 66 can deliver high-resolution images to the surgical display 20, allowing the surgeon to clearly observe the surgical field. For example, the video feed can be ported to one or two surgical displays in the surgical display 20. As Figure 27In the embodiment shown, the display 20 can be presented to two surgeons directly at eye level in a fully folded position, which simulates the workflow and ergonomics of using a microscope that the surgeons are already familiar with.

[0129] The microscope camera 66 can be mounted to one or both of the monitor arm 18, the surgical arm 16 and / or the end effector 26, or another suitable location on the robot 10. In one embodiment, the microscope camera 66 can be mounted to the underside of the monitor arm 18, using the smart display arm 18 as a microscope camera mounting point and locator. The motorized arm 18 helps to fine-tune the microscope camera position so that the surgeon can easily observe and zoom in on a specific anatomical structure of interest. Fine positioning controls for the camera view can be located on the display or non-sterile terminal. Alternatively, the system-mounted microscope camera 66 can have camera optics mounted to the end effector 26. The end effector 26 can be centrally located at the surgical site and is less likely to have an obstructed view. The video signal can be transmitted by an external cable or routed internally through the robot arm's main data communications.

[0130] Alternatively, the untethered magnifying camera 66 can be mounted to another remote location. For example, the magnifying camera 66 can have a spring-loaded clamping mechanism, such as a chip clip-on mount, that enables quick attachment and detachment. The remote camera 66 can be secured to an arm mounted on a table, a retractor previously installed to gain access, directly to the patient, or to other suitable attachment sites. For MIS situations, the magnifying camera 66 can be mounted to look down into a port attached to the patient. Figure 28 As shown, the system 10 may include a downward-facing magnified camera 66A suspended below each monitor 20 and a clip-on magnified camera 66B on the surgical port. One monitor 20A may display a magnified camera image of the surgical site for detailed observation, and the other monitor 20B may display the surgical workflow, providing a comprehensive view of the progress and steps of the procedure.

[0131] Further emphasize Figure 29 , one or more ports 94 can be attached to the patient 62. The port 94 can include a small tubular device that is inserted into the patient 62 to provide direct access to the surgical site. The port 94 can allow surgical instruments to be accurately inserted and manipulated during minimally invasive surgical procedures. For magnified embodiments, the port 94 can be customized with fiducial markers 96, such as scale or incremental markings along the inside of the tube, which act as a reference scale, allowing the system 10 and / or the surgeon to accurately adjust the magnification on the camera 66. The fiducial markers 96 can assist in establishing camera focus and using the motorized display arm 18 to maintain the camera position in a field of view that changes due to patient movement.

[0132] By duplicating the microscope functionality and utilizing dual monitors 20, the microscope mode is also suitable for dual configurations where two surgeons can work simultaneously. Figure 30 In the embodiment of the present invention, surgeons are positioned on opposite sides of patient 62. Displays 20 are positioned in a back-to-back configuration. Dual microscopes 68 can be positioned on patient 62 so that magnified images are sent to respective displays 20. In this manner, each surgeon has a surgeon-specific view on their display 20 and can independently activate their surgical arms 16. This dual-user configuration enables simultaneous work, increasing efficiency and reducing surgical time for patient 62.

[0133] Traditionally, optical visualization under magnification has required separate, stand-alone equipment in the operating room and surgical field. Being able to provide this capability integrated with the system 10 without any additional equipment is a significant benefit in situations where space is at a premium. Combining the microscope mode functionality with the smart monitor 20 facilitates automatic visualization of the patient's anatomy under magnification, further reducing the surgeon's mental workload as they no longer need to manipulate a separate microscope in the surgical field to achieve their desired view.

[0134] Now go to Figure 31 The integrated and coordinated robotic system 10 is configured for collision detection and avoidance. Operating rooms and surgical fields are crowded spaces. Encoders can be integrated not only on the robotic arm joints, but also on all moving components of the deployment system 10. Combined with the known system geometry, this ensures that all automated system movements are accomplished without self-contact between the different moving components of the system 10. Although not all potential collision sources are within the system's control, the system 10 is configured to detect collisions with external sources and safely recover from them.

[0135] Each robot axis can have a motor to enable movement. Each motor can have a known and understood power profile to move each joint during different postures under normal operation. If the power used for movement rises above expected values, it may be due to the robot encountering an obstacle, whether human or inanimate. Although resistance to movement may often be encountered during procedural functions such as bone removal, screw installation, and discectomy, additional components can help distinguish between collisions and the clinical need for additional power.

[0136] In one embodiment, each surgical arm 16 includes a dual load sensor configuration: a first six-degree-of-freedom load sensor 44 at the end effector mounting point 42, which is configured to measure the procedure load; and a second six-degree-of-freedom load sensor 46 at the base of the robotic arm 16 to measure any load on the surgical arm 16. The dual load sensors 44, 46 can be capable of separating the surgical load from all other loads placed on the arm 16. Therefore, if the motor power is higher than normal and a non-surgical load is detected, it can be inferred that the robotic arm 16 is experiencing a collision and a safety stop protocol can be initiated. Due to the high update rate of the robot's kinematic solution, remedial actions can be completed quickly to mitigate damage to patients, staff, and equipment.

[0137] Collision detection and avoidance enable safe, reliable, and predictable use of the surgical robotic platform 10. Because the multiple independently movable arms 16, 18, 22 and axes are susceptible to unpredictable external inputs, safety is paramount when performing surgery on a patient 62, both for the patient 62 and for all medical personnel involved in the procedure. These safety systems are also architected to achieve additional performance gains during robotic operation.

[0138] According to some embodiments, coordinated movement of robotic arms 16 can be achieved via a layout manager algorithm. In traditional graphical user interface (GUI) design, a layout manager is used to position UI elements based on relative constraints such as upper and lower limits, alignment preferences, and inter-object spacing. This concept can also be applied to the spatial coordination of robotic arms 16 in a surgical environment. Functionally, each robotic arm's operating "space" is defined relative to other robotic arms and the surrounding environment, similar to UI components in a graphical interface. Constraints can be set for each arm 16, taking into account the entire operating room scene (including other arms, surgical tools, patients, and medical staff). These constraints can include distance limits, alignment instructions, and movement and positioning priorities. Algorithmically, the robotic system 10 can employ a sophisticated algorithm similar to the layout manager. This algorithm dynamically calculates the optimal position and trajectory for each arm 16, ensuring that movement is harmonious, collision-free, and efficient, adhering to established constraints. It can adapt in real time to changes in the operating environment, such as equipment movement or surgical staff repositioning. In terms of integration with existing systems, this coordinated movement can be integrated with existing collision detection and avoidance systems, thereby enhancing overall spatial awareness and operational safety. The system 10 can utilize coded joint positions and dual load sensors 44, 46 to collect real-time feedback on arm position and applied force, thereby ensuring precise and safe movement. By implementing relative positioning and movement constraints, the risk of collision between arms 16 and with other objects in the surgical field is significantly reduced. The system 10 can optimize the positioning of each arm 16 for the surgical task, thereby improving procedural efficiency and reducing surgical time. The layout manager allows easy adaptation to various surgical settings and procedures, making the system 10 highly versatile and scalable for different operating room environments.

[0139] In addition to the coordinated movement of the robotic arm 16, the integration of light detection and ranging (LIDAR) sensors on the motorized display 20 can also be provided to enhance the collision avoidance capabilities of the surgical robotic system 10. Functionally, LIDAR sensors can be equipped on the motorized display 20 to continuously scan their immediate surroundings. This real-time spatial data can be fed into the system's scene modeling algorithms, providing a more comprehensive understanding of the operating room environment. LIDAR sensors can allow for integration with scene modeling. LIDAR data can complement existing navigation and camera-based systems, providing more detailed and accurate environmental awareness. This enhanced scene modeling can not only help avoid collisions between the display 20 and the robotic arm 16, but also help avoid collisions with other elements in the surgical field, such as medical staff, patients, and surgical tools. Algorithm enhancements can include collision avoidance algorithms that can incorporate LIDAR input, enabling more precise and proactive adjustments to the position of the motorized display 20. This ensures that the display 20 maintains optimal positioning for the surgical workflow while avoiding any potential collisions. LIDAR sensors can provide a level of detail and accuracy in environmental sensing that complements camera-based systems, resulting in more robust collision avoidance capabilities. Integrating LIDAR into the collision avoidance system ensures a safer operating environment by reducing the risk of accidental contact between the display 20 and other elements in the operating room. The use of LIDAR can contribute to the reliable operation of the robotic system 10, particularly in complex and dynamically changing surgical environments.

[0140] Optional camera and display configuration

[0141] Now go to FIG. 32A to FIG. 32B , the system 10 may include an additional navigation camera 24 to provide redundancy and further reduce line-of-sight issues. Figure 32B As shown in the deployed configuration shown, the camera arm 22 may include a bifurcated distal arm section 23 for supporting two separate navigation cameras 24. The bifurcated distal arm section 23 may include two arm segments attached at a swivel joint or other suitable joint. The split or bifurcation at the distal end of the camera arm 22 enables the cameras 24 to be positioned at different positions or angles, thereby reducing blind spots and improving the overall field of view. Figure 32A As shown, the system 10 may include a docked configuration in which the arms 18 , 22 are retracted and folded upon themselves to protect the camera 24 and display 20 .

[0142] Figures 33A to 33B A simplified embodiment is shown in which the navigation camera 24 and display 20 share a single positioning arm 22 . Figure 33A The camera 24 and surgical display 20 are shown in a docked position, and Figure 33BThe camera 24 and display 20 are shown in a deployed position. In this embodiment, the navigation camera 24 and surgical display 20 are mounted to the SCARA arms 14, 22. The navigation camera 24 can be located above the arm 22, and the display 20 can be suspended below the arm 22. This configuration can simplify the system 10 and provide a more user-friendly system.

[0143] Surgical arm configuration

[0144] Now go to Figures 34A to 34B and Figures 35 to 37 , shows the configuration of each surgical arm 16 according to one embodiment. Each surgical arm 16 can include multiple arm segments or links interconnected by numerous joints, such that the arm 16 is configured to replicate the complex movements of a human arm, hand, and / or finger. Each joint can allow a specific type of movement or provide specialized motion. The surgical arm 16 described herein may include one or more of the following: (1) increased degrees of freedom and improved articulation; (2) improved accuracy by encoding the output of each joint and direct machine vision tracking of the arm links; (3) enabling collaborative functionality with faster motion control loops, closed kinematics, and tactile feedback; (4) sensing forces along the length of the arm for surgeon control and collision detection; (5) improved power transfer to enable powered end effectors; (6) improved communication to enable two-way data communication between the end effector and the robot for smart instruments; (7) eliminating the need for system homing, which eliminates potential interference for the user, improves confidence, and streamlines workflow; and / or (8) utilizing motor encoders to enable active movement of the arm, enabling a safety architecture for the system, facilitating enhanced procedural impact, such as for milling. These improvements may enable the surgical robot to perform more parts of a procedure, thereby creating more value for the surgeon.

[0145] A typical arrangement of a surgical robotic system (e.g., customized for orthopedic and neurosurgery procedures) may include positioning the system next to an OR table 60 with the robotic arm in a right-angled position, such as Figure 35 This allows the surgeon to stand comfortably beside or across from the system without compromising their workspace. Additionally, the elbow's motion and bulk are typically kept away from the surgical site. Figure 35The configuration shown provides only five degrees of freedom (5DoF) and is arranged in such a way that inverse kinematics does not have a closed-form solution. It would be preferable to have a minimum of 6DoF to achieve a generalized trajectory in 3D space at any orientation. Systems with only 5DoF arms rely on the user to set the 6th DoF, which is the rotational position of the instrument in the guide tube. This may be effective in some procedures, particularly for instruments where rotational position control is not important, such as drilling and screwdriving. However, for a given, achievable trajectory, a 5DOF system may only be able to achieve that trajectory in one or two specific poses. This limits the flexibility of the system to work around other objects that may be present in the surgical field, such as retractors, pedicle screw towers, reference arrays, etc.

[0146] like Figures 34A to 34B As shown, the surgical arm 16 has seven degrees of freedom (7DoF). The surgical arm 16 may include seven arm segments or links, starting from the base 12 or positioner 14 and ending at the free end at the end effector interface 42, including: a first link L1, a second link L2, a third link L3, a fourth link L4, a fifth link L5, a sixth link L6 and a seventh link L7. These seven links may be interconnected via seven joints, including: a first joint J1, a second joint J2, a third joint J3, a fourth joint J4, a fifth joint J5, a sixth joint J6 and a seventh joint J7. The surgical arm 16 may have seven degrees of freedom (7DoF) consisting only of revolute joints, each of which allows a single axis of rotation. Each subsequent joint has an orthogonal axis of rotation compared to the previous joint. The seven degrees of freedom provide redundant axes for a general trajectory solution, thereby enabling a universal solution space to solve trajectories with many poses. In practice, this allows the user to manipulate the arm's attitude, moving the links to provide more clearance where desired while keeping it locked on track.

[0147] exist Figure 34A , the surgical arm 16 is shown in a docked position. In the docked position, the fifth, sixth, and seventh links (L5-L7) can be aligned proximate to the first and second links (L1-L2). For example, the fifth, sixth, and seventh links (L5-L7) can be aligned along an axis that is substantially parallel to the axis of the first and second links (L1-L2). The compact docking position allows the arm 16 to be folded, for example, for storage or transport. Figure 34B Shown is the surgical arm 16 in the deployed position. In this view, the arm 16 is fully extended. However, it should be understood that the arm 16 can be deployed so that the joints are bent and the arm segments are positioned or extended in any suitable manner to actively participate in a surgical procedure.

[0148] Unlike other systems that are arranged in a way that inverse kinematics does not have a closed-form solution, the surgical arm 16 has closed-form inverse kinematics. In order to achieve a single trajectory, the motion controller uses a numerical method to iteratively solve the system of equations until it converges to a solution. Iterative calculations take time and may limit the speed of the motion control loop. In contrast, closed-form inverse kinematics enables the motion controller to calculate the trajectory by solving the system of equations once for each trajectory. In the closed-form solution, the inverse kinematics problem is solved by deriving an accurate analytical formula that provides the joint parameters (angles, distances) required to achieve the specified end effector position and orientation. With all other conditions being equal, eliminating the need for iterative calculations greatly increases the control loop speed. This increase in control loop speed provides a weightless experience for the user to move the arm via force input (pushing / pulling on the end effector or arm) and enables tactile user feedback.

[0149] refer to Figure 36 , a schematic diagram of a joint arrangement is shown according to one embodiment. Figure 37 The joint coordinate system of the surgical arm 16 is shown. The joint arrangement is configured so that the following mathematical assumptions can be used in the inverse kinematics calculation: (1) The rotation axes of the fifth joint J5, the sixth joint J6, and the seventh joint J7 all intersect at point P1 and are orthogonal to their respective previous joints. Figure 37 As best seen in the figure, the coincident origins of joints J5, J6, and J7 intersect at point P1, which allows the system to solve for this single intersection point P1, merging the three unknowns into one. (2) The origins of the coordinate systems for the second to seventh links (L2-L7) are all coplanar. Figure 37 As best seen in FIG, the constant plane of origin for J2-J7 (regardless of any joint orientation) is plane P2 (depicted as a triangle). The angle of plane P2 relative to the ground is set by the first joint J1. Again, this given information eliminates unknown quantities. In this way, the position and orientation of the surgical arm 16 and end effector 26 are directly calculated from a given set of coordinates or a desired pose using explicit equations.

[0150] Now go to Figures 38A to 38B and Figures 39A to 39D , the surgical arm 16 is configured to have a compact docking and to occupy a minimal volume when deployed in the surgical field. For example, the compact docking aids visibility when transporting the system 10 and during use in a low-profile single-arm mode. Because two or more arms 16 can be deployed simultaneously, each surgical arm 16 is configured to occupy a minimal volume in the surgical field. The docking and volume minimization requirements can be achieved by offsetting the third link L3 of the surgical arm 16. The offset of the link L3 can include a bend or bend between the second link L2 and the fourth link L4. As Figure 38AAs best seen in FIG, the offset of link L3 allows arm 16 to fold back upon itself for compact docking. Figure 38B The figure shows the inefficient storage volume when the arm 16 is docked with the straight third link L3. Therefore, when docked, the offset of the link L3 provides an efficient, streamlined and compact storage solution for the surgical arm 16. The offset of the link L3 is also configured to maintain the coplanarity of the axis of the third joint J3 and the axis of the fifth joint J5. Maintaining coplanarity is kinematically important and minimizes the volume occupied by the arm 16 when both arms are deployed.

[0151] like Figures 39A to 39D As shown, the surgical workflow with right-angle arm crossing is compared for different configurations of the link L3. Figure 39A and Figure 39C As shown, the offset of the link L3 allows each surgical arm 16 to occupy a minimum volume in the surgical space. Figure 39A As best seen in FIG, when both arms 16 are deployed, the surgical arm 16 requires a reduced volume of space 190. In an alternative embodiment, the third joint J3 axis and the fifth joint J5 axis can be offset to parallel planes to achieve an equally low-profile docking configuration. However, this results in the arm 16 being Figure 39B and Figure 39D The cross-angled posture shown occupies approximately twice the volume. The surgical workflow of positioning the robotic system 10 in the cross-angled posture allows the system 10 to be positioned close to the OR table 60 while allowing the surgeon to stand comfortably beside or across from the system 10 without compromising their workspace. The surgical arm 16 is configured to occupy minimal space within the surgical field, thereby not overcrowding the operating environment and enhancing visibility.

[0152] The arm joint and linkage geometry are arranged to minimize obstruction when deployed in the surgical field and to minimize enclosed volume when docked. Streamlining the docking of the two arms 16 allows one arm 16 to remain docked, and if a procedure requires only deployment of one arm 16, the docked arm does not become an obstruction. The additional degrees of freedom increase the accessibility of the robotic arm 16 to facilitate more procedures. The joint configuration also enables a closed-loop kinematic solution, which increases control loop speed, resulting in better tactile feel and overall motion.

[0153] Now go to Figures 40A to 41BEach joint of the surgical arm 16 can be motorized, enabling precise, automated movement and adjustment of the surgical arm 16. Backlash can affect the controllability of the arm. Backlash (sometimes called play) in a motion system can be seen when an axis reverses direction (i.e., changing rotation from clockwise to counterclockwise) and can be defined as the amount of input movement required before the output also changes direction. Backlash is typically caused by clearance in the drive train, a typical example being the gap between spur gear teeth. This clearance allows the gears to fit together and allows for free-running motion, but it also introduces play into the system. When the drive gear changes direction, the drive teeth must travel through a clearance zone before the output gear changes direction accordingly. Within this clearance window, the system cannot correct the output position, which results in positional errors and generally reduces the accuracy of the arm. Therefore, the surgical arm 16 can be configured with zero backlash to provide precise control and movement accuracy. Zero backlash can be achieved by using a direct drive input to a gearbox specifically designed to have zero backlash (e.g., cycloid or strain wave). The direct drive arrangement ensures that there is no backlash introduced from the coupling to the motor compared to spur, helical or planetary gear inputs.

[0154] The joint can use a frameless motor, which means that the motor stator (windings) are integrated directly into the link housing, saving volume compared to motors with separate frames. The motor rotor can be attached to a hollow shaft. The gearbox can also have through-holes to provide paths for cables and rigid components, which will be discussed in the following sections. Overall, zero backlash will improve the accuracy of the arm and, therefore, the accuracy of the entire robotic system.

[0155] Each joint can use an absolute encoder on the load (output of the gearbox) to directly measure the joint position, and an absolute encoder on the motor for commutation feedback. The encoder converts mechanical motion into an electrical signal to determine position, speed, or direction, accurately reflecting the movement of the connected load and providing feedback to the control system. Using an absolute encoder on the load ensures that the system knows the absolute joint position at power-up or after power loss, eliminating the need to perform a homing routine. This is particularly important for seamlessly resuming procedures in the event of intermittent power outages. This feature also improves the efficiency of setting up and deploying the system in a procedure. The encoder on the load also ensures that torsional flexures in the gearbox can be actively compensated because the joint position is directly measured after and including any flexure.

[0156] The load encoder can be located at the joint interface, directly measuring the gearbox output. Alternatively, the gearbox output can be extended back through the actuator's bore and measured inside the body of the preceding link. This arrangement saves space and provides the opportunity to collocate the encoder with the motor encoder. FIG. 40A to FIG. 40BAn example of a load encoder system 200A having a load encoder at the output of a gearbox is shown, and Figures 41A to 41B An example of a load encoder system 200B is shown before the motor via an extension through a hole.

[0157] The encoder system 200A, 200B may include a motor 202 having a motor shaft 204 (which serves as the primary source of mechanical power), a gearbox 206 attached to the motor 202, and an output plate 208 to which a load is applied. The encoder may be mounted before the gearbox 206 (e.g., on the motor shaft 204) or after the gearbox 206 (e.g., on the load side). FIG. 40A to FIG. 40B In the embodiment, a load encoder sensor 210 for measuring the rotational position, speed or direction of the load and a load encoder scale 212 for quantifying the load are mounted on the load side of the system 200A. Figures 41A to 41B , the load encoder sensor 210 and the load encoder scale 212 are attached to an output extension 218 extending from the output plate 208 .

[0158] The systems 200A, 200B may also include a motor encoder to provide commutation feedback and accurate control of the motor 202. For example, a motor encoder sensor 214 and a motor encoder scale 216 may be attached to the motor 202. The use of an absolute encoder on the motor 202 supports a safety architecture capable of achieving Safety Integrity Level 3 (SIL 3), enabling active motion in the patient space.

[0159] Incorporating a zero-backlash harmonic gearbox into the robotic arm 16 yields greater positional accuracy and minimizes noise during motion. This can be beneficial for surgeons performing delicate procedures, allowing them to be more confident in tool placement and not be distracted or discouraged by the excessive sound of the motor while working. Using an absolute encoder with each motor allows the arm position to be known without requiring an additional step to home the robot. This saves time during surgical preparation and prevents collisions, particularly when both arms 16 are moving in the field. Using a motor with dominant torque instead of a brake reduces system heating and energy consumption.

[0160] Now go to Figure 42, the surgical arm 16 can be configured for cable management. Specifically, all arm wires or cables 220 can be routed internally through the arm joints. This prevents externally routed cables from pinching or pulling on the drape and object as the arm 16 moves through its highly articulated range of motion. Therefore, the challenge is to ensure that internal cables are not damaged by relative motion within the confined arm volume, for example, due to shearing, wear, fatigue, pulling, or other causes. In one embodiment, a miniature slip ring 222 is provided at each joint to allow the cables 220 to pass through the axis of rotation. The slip ring 222 can pass through the central gearbox and motor bore. When the slip ring stator and rotor are attached to the joint input and output, respectively, relative motion is eliminated, and the cable routing becomes effectively static. This eliminates cable entanglement and provides a theoretically unlimited range of rotational motion for joints where the link bodies do not collide with each other (e.g., rolling joints J1, J3, J5, and J7). Requiring all cables 220 to be internal to the robotic system 10 makes the draping process more efficient and simpler, and reduces potential site obstructions. The use of slip rings 222 reduces cable wear at the arm joints, which can increase their lifespan beyond that expected for external cables or cables subjected to repeated twisting and bending. Overall, internally guiding cables 220 through arm 16 enhances the efficiency, safety, and functionality of system 10.

[0161] As previously referenced Figure 31 As described above, the surgical arm 16 is integrated with a 6-axis load sensor 44 at the distal end of the arm 16, which is used to measure force input from the user and convert the force into movement commands. The load sensor 44 can also be used to measure the force applied to the patient to monitor the scraping and generally ensure that no unsafe forces are applied to the patient. In addition to the distal load sensor 44, the arm 16 also has a proximal load sensor 46 integrated at the base of each arm 16 before the joint J1. The proximal load sensor 46 is configured to monitor external forces on the arm 16, which are different from the external forces on the end effector 26. By subtracting the distal load sensor measurement from the proximal load sensor measurement, the external forces on the arm 16 are separated from the forces on the end effector 23. The system can also take into account the kinematic posture, arm geometry, and weight distribution, and subtract the corresponding expected measurement from the actual load sensor reading. This net reading can be used to reversely calculate the resultant force / torque vector and the location where it must be applied along the arm 16 to give a net measurement. Using this information, the system can move the arm 16 to follow the force vector, allowing the user to push or pull anywhere on the arm 16 and change posture while remaining locked on track. It also acts as a collision detection function with an automatic safety feature to avoid collisions with patients or other objects in the field.

[0162] Utilizing dual 6-DOF load sensors 44, 46 allows the system 10 to calculate the incremental forces acting on the arm 16. By being able to differentiate between program loads and arm loads, the robotic system 10 can react to unexpected obstacles and collisions. For example, if the force applied by the surgeon to a tool in the field is acceptable, then if that force pushes against an obstacle in the field during a trajectory move, the system 10 may generate an error or invalidate the move. This feature also enables the system 10 to be collaborative, allowing the user to manually adjust the position of the arm 16 in addition to the automated robotic movement of the arm 16.

[0163] The brakes on the surgical robot serve as safety and control mechanisms, ensuring stability and precision during surgical procedures. In one embodiment, the system 10 may not use discrete electromechanical brakes. In particular, the surgical arm 16 may not have an electromagnet to apply or release mechanical resistance (friction) to the joint. This minimizes the arm volume and saves electricity by not needing to constantly power the electromagnet that keeps the brake open when the arm 16 moves. Nevertheless, braking may be required when the system 10 is unpowered, in active use or active servo mode, and during emergency stop conditions.

[0164] Instead of using brakes under static conditions, the system 10 can take advantage of the friction inherent in the high reduction ratio gearbox 206. The friction is sufficient to support the deadweight of the arm 16 in the unpowered state, which means that the arm 16 maintains its static attitude even without power. In the event that the system 10 requires a higher static holding force than the gearbox 206 can provide, the joint can be enhanced with a dominant torque mechanism. The additional torque can be added incrementally until the desired holding force is achieved. The trade-off is that the power of the motor 202 must be large enough to constantly overcome this additional torque. Some examples of dominant torque enhancement may include spring-loaded clutch plates, compression-fit nylon or bronze sleeves, radial nylon tip set screws, and / or friction hinges in line with the gearbox output.

[0165] During active use, or in active servo mode, precise positioning of the surgical arm 16 can be achieved through active control. When powered, the primary mode of operation is active servo in position, which allows the servo motor 202 to actively control and maintain the position of the arm 16. The servo motor 202 is able to perform precise position control because a feedback mechanism (e.g., from an encoder) constantly monitors and adjusts the position of the motor. In this active mode, it is motor power, not brake power, that maintains position. If the joint is ever backdriven, the feedback system recognizes the movement and the arms 16 correct their respective positions.

[0166] During an emergency stop condition, power to the motor 202 is cut off in an emergency. If the surgical arm 16 is moving when the emergency stop is engaged, the arm 16 needs to stop within the safe stopping distance. Since the motor power is cut off, this must be done without servo control. When the arm 16 has momentum, the friction in the gearbox alone is not enough to achieve this safe stopping distance. To achieve the safe stopping distance during an emergency stop, the motor phases are shorted together, electromechanically locking the rotor and stator together. This occurs because when the phases are unpowered and shorted together, any arm movement induces a current and a corresponding magnetic field that opposes the initial movement. The more movement, the greater the restoring force, resulting in a faster response time to stop the movement. By utilizing a robotic arm 16 that does not use discrete electromechanical brakes, the arm size can be minimized and power can be saved. The minimal arm size helps ensure that the user's direct line of sight is unobstructed and also reduces the occurrence of potential collisions.

[0167] Now go to Figure 43 , the surgical arm 16 can be tracked directly by the navigation system, for example as a redundancy and safety mechanism in addition to tracking the end effector 26. For example, one or more tracking elements or markers 98 can be incorporated into the robotic arm 16 to support overall tracking. The tracking markers 98 can be provided on one or more individual arm links L1-L7. In the illustrated embodiment, the tracking markers 98 can be provided on links L2, L4 and L6, respectively. The tracking markers 98 can include machined fiducials, reflective disks, reflective balls and / or active LEDs, all of which are visible through the sterile drape using machine vision. In one embodiment, a circle of machined fiducials can be provided around the periphery of a given arm link (e.g., links L2, L4 and L6) to assist in accurate and reliable positioning of the arm 16. Fine tracking elements can also be incorporated into the end effector 26 and tool 28 outside the drape.

[0168] By tracking individual arm links (e.g., one or more of links L1-L7) in addition to the end effector 26, the system 10 can continue to navigate for a period of time if the end effector 26 becomes obscured. In such cases, the system 10 relies on the kinematics of the tracked link from the farthest side, bridging the navigation gap until the end effector 26 is again in line of sight and can be directly tracked. This greatly improves the workflow of the system 10 because it reduces interruptions from loss of navigation and allows the user to proceed seamlessly during a particular task. Whole-arm tracking can help improve tracking accuracy because more positional data is collected via machine vision than from the end effector or tool array alone. This additional positional information streamlines the workflow and can result in fewer interruptions during a procedure because the system can continue to move even if there are small obstructions in the line of sight during the procedure.

[0169] Now go to Figures 44A to 44B , an information ring (ROI) 48 can be integrated into the robotic platform 10 to visually communicate the arm status to the user. In the case of dual arms, the information ring 48 can be used to display the active / inactive arm status. Other states may include off, start, servo, move, in position, error, user force input mode, and trajectory mode. These states can be communicated by color (e.g., green, red, yellow, blue, etc.) and brightness sequences (e.g., off, on, flashing, pulse, comet, etc.). The information ring 48 can also convey active mode and passive mode. Figure 44A As shown, an information ring 48A may be positioned towards the distal end of each surgical arm 16 to ensure they are within the surgeon's line of sight during use. Figure 44B As shown, the information ring 48B can be integrated into the end effector 26. This position is ideal for active use status, which can be effectively communicated to the surgeon's direct line of sight on the outside of the drape. Arm status communication provides the user with visual cues indicating the status of each surgical arm 16, thereby enhancing operational safety and efficiency by allowing the user to quickly assess the status of the system and respond appropriately.

[0170] Clear and obvious display of arm status allows for safe and effective use of the robotic platform 10. It gives the user actionable information and reduces the amount of unknowns when using computer-assisted techniques. Introducing the second arm 16 into the configuration also creates new status conditions, such as arm active / inactive, and provides clear differentiation between arms 16 when using dual-actor mode, for example. Clear status communication helps surgeons and OR personnel use and monitor the system effectively.

[0171] Although several embodiments of the present invention have been disclosed in the foregoing description, it will be understood that many modifications and other embodiments to which the present invention pertains will be contemplated, thanks to the teachings presented in the foregoing description and the associated drawings. Therefore, it will be understood that the present invention is not limited to the specific embodiments disclosed above, and that many modifications and other embodiments are intended to be included within the scope of the appended claims. It is also foreseeable that features from one embodiment may be combined or used together with features from different embodiments described herein. In addition, although specific terms are used herein and in the appended claims, they are used in a general and descriptive sense only and not for the purpose of limiting the described invention or the appended claims. The entire disclosure of each patent and publication cited herein is incorporated herein by reference in its entirety, as if each such patent or publication were individually incorporated herein by reference. Various features and advantages of the present invention are set forth in the following claims.

Claims

1. A multi-arm surgical robot system comprising: A movable base station, the movable base station comprising an onboard computer; a display electrically coupled to the computer; a camera electrically coupled to the computer and configured to detect one or more tracking markers; a pair of surgical arms electrically coupled to the computer and movable based on commands processed by the computer; and An end effector is electrically coupled to each surgical arm, wherein each end effector is positioned to enable a tool to perform a surgical procedure on a spinal member.

2. A multi-arm surgical robotic system according to claim 1, wherein the surgical arms are configured to be synchronized relative to each other.

3. A multi-arm surgical robotic system according to claim 1, wherein the surgical arms are configured to perform independent surgical tasks simultaneously.

4. A multi-arm surgical robotic system according to claim 1, wherein the surgical arms are configured to perform independent surgical tasks sequentially.

5. The multi-arm surgical robotic system of claim 1, wherein each of the surgical arms is configured to be controlled by a different user.

6. The multi-arm surgical robotic system of claim 1, wherein one of the surgical arms is configured to perform one type of task and the other surgical arm is configured to perform a different type of task.

7. A multi-arm surgical robotic system according to claim 1, wherein one of the surgical arms controls the other surgical arm during the zoom mode.

8. The multi-arm surgical robotic system of claim 1, wherein the surgical arms automatically execute verification procedures.

9. A multi-arm surgical robot system comprising: A movable base station, the movable base station comprising an onboard computer; an arm positioner attached to the base station; a monitor arm attached to the arm positioner, the monitor arm supporting a display electrically coupled to the computer; a camera arm attached to the arm positioner, the camera arm supporting a camera electrically coupled to the computer and configured to detect one or more tracking markers; and a pair of surgical arms attached to the arm positioner and electrically coupled to the computer and movable based on commands processed by the computer, Wherein the pair of surgical arms are configured to enable tools to contact a spinal member.

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