Tissue sensing with ultrasonic resection tools

Abstract

The surgical system includes an ultrasound instrument capable of operating in tissue sensing and tissue resection modes. In tissue resection mode, a first AC drive signal is provided to the ultrasound instrument, inducing vibration in the tip of the instrument used to remove patient tissue. In tissue sensing mode, a second AC drive signal is provided to the ultrasound instrument, inducing vibration in the tip insufficient to remove patient tissue. The frequency corresponding to the target vibration characteristics of the ultrasound instrument is determined based on voltage and current measurements of the second AC drive signal and is used to determine the type of patient tissue contacted by the distal region of the tip. The operation of the surgical system is then controlled based on the determined tissue type.

Description

Cross-reference to related applications

[0001] This application claims priority and all benefits to U.S. Provisional Application No. 63 / 589,630, filed October 11, 2023, and U.S. Provisional Application No. 63 / 589,988, filed October 12, 2023, the disclosures of which are incorporated herein by reference in their entirety. Background Technology

[0002] Ultrasonic surgical aspirators are operated to remove patient tissue by rapidly vibrating against it while simultaneously applying suction through a built-in pathway. When using such devices, limiting the removal of non-target tissue often depends on the operator's ability to distinguish different tissue types and respond accordingly, which can be particularly difficult when the surgical site is obstructed. Summary of the Invention

[0003] A system of one or more computers can be configured to perform specific operations or actions by installing software, firmware, hardware, or combinations thereof on the system, which, when operated, causes the system to perform the actions. One or more computer programs can be configured to perform specific operations or actions by including instructions that, when executed by a data processing device, cause the device to perform the actions.

[0004] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to supply a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power supply and configured to: operate the ultrasound device in a tissue resection mode, in which a first AC drive signal is provided to the ultrasound device, the first AC drive signal inducing vibration in the tip of the ultrasound device for resecting patient tissue; operate the ultrasound device in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound device, the second AC drive signal inducing vibration for sensing patient tissue in the tip, the power of the second AC drive signal being lower than the power of the first AC drive signal; obtain at least one measured first electrical characteristic of the second AC drive signal; determine a first frequency corresponding to a target vibration characteristic of the ultrasound device based on the at least one measured first electrical characteristic; determine the type of patient tissue contacted by the distal region of the tip based on the determined first frequency; and control the operation of the surgical system based on the determined type of patient tissue. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of the one or more controllers, and methods for detecting tissue type using an ultrasound device for resecting patient tissue, each method including performing the above actions.

[0005] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to provide a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power source and configured to: provide the AC drive signal to the ultrasound instrument, the AC drive signal inducing vibrations in the ultrasound instrument for removing patient tissue; obtain at least one measured first electrical characteristic of the AC drive signal; determine one or more frequency characteristics of the AC drive signal based on the at least one measured first electrical characteristic, each of the frequency characteristics corresponding to a frequency other than the fundamental frequency of the AC drive signal; determine the type of patient tissue contacted by a distal region of the tip based on the determined one or more frequency characteristics; and control the operation of the surgical system based on the determined type of patient tissue. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of one or more controllers, and methods for detecting tissue type using ultrasound instruments for removing patient tissue, each method including performing the aforementioned actions.

[0006] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to provide a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power source and configured to: provide the ultrasound instrument with the AC drive signal, the AC drive signal in the tip inducing vibrations insufficient to remove the patient tissue; determine a first frequency corresponding to a target vibration characteristic of the ultrasound instrument in an unloaded state; obtain at least one measured first electrical characteristic of the AC drive signal; determine a second frequency corresponding to the target vibration characteristic of the ultrasound instrument in a loaded state; determine the type of patient tissue contacted by a distal region of the tip based on the first frequency and the second frequency; and control the operation of the surgical system based on the determined type of patient tissue. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of one or more controllers, and methods for detecting tissue type using ultrasound instruments for removing patient tissue, each method including performing the aforementioned actions.

[0007] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to provide a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power source and configured to: operate the ultrasound instrument in a tissue removal mode, in which a first AC drive signal is provided to the ultrasound instrument to induce vibrations in the tip of the ultrasound instrument for removing patient tissue, wherein the first AC drive signal includes a frequency component corresponding to a first resonant mode of the tip; operate the ultrasound instrument in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound instrument to induce vibrations in the tip insufficient to remove patient tissue, wherein the second AC drive signal includes a frequency component corresponding to a second resonant mode of the tip; obtain at least one measured first electrical characteristic of the second AC drive signal; determine the type of patient tissue contacted by a distal region of the tip based on the at least one measured first electrical characteristic; and control the operation of the surgical system based on the determined type of patient tissue. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of one or more controllers, and methods for detecting tissue type using ultrasound instruments for removing patient tissue, each method including performing the aforementioned actions.

[0008] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to supply a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power supply and configured to: operate the ultrasound device in a tissue resection mode, in which a first AC drive signal is provided to the ultrasound device to induce vibration in the tip of the ultrasound device for resecting patient tissue, the first AC drive signal being limited to a first permissible frequency range associated with the tissue resection mode; operate the ultrasound device in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound device to induce vibration in the tip for sensing patient tissue, the second AC drive signal being limited to a second permissible frequency range associated with the tissue sensing mode; obtain at least one measured first electrical characteristic of the second AC drive signal; determine the type of patient tissue contacted by the distal region of the tip based on the at least one measured first electrical characteristic; and control the operation of the surgical system based on the determined type of patient tissue. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of the one or more controllers, and methods for detecting tissue type using an ultrasound device for resecting patient tissue, each method including performing the aforementioned actions.

[0009] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to supply a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power supply and configured to: operate the ultrasound device in a tissue resection mode, in which a first AC drive signal is provided to the ultrasound device, the first AC drive signal causing vibration in the tip of the ultrasound device for resecting patient tissue, and wherein suction is provided by at least a portion of the ultrasound device at a distal region of the tip; operate the ultrasound device in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound device, the second AC drive signal causing vibration in the tip for sensing patient tissue but insufficient to resecte patient tissue, and wherein suction provided by the at least a portion of the ultrasound device at the distal region of the tip is disabled; obtain at least one measured first electrical characteristic of the second AC drive signal; determine the type of patient tissue contacted by the distal region of the tip based on the at least one measured first electrical characteristic; and control the operation of the surgical system based on the determined type of patient tissue. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of one or more controllers, and methods for detecting tissue type using ultrasound instruments for removing patient tissue, each method including performing the aforementioned actions.

[0010] One general aspect includes a surgical system for detecting tissue type using an ultrasound instrument for removing patient tissue. The surgical system includes a power source configured to provide a varying AC drive signal to the ultrasound instrument to induce varying vibrations in the tip of the ultrasound instrument. The system includes at least one sensor for measuring at least one electrical characteristic of the AC drive signal. The system includes one or more controllers coupled to the at least one sensor and the power source and configured to: operate the ultrasound instrument in a tissue removal mode, in which the AC drive signal is provided to the ultrasound instrument, the AC drive signal inducing vibrations in the ultrasound instrument for removing patient tissue, and wherein suction is provided at a distal region of the tip through at least a portion of the ultrasound instrument; obtain at least one measured first electrical characteristic of the AC drive signal; determine the type of patient tissue contacted by the distal region of the tip based on the at least one measured first electrical characteristic; and adjust the suction provided at the distal region of the tip based on the determined type of patient tissue when operating in the tissue removal mode. Other embodiments related to this aspect include corresponding computer systems, apparatuses, and computer programs recorded on one or more computer storage devices, each configured to perform configuration actions of one or more controllers, and methods for detecting tissue type using ultrasound instruments for removing patient tissue, each method including performing the above.

[0011] One general aspect includes a sleeve for an ultrasonic surgical tool, the ultrasonic surgical tool including a tip and at least one actuator, the tip being coupled to the actuator and an AC drive signal being provided from a console to the actuator to vibrate the tip. The sleeve includes a body and a conduit, the body including a proximal and distal end of an opening, the conduit being used to allow flushing fluid to flow along the sleeve and out of the distal end of the opening during operation of the ultrasonic surgical tool to vibrate the tip, the body being adapted to be disposed around the tip and positioned in an operating position for operating the ultrasonic surgical tool to vibrate the tip, wherein the tip extends from the proximal end of the opening and protrudes beyond the distal end of the opening. The sleeve includes a tip memory disposed in the body and storing data for controlling the actuation of the tip in tissue resection mode and tissue sensing mode, wherein the data for controlling the actuation of the tip indicates at least one of the following: a drive signal frequency for tissue sensing mode, a drive signal frequency for tissue resection mode that is different from the drive signal frequency for tissue sensing mode, a permissible drive signal frequency range for tissue sensing mode, a permissible drive signal frequency range for tissue resection mode that is different from the permissible drive signal frequency range for tissue sensing mode, a drive signal frequency corresponding to the target vibration characteristics of the ultrasonic surgical tool in an unloaded state, data for identifying the tissue type of the change in contact with the distal region of the tip based on the electrical characteristics of the drive signal, and aspiration parameters for the change in tissue type.

[0012] One general aspect includes a method for detecting tissue type using a surgical system comprising an ultrasonic instrument for removing patient tissue. The method includes: operating the ultrasonic instrument in a tissue removal mode, in which a first AC drive signal is provided to the ultrasonic instrument, the first AC drive signal inducing vibration in a tip of the ultrasonic instrument for removing patient tissue; and providing suction via at least a portion of the ultrasonic instrument at a distal region of the tip while operating in the tissue removal mode. The method also includes operating the ultrasonic instrument in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasonic instrument, the second AC drive signal inducing vibration in the tip insufficient to remove patient tissue. The method further includes: obtaining voltage and current measurements of the second AC drive signal when the distal region of the tip contacts patient tissue; determining a frequency corresponding to a target vibration characteristic of the ultrasonic instrument based on the voltage and current measurements; determining the type of patient tissue contacted by the distal region of the tip based on the determined frequency; and controlling the operation of the surgical system based on the determined type of patient tissue.

[0013] One general aspect includes a method for detecting tissue type using a surgical system comprising an ultrasonic instrument for removing patient tissue. The method includes: providing an AC drive signal to the ultrasonic instrument, the AC drive signal inducing vibration in a tip of the ultrasonic instrument for removing patient tissue; and providing suction at a distal region of the tip via at least a portion of the ultrasonic instrument as the tip vibrates to remove patient tissue. The method includes: obtaining a current measurement of the AC drive signal; determining one or more frequency characteristics of the AC drive signal based on the current measurement of the AC drive signal, each frequency characteristic corresponding to a frequency other than the fundamental frequency of the AC drive signal; and determining the type of patient tissue contacted by the distal region of the tip based on the one or more frequency characteristics. The method includes controlling the operation of the surgical system based on the determined type of patient tissue.

[0014] Other aspects include corresponding computer systems, apparatus, and computer programs recorded on one or more computer storage devices, each configured to perform any of the above methods.

[0015] Implementation of any aspect may include a robotic manipulator coupled to an ultrasound instrument and configured to guide the ultrasound instrument to treat patient tissue, and may include controlling the robotic manipulator based on the determined type of patient tissue, such as by adjusting parameters of a virtual object (e.g., a tactile object) associated with the patient tissue and used to control the robotic manipulator. Attached Figure Description

[0016] Figure 1 A surgical system according to an exemplary aspect is shown, comprising an ultrasound resection system having ultrasound instruments for resection and sensing of patient tissue, a surgical navigation system for tracking the position of the ultrasound instruments, and a robotic manipulator for manipulating and / or guiding the movement of the ultrasound instruments relative to the patient tissue.

[0017] Figure 2 An ultrasound resection system according to an exemplary aspect is shown in more detail.

[0018] Figure 3 An ultrasonic device according to an exemplary aspect is shown in more detail.

[0019] Figure 4A and 4B The diagram illustrates an electric current flowing through an ultrasonic instrument according to an exemplary aspect.

[0020] Figure 5 The components that may be included in the console of an ultrasound resection system according to exemplary aspects are shown.

[0021] Figure 6 The diagram illustrates components that can be included in an ultrasound device according to exemplary aspects.

[0022] Figure 7 A procedure for low-power tissue sensing using an ultrasound instrument, which can be implemented by a surgical system according to an exemplary aspect, is shown.

[0023] Figure 8 A procedure for high-power tissue sensing using an ultrasound instrument, which can be implemented by a surgical system according to an exemplary aspect, is shown. Detailed Implementation

[0024] This document describes systems and methods for identifying different patient tissues using an ultrasound instrument operable to remove patient tissue. The ultrasound instrument may include a tip configured to vibrate when an AC drive signal is applied to the instrument. The vibrating tip can then be placed against the tissue, which can cause the instrument to exhibit different operating characteristics depending on the mechanical properties of the tissue being contacted. This difference in operating characteristics can be used to differentiate contact with different types of patient tissue, such as hard tissue (e.g., bone) versus soft tissue (e.g., the dura mater). In some embodiments, this information may be used to determine whether the ultrasound instrument is operated in a resection mode that fragments the contacted tissue, and / or to determine the power level at which the ultrasound instrument is operated to fragment the tissue.

[0025] In some implementations, the ultrasound instrument can operate in multiple modes, namely a tissue resection mode and a tissue sensing mode. In tissue sensing mode, relatively low-amplitude vibrations, in some cases pulse amplitude vibrations, can be induced in the tip of the ultrasound instrument. These vibrations may be insufficient to resect the patient's tissue in and around the target site, but are only used to probe the tissue contacted by the tip. Different tissues may have different effects on the vibration characteristics of the ultrasound instrument, such as by causing different variations in the resonant frequency of the ultrasound instrument. Therefore, different jumps or variations in the resonant frequency of the ultrasound instrument may be related to the contact of the vibrating tip and different types of tissue.

[0026] In some implementations, the operation of the ultrasound device can switch from a tissue sensing mode to a tissue resection mode when the tip comes into contact with the type of tissue to be removed. In tissue resection mode, relatively high-amplitude vibrations, such as those based on a user-requested power level, can be induced in the tip of the ultrasound device to remove the patient tissue being contacted. The tissue resection mode may similarly include sensing capabilities to determine the type of tissue the tip of the ultrasound device is contacting as the tip is manipulated to fragment the tissue. For example, a vibration level of the ultrasound device that is not at its primary drive frequency can be monitored and correlated with different tissue types. In some implementations, when the tissue type determined during operation of the ultrasound device in tissue resection mode indicates contact with or proximity to tissue to be kept intact, the operation of the ultrasound device can be adjusted to limit potential resection of non-target tissue. For example, the operation of the ultrasound device can be switched back to tissue mode, or it can be adjusted to remain in tissue resection mode but operate at a reduced power level.

[0027] The ability of an ultrasound instrument operable to remove patient tissue to also sense the type of tissue the instrument is contacting offers several benefits. In addition to optimizing the removal of target tissue while preserving non-target tissue (e.g., for removing soft tissue while preserving harder bone tissue during endplate preparation procedures), the embodiments described herein allow for continued sensing of tissue type while fragmenting the tissue (e.g., rather than stopping fragmentation to probe the tissue type), and also allow for the use of the same instrument used for resection to sense the tissue (e.g., rather than prolonging the procedure by switching between fragmentation and probing instruments), thereby increasing procedure speed. As another example, the embodiments described herein can be used to provide cut-through and / or pre-cut-through detection, which can be used to stop or reduce the power of the ultrasound instrument to reduce potential damage to sensitive structures and other non-target tissues adjacent to the patient tissue being the target of resection. For example, when cutting bone toward the spinal cord, the vibration of the tip can be turned off once bone is detected. As yet another example, when thinning the skull base near the carotid artery, the vibration of the tip can be turned off before cut-through to preserve a thin layer of bone as needed.

[0028] The embodiments described herein can also be used to improve or validate the accuracy of surgical navigation, such as by comparing the tissue type indicated by automatic segmentation and / or navigation tracking during preoperative scans with what the ultrasound instrument is sensing, and taking corresponding actions, as described in PCT application PCT / US2023 / 017790, filed April 6, 2023, the contents of which are incorporated herein by reference in their entirety. In robotic applications, the embodiments described herein can also be used to adjust parameters of virtual and / or tactile objects used to control robotic manipulators coupled to ultrasound instruments, such as those described in U.S. Patents 9,775,681 and 10,398,449, the contents of which are respectively incorporated herein by reference in their entirety. As yet another example, the tissue type detected according to the embodiments described herein can be used in conjunction with navigation or robotic kinematics to generate virtual objects corresponding to the patient's anatomy in a known coordinate system, and / or adjust the posture and / or shape of such virtual objects in a known coordinate system, such as taking tissue movement into account during surgery.

[0029] Now turn to the attached image. Figure 1 A surgical system 10 for treating the anatomical structures (i.e., target sites) of a patient P is shown. The surgical system 10 can be installed in a surgical environment such as an operating room in a medical facility. The surgical system 10 may include an ultrasound resection system 11, a surgical navigation system 12, and a robotic manipulator 14.

[0030] The robotic manipulator 14 can be coupled to the ultrasound instrument 15 of the ultrasound resection system 11 and can be configured to manipulate and / or guide the ultrasound instrument 15 to treat a target volume of patient tissue, such as under the instruction of a surgeon and / or a surgical navigation system 12. For example, the surgical navigation system 12 can cause the robotic manipulator 14 to manipulate the ultrasound instrument 15 to remove a target volume of patient tissue while avoiding other objects adjacent to the target volume in the surgical workspace, such as other medical instruments and adjacent anatomical structures that are to be avoided. Alternatively or additionally, the surgeon may manually hold and manipulate the ultrasound instrument 15 while receiving guidance from the surgical navigation system 12 and / or from the robotic manipulator 14. For example, the robotic manipulator 14 can be configured to provide tactile feedback and / or constrain the movement of the ultrasound instrument 15 to avoid adjacent objects as the surgeon moves the ultrasound instrument 15 relative to the target volume.

[0031] The surgical navigation system 12 can be configured to use tracker-based positioning to track the posture (i.e., position and orientation) of objects of interest within the surgical workspace. Tracked objects may include, but are not limited to, patient anatomy and surgical instruments, such as ultrasound instruments 15. Tracked patient anatomy may include soft and hard tissues, such as fat, ligaments, muscles, skin, and bones. In addition to ultrasound instruments 15, tracked surgical instruments may include retractors, other cutting tools, inserters, implants, and waste management devices used during surgical procedures.

[0032] Each object of interest can be attached to tracker 16 for positioning the object in a known coordinate system. For example, in Figure 1 In the example shown, surgical system 10 is used to perform spinal surgery on patient P, such as minimally invasive intervertebral fusion, where an ultrasound instrument 15 is used to prepare an intervertebral disc space to receive an implant (e.g., a spacer, graft, fusion device). To support optimal preparation of the intervertebral disc space using ultrasound instrument 15, surgical navigation system 12 can be configured to continuously track the posture of multiple vertebrae V using a patient tracker 16A coupled to each vertebra V, and also track the posture of ultrasound instrument 15 via an instrument tracker 16B coupled to ultrasound instrument 15 or to a robot manipulator 14 at a location known to the ultrasound instrument 15.

[0033] In some embodiments, tracker 16 may be an optical tracker 16, in which case the surgical navigation system 12 may be configured to detect light signals emitted from each tracker 16 by imaging the trackers 16. The surgical navigation system 12 may then be configured to determine the pose of the trackers 16 in a known coordinate system based on the image, and subsequently determine the pose of the object to which the trackers 16 are attached in the known coordinate system based on the determined pose of the trackers 16 and a predefined positional relationship between the object and the trackers 16. The surgical navigation system 12 may have various functions and features, such as those described in U.S. Patent 7,725,162 and U.S. Patent Publication 2020 / 0100849, the contents of which are incorporated herein by reference in their entirety. While an example in which the surgical navigation system 12 is an optical tracking system has been provided, other tracking systems may be employed.

[0034] For example, in some embodiments, the surgical navigation system 12 may be implemented as an electromagnetic tracking system, wherein each tracker 16 includes a position sensor disposed thereon and / or embedded therein. The position sensor may include a coil that generates a current when moved within an electromagnetic field, which can then be transmitted to the surgical navigation system 12. This phenomenon allows the surgical navigation system 12 to determine the position of the coil in three-dimensional space, such as relative to a target volume of patient tissue.

[0035] By way of example only, a position sensor may be constructed and operated in accordance with at least some of the teachings of the following patents: U.S. Patent 8,702,626, the disclosure of which is incorporated herein by reference; U.S. Patent 8,320,711, the disclosure of which is incorporated herein by reference; U.S. Patent 8,190,389, the disclosure of which is incorporated herein by reference; U.S. Patent 8,123,722, the disclosure of which is incorporated herein by reference; U.S. Patent 7,720,521, the disclosure of which is incorporated herein by reference; U.S. Patent Publications... The following patents are incorporated herein by reference: Patent Publication No. 2014 / 0364725, U.S. Patent Publication No. 2014 / 0200444, U.S. Patent Publication No. 2012 / 0245456, U.S. Patent Publication No. 2011 / 0060214, U.S. Patent Publication No. 2008 / 0281156, U.S. Patent Publication No. 2007 / 0208252.

[0036] In response to determining the posture of the object of interest, the surgical navigation system 12 can display the relative posture of the tracked object to assist the surgeon, such as in the form of a virtual model. The surgical navigation system 12 can also control the operation of the robotic manipulator 14 and / or the ultrasound instrument 15 based on the virtual object associated with the tracked object, as described in PCT application PCT / US2022 / 054115 (filed December 28, 2022), U.S. Patent 9,775,681, and U.S. Patent Publication 2022 / 0338938, the contents of each of which are incorporated herein by reference in their entirety.

[0037] For example, the surgical navigation system 12 can identify the target volume of patient tissue to be treated and potential obstacles in the surgical workspace based on the tracked object, and generate a virtual object corresponding to the tracked object in a known coordinate system. The surgical navigation system 12 can then control the robotic manipulator 14 to manipulate and / or guide the ultrasound instrument 15 based on this virtual object, such as guiding the ultrasound instrument 15 toward the patient tissue to be treated and / or away from contact with anything outside the target volume of the patient tissue to be treated. In this way, the surgical navigation system 12 can both improve surgical accuracy and eliminate damage to the surgical instrument due to accidental contact with other objects, which could produce undesirable debris at the target site. Additionally or alternatively, the surgical navigation system 12 can be configured to adjust the operation of the ultrasound instrument 15 based on the virtual object, such as by stopping or reducing the power supplied to the ultrasound instrument 15 when the virtual object indicates that the ultrasound instrument 15 is contacting or approaching tissue outside the target volume of the patient tissue to be treated.

[0038] Still referencing Figure 1 The surgical navigation system 12 may include a locator camera 20 and a navigation cart assembly 22. The navigation cart assembly 22 may house a navigation controller 24 configured to implement the functions, features, and processes of the surgical navigation system 12 as described herein. For example, the navigation controller 24 may be configured to convert optical-based image data received from the locator camera 20 into object pose data indicating the pose of the tracked object in the surgical workspace, and to control the operation of the robotic manipulator 14 based on the indicated pose as described herein.

[0039] The navigation controller 24 may include or be operatively communicating with a navigation storage device 25, and / or may be operatively communicating with a user interface 28A of the surgical navigation system 12. The navigation storage device 25 may store data to facilitate the operation of the surgical navigation system 12, as described in more detail below. The user interface 28A facilitates user interaction with the surgical navigation system 12 and the navigation controller 24. For example, the user interface 28A may include one or more output devices, such as providing information to the user from the navigation controller 24. Output devices may include a display 30 adapted to be positioned outside a sterile area including the surgical workspace, and may include a display 32 adapted to be positioned inside the sterile area. Displays 30, 32 may be adjustablely mounted to the navigation cart assembly 22. The user interface 28A may also include one or more input devices that enable user input to the surgical navigation system 12. Input devices may include a keyboard, mouse, and / or touchscreen 34, with which the user can interact to input surgical parameters to the navigation controller 24 and control various aspects of the navigation controller 24. Input devices may also include a microphone capable of enabling user input via voice recognition technology.

[0040] The locator camera 20 can be configured to facilitate the identification of the orientation of the tracked object in the surgical workspace relative to a known coordinate system (such as the locator coordinate system LCLZ of the locator camera 20) by generating image data indicating the orientation of the tracker 16 attached to the object. The locator camera 20 may have a housing 36 that houses at least two optical sensors 38. Each optical sensor 38 may be adapted to detect light signals of a specific frequency band emitted by the tracker, such as invisible light signals (e.g., infrared or ultraviolet). Although Figure 1 The locator camera 20 is shown as a single unit with multiple optical sensors 38, but in an alternative example, the locator camera 20 may include separate units arranged around the surgical workspace, each unit having a separate housing 36 and one or more optical sensors 38.

[0041] The optical sensor 38 can be a one-dimensional or two-dimensional charge-coupled device (CCD). For example, the housing 36 can house two two-dimensional CCDs or three one-dimensional CCDs for triangulation of the position of the optical marker of the tracker 16 in the surgical workspace. Additionally or alternatively, the locator camera 20 can employ other optical sensing technologies, such as complementary metal-oxide-semiconductor (CMOS) active pixels.

[0042] The locator camera 20 can be mounted to an adjustable arm to selectively position the optical sensor 38 into a field of view with a surgical workspace and target volume, ideally free of obstructions. The locator camera 20 is adjustable in at least one degree of freedom by rotating about a rotary joint, and can be adjustable about two or more degrees of freedom.

[0043] In some embodiments, the object to which each tracker 16 is attached may be rigid and inflexible, such that movement of the object cannot or is unlikely to change the positional relationship between the object and the tracker 16. In other words, the relationship between the tracker 16 and the object to which the tracker 16 is attached in the surgical workspace can remain constant, even if the position of the object changes within the surgical workspace. For example, the tracker 16 may be firmly attached to a patient bone, such as a vertebra V, and to surgical instruments, such as retractors and ultrasound instruments 15. In this way, in response to determining the orientation of the tracker 16 in the surgical workspace using the locator camera 20, the navigation controller 24 may infer the orientation of the object to which the tracker 16 is attached based on the determined position of the tracker. In some embodiments, the navigation controller 24 may also infer the orientation of relatively non-rigid and inflexible patient tissue based on the determined orientation of other tracked objects adjacent to or having a known relationship with the patient tissue. Additionally or alternatively, the navigation controller 24 may be configured to cooperate with one or more flexible trackers attached to the patient and registered with the patient tissue of interest (such as non-rigid and flexible patient tissue) to track such patient tissue in a known coordinate system.

[0044] Now for reference Figure 5 Each tracker 16 may include at least three optical markers 48 that direct light signals to the optical sensor 38 of the locator camera 20. In some embodiments, the markers 48 may be implemented as active markers 48 that receive current from a power source to generate light signals and emit them to the optical sensor 38. In this case, the trackers 16 may each be powered by an internal battery or may have leads that receive power through the navigation controller 24. For example, the markers 48 may be light-emitting diodes (LEDs) that emit light (such as invisible light, e.g., infrared or ultraviolet light) toward the optical sensor 38.

[0045] Each tracker 16 may also include a tracker controller 50 communicatively coupled to the marker 48 and the navigation controller 24. The tracker controller 50 may be configured to control the rate and sequence of illumination of the marker 48, such as at the instruction of the navigation controller 24. For example, the tracker controller 50 may cause the marker 48 of each tracker 16 to illuminate at different rates and / or times to allow the navigation controller 24 to distinguish the marker 48. In some examples, the navigation controller 24 may form a bidirectional infrared communication channel with each tracker controller 50 to control the trigger timing of the active marker 48 operated by the tracker controller 50, write / read non-volatile data, and obtain the status (e.g., battery level, damaged LED) of the tracker 16 or the object to which the tracker 16 is attached.

[0046] The marker 48 of tracker 16 can be implemented as a passive marker, such as a reflector that reflects light emitted from locator camera 20, rather than an active marker. For this purpose, locator camera 20 may include a light source 51. Figure 1 The light source illuminates tracker 16 with light such as invisible light (e.g., infrared or ultraviolet). Marker 48 can then be configured to reflect the light back toward locator camera 20, which can then be detected by optical sensor 38.

[0047] Before initiating a surgical procedure using the surgical system 10, preoperative images can be generated for anatomical structures of interest, such as those defining and / or adjacent to the target volume of patient tissue to be treated by the ultrasound instrument 15. For example, when the target volume of patient tissue to be treated is in the patient's spinal region, preoperative images of the patient's spine can be taken. These images can be based on MRI, radiographic, or computed tomography (CT) scans of the patient's anatomy and can be used to generate a virtual model of the anatomy, which is stored as model data 52 in the navigation storage device 25.

[0048] Each virtual model of the anatomical structure indicated by model data 52 may include a three-dimensional model (e.g., point cloud, mesh, CAD) representing the whole or at least a portion of the anatomical structure, and / or may include data indicating a portion of the anatomical structure to be processed relative to a three-dimensional coordinate system associated with the anatomical structure. These virtual models may be provided as model data 52 to and stored by the navigation controller 24 prior to surgery. As a supplement to or alternative to taking preoperative images, the aforementioned virtual models may be used for kinematic studies, bone tracking (e.g., using pointer 55 (…)). Figure 1 Generates using other methods.

[0049] In addition to virtual models corresponding to anatomical structures of interest to the patient, prior to surgery, the navigation controller 24 can receive and store virtual models of other tracked objects of interest (such as the ultrasound instrument 15 and / or the robotic manipulator 14) as model data 52. The navigation controller 24 can also receive and store as model data 52: virtual models for each tracker 16 positioned in the surgical workspace, and relational data 54 for each tracker 16, indicating the positional relationship between the tracker 16 and the object to which it is attached. This positional relationship can be defined relative to the virtual models of the tracker 16 and the object. For example, relative to a given tracker 16 attached to a vertebra V, the navigation controller 24 can receive relational data 54 indicating the orientation of the coordinate system associated with the vertebra V relative to the coordinate system associated with the tracker 16. In this way, in response to identifying the orientation of the tracker 16 relative to a known coordinate system, the navigation controller 24 can refer to the relational data 54 of the tracker 16 to determine the coordinate system associated with the vertebra V and the corresponding orientation of the vertebra V relative to the known coordinate system.

[0050] In some examples, the positional relationship between each tracker 16 and the object to which it is attached can be manually indicated via interaction with a patient image depicting the trackers 16 and the object on user interface 28A. Alternatively, the positional relationship between each tracker 16 and the object to which it is attached can be indicated using pointer 55 ( Figure 1 The object is tracked to determine that the pointer has a set of markers 48 that are tracked by the surgical navigation system 12 during tracking, wherein the surgical navigation system 12 also tracks the tracker 16 attached to the object to associate the pose of the tracked object with the pose of the attached tracker 16.

[0051] Prior to surgery, the navigation controller 24 can also receive and store surgical planning data 56. The surgical planning data 56 can identify patient anatomy involved in the surgery, identify instruments used in the surgery, and define the planned trajectory of instruments and planned movement of patient tissues during the surgery.

[0052] During surgical procedures, the navigation controller 24 can be configured to operate the locator camera 20 to cause the optical sensor 38 to generate an optically based signal indicating detected light signals received from the tracker 16, or more specifically, the image plane position of the optical sensor 38 that detected such light signals. The sampling rate of the optical sensor 38 is the rate at which the optical sensor 38 detects light signals from sequentially illuminated markers 48. The optical sensor 38 may have a sampling rate of 100 Hz or higher, more preferably 300 Hz or higher, or most preferably 500 Hz or higher. In one example, the optical sensor 38 may have a sampling rate of 8000 Hz.

[0053] In response to receiving light signals from tracker 16, optical sensor 38 may output an optical-based signal indicating the position of marker 48 on tracker 16 relative to locator camera 20. This optical-based signal can be used by navigation controller 24 to determine the attitude of the object attached to tracker 16 relative to locator camera 20. Specifically, each optical sensor 38 may include a one-dimensional or two-dimensional sensor region (also referred to as an "image plane") that detects light signals from tracker 16 and outputs an optical-based signal in response indicating the pixel coordinates within the sensor region where each light signal is detected. Therefore, the optical-based signal output from each optical sensor 38 may represent an image of tracker 16 generated by optical sensor 38 based on the detected light signals, wherein the image includes spots in pixel coordinates corresponding to the positions of the detected light signals in the image plane of optical sensor 38. The detection position of each light signal may be based on the angle at which the light signal is received by optical sensor 38, and thus may correspond to the position of marker 48 emitting the detected light signal to optical sensor 38 in the surgical workspace.

[0054] The locator camera 20 can be configured to generate image data based on optical signals received from optical sensors 38 and transmit such image data to the navigation controller 24. The image data can indicate the image and / or image planar position represented by the optical signals received from each optical sensor 38.

[0055] The navigation controller 24 can be configured to generate tracker attitude data indicating the attitude of the tracker 16 relative to the locator camera 20 based on the received image data. More specifically, the navigation controller 24 can determine the position of each marker 48 in the locator coordinate system (LCLZ) based on the image data. For example, the navigation controller 24 can be configured to associate spots in the image data corresponding to the same optical marker 48, triangulate the position of the optical marker 48 relative to the locator camera 20 based on the positions of the associated spots in the image data and the known positional relationships between the optical sensors 38, and assign the triangulated positions to each marker 48 of the tracker 16 based on the known geometry of the marker 48 of each tracker 16 or alternatively based on the known frequency, timing, or intensity associated with each marker 48. The position of the marker 48 in the locator coordinate system (LCLZ) can define the attitude of the tracker 16 in the locator coordinate system (LCLZ).

[0056] Based on the orientation of tracker 16 in a known coordinate system, navigation controller 24 can be configured to generate object orientation data indicating the orientation of the object attached to tracker 16 in the known coordinate system. Specifically, navigation controller 24 can apply previously stored relation data 54, indicating the positional relationship between tracker 16 and the object to which tracker 16 is attached, to the tracker orientation data to determine the orientation of the object fixed to tracker 16 in the known coordinate system.

[0057] The navigation controller 24 can be configured to continuously track the pose of the object throughout the surgical procedure and generate a virtual object in a known coordinate system based on the pose of the tracked object. The navigation controller 24 (such as in cooperation with the ultrasound resection system 11) can then control the operation of the robot manipulator 14 based on the virtual object to guide the ultrasound instrument 15, and / or control the operation of the ultrasound instrument 15 to limit the resection of non-target tissue.

[0058] As described above, the navigation controller 24 can be configured to track the posture of such structures by tracking the posture of the tracker 16 attached to the anatomical structure of interest. Additionally or alternatively, the navigation controller 24 can be configured to track the posture of the anatomical structure based on images of the anatomical structure received before and / or during surgery. For this purpose, the surgical system 10 may include an imaging system coupled to the navigation controller 24 and configured to generate images of the patient's anatomical structures, such as those described in PCT application PCT / US2023 / 017790. Similar to the ultrasound instrument 15, the imaging system may include a tracker 16 with a fixed relationship to the pixel coordinates of the images generated by the imaging system, which may be stored by the navigation controller 24 as additional relationship data 54.

[0059] Before and / or during surgery, navigation controller 24 may thus receive patient images from the imaging system and (e.g., based on data generated by locator camera 20 as described herein) determine the pose of tracker 16 coupled to the imaging system corresponding to the images. Navigation controller 24 may then segment each image to determine one or more virtual objects in the coordinate system of that image, and, based on the pose of tracker 16 coupled to the imaging system corresponding to the image and a fixed relationship between tracker 16 and the coordinate system of the image, determine the pose of such virtual objects in a known coordinate system (e.g., the locator coordinate system LCLZ). Navigation controller 24 may then be configured to control the operation of robot manipulator 14 and / or ultrasound instrument 15 based on the tracking position of the distal region 84 of tip 82 relative to the virtual objects in a known coordinate system (e.g., via tracker 16B coupled to ultrasound instrument 15).

[0060] See you again Figure 1 The ultrasonic instrument 15 may form part of the end effector of the robot manipulator 14. The robot manipulator 14 may include a base 64, a plurality of links 66 extending from the base 64, and a plurality of active joints 68 for moving the ultrasonic instrument 15 relative to the base 64. The links 66 may be configured as follows: Figure 1 The illustrated tandem arm structure, parallel arm structure, or other suitable structure may be used. The robot manipulator 14 may include the ability to operate in a manual mode, in which a user grasps the end effector of the robot manipulator 14 to induce movement of the ultrasound instrument 15 (e.g., directly, or measured by force / torque sensors that induce active actuation of the robot manipulator 14). In this case, at least one of the virtual objects generated by the navigation controller 24 may be a tactile object, which (such as based on the tracking posture of the ultrasound instrument 15 relative to the tactile object) generates a force (e.g., positive or negative) on the robot manipulator 14 to guide the user to position the ultrasound instrument 15 to treat target tissue. Non-limiting examples of tactile objects and corresponding operations of the robot manipulator 14 based on such objects are described in U.S. Patent Nos. 9,775,681 and 10,398,449, the contents of each of which are incorporated herein by reference in their entirety.

[0061] The robotic manipulator 14 may also include a semi-autonomous mode in which the ultrasonic instrument 15 is moved by the robotic manipulator 14 along a predefined toolpath (e.g., the active joint 68 of the robotic manipulator 14 is manipulated to move the ultrasonic instrument 15 without requiring a user to apply force / torque to the end effector). An example of operation in the semi-autonomous mode is described in U.S. Patent No. 9,119,655, the entire contents of which are incorporated herein by reference. A separate tracker 16 may be attached to the base 64 of the robotic manipulator 14 to also track the movement of the base 64 via the locator camera 20.

[0062] Similar to the surgical navigation system 12, the robot manipulator 14 may house a manipulator controller 70 configured to implement the functions, features, and procedures of the robot manipulator 14 described herein. During surgical procedures, the manipulator controller 70 may be configured to determine, for example, based on navigation data received from the navigation controller 24, the desired location where the ultrasound instrument 15 should be moved. Based on this determination, and information relating to the current position of the ultrasound instrument 15, the manipulator controller 70 may be configured to determine the extent to which link 66 needs to be moved to reposition the ultrasound instrument 15 from its current position to the desired location. Data indicating where link 66 will be repositioned may be forwarded to a joint motor controller (e.g., a joint motor controller for controlling each motor) that controls the active joints 68 of the robot manipulator 14. In response to receiving such data, the joint motor controller may be configured to move link 66 according to the data, and thus move the ultrasound instrument 15 to the desired location.

[0063] See now Figure 2 The ultrasonic ablation system 11 may include a console 80 and an ultrasonic instrument 15 coupled to the console 80. The ultrasonic instrument 15 may include a tip 82 having a distal region 84 configured to contact and manipulate patient tissue. During operation, the console 80 may be configured to generate and supply an AC drive signal to the ultrasonic instrument 15, which induces ultrasonic energy in the ultrasonic instrument 15, thereby causing the distal region 84 of the tip 82 to vibrate rapidly. The operator can then position the vibrating distal region 84 of the tip 82 (also referred to as the tip head 84) against the patient tissue to ablate the contacted tissue. The frequency, amplitude, and velocity of the vibration of the tip 82 may correspond to the frequency, amplitude, and velocity of the supplied AC drive signal.

[0064] The ultrasound instrument 15 may include a handpiece 86 for an operator to grip and manipulate against patient tissue. A tip 82 may be removably attached to the handpiece 86, allowing the handpiece 86 to be used with different interchangeable tips 82. The different tips 82 removably attached to the handpiece 86 can be configured for different types of procedures. For example, some tips 82 removably attached to the handpiece 86 may be configured for ablation of soft tissue, such as by inducing cavitation in such tissue. Tips 82 configured for ablation of soft tissue may define a lumen for providing suction at the surgical site via the tip 82. Some tips 82 removably attached to the handpiece 86 may be configured for ablation of hard tissue, such as fibrous tissue and bone. Tips 82 configured for ablation of hard tissue may feature a tip head 84 formed with teeth or grooves sized to remove tissue via a cutting action. Tips 82 removably attached to the handpiece 86 may also have different lengths to operate at different depths of the patient's anatomy. Some tips 82 removably attached to the handpiece 86 may be designed to vibrate only longitudinally at their tip head 84, while other tips 82 removably attached to the handpiece 86 may be designed to vibrate longitudinally and torsionally and / or substantially torsionally at their tip head 84.

[0065] The handheld component 86 can form the proximal end of the ultrasound device 15, and the tip 82 connected to the handheld component 86 can form the distal end of the ultrasound device 15. "Proximal" can be understood as the tissue that is towards the operator holding the ultrasound device 15 and away from the tissue to which the tip 82 is applied, and "distal" can be understood as the tissue that is away from the operator and towards the tissue to which the tip 82 of the ultrasound device 15 is applied.

[0066] See now Figure 3 The handheld component 86 may include a housing 88 defining a handle for an operator to grip and manipulate the ultrasonic instrument 15, and may also include a transducer 90 disposed within a cavity defined by the housing 88. The transducer 90 may include one or more actuators 92, such as piezoelectric crystals. The actuators 92 may be disc-shaped and may be stacked end-to-end within the housing 88. Each actuator 92 may be formed of a material that undergoes instantaneous expansion and contraction along the longitudinal axis of the actuator 92 (i.e., an axis extending between the proximal and distal faces of the actuator 92) when alternating current is applied. Insulating discs may be disposed between adjacent actuators 92 and abut against adjacent actuators 92. The transducer 90 may also include a tube 94 extending through the collinear longitudinal axes of the respective actuators 92.

[0067] A proximal mass, such as that described in U.S. Patent 10,16,209, the contents of which are incorporated herein by reference in their entirety, may also be disposed in the cavity defined by housing 88 and attached to the proximal face of actuator 92 located on the nearest side. In some embodiments, tube 94 may include an exposed proximal section fixedly attached to the mass. In some examples, this proximal section of tube 94 may be threaded, in which case the mass may be a nut.

[0068] The handheld component 86 may also include an amplitude rod 96, at least partially disposed within a clearance defined by the housing 88. The amplitude rod 96 may be coupled to the distal end of the transducer 90. The amplitude rod 96 may be constructed of a rigid steel alloy, titanium, or similar materials. In operation, the amplitude rod 96 may oscillate as the transducer 90 expands and contracts. The amplitude rod 96 may be removably coupled to the transducer 90. For example, the proximal end of the amplitude rod 96 may include a male threaded connector, and the distal end of the transducer 90 may include a corresponding female threaded connector. Alternatively, the transducer 90 and the amplitude rod 96 may be permanently coupled via welding, adhesive, or similar bonding processes.

[0069] Tip 82 can be removably coupled to luffing rod 96. More specifically, the distal end of luffing rod 96 may include a threaded connector configured to engage a corresponding thread on the proximal end of tip 82. It is also conceivable that other coupling methods can be used to removably couple tip 82 to luffing rod 96. For example, the distal end of luffing rod 96 may include features that allow snap-fit ​​engagement with tip 82.

[0070] See you again Figure 2 The ultrasound instrument 15 can be removably coupled to the console 80 via a power cable 98 (also referred to herein as cable 98). One end of the cable 98 may be permanently connected to a proximal end of the housing 88 of the ultrasound instrument 15, and the other end of the cable 98 may include an adapter 100 corresponding to a receptacle 102 of the console 80. The receptacle 102 may be shaped to receive the adapter 100 and may include electrical contacts corresponding to the electrical contacts of the adapter 100, such that an electrical connection is formed between the ultrasound instrument 15 and the console 80 when the adapter 100 is fully seated in the receptacle 102.

[0071] When the ultrasonic instrument 15 is actuated, the console 80 can generate an AC drive signal and provide it to the ultrasonic instrument 15 via cable 98. The ultrasonic instrument 15 can be designed such that the AC drive signal from the console 80 is applied in parallel to each of the drivers 92 in the transducer 90, causing each driver 92 to expand and contract simultaneously along the longitudinal axis of the transducer 90 according to the AC drive signal. The length of the stacked structure of the drivers 92 can be between 1 cm and 5 cm. The distance or amplitude that the drivers 92 move in a single expansion / contraction cycle can be between 0.01 and 10 micrometers.

[0072] The amplitude rod 96 can be configured to amplify this movement. Thus, the distal end of the amplitude rod 96 and the (extended) tip 82 can each move back and forth along their longitudinal axis between a fully retracted position and a fully extended position, thereby generating longitudinal vibrational motion. As some examples, the maximum peak-to-peak (or inter-peak) vibration of the tip head 84 (representing a single movement from the fully retracted position to the fully extended position) can be 1000 micrometers, 500 micrometers, or 300 micrometers. As previously described, some tips 82 removably coupled to the handpiece 86 can be configured to vibrate longitudinally and torsionally and / or substantially torsionally at their tip heads 84. Such tips 82 may include features along their length, such as helical grooves, configured to convert at least a portion of the longitudinal vibration applied to the proximal end of the tip 82 into vibration having both longitudinal and torsional components and / or substantially only a torsional component at the tip head 84.

[0073] Now for reference Figure 2 and Figure 3 Both, to help reduce heat generation during operation, the ultrasound device 15 may define a flushing path for supplying flushing fluid to the distal region 84 of the tip 82 and the surgical site. For this purpose, the ultrasound device 15 may include a flushing sleeve 104 adapted to be disposed around the tip 82 and removably coupled to a handpiece 86, such as a housing 88 of the handpiece 86, for supplying flushing fluid at least to the distal region 84 of the tip 82 and the surgical site.

[0074] The flushing sleeve 104 may include a sleeve body 106 having a proximal and distal opening and defining a lumen 108 extending between the proximal and distal openings. The sleeve body 106 may be adapted to be coupled to a handpiece 86, such as the housing 88 of the handpiece 86, such that a tip 82 extends through the lumen 108 and extends distally from the opening of the sleeve body 106. For example, the proximal end of the sleeve body 106 may be formed with coupling features for releasably coupling the sleeve body 106 to the distal end of the housing 88. When positioned on the tip 82 and coupled to the housing 88, the sleeve body 106 may be radially spaced from the tip 82 and longitudinally spaced from the tip head 84 as described above. Components of the ultrasonic instrument 15 may be sized such that the tip 82 does not contact the flushing sleeve 104 during normal operation.

[0075] During operation of the ultrasound instrument 15, flushing fluid can flow from the handpiece 86 into the gap between the tip 82 and the sleeve body 106, and then out to the distal end of the opening of the sleeve body 106. More specifically, the handpiece 86 may include a flushing conduit 110 extending from the proximal end of the handpiece 86 through the housing 88 to the distal end. The proximal end of the flushing conduit 110 may be coupled to a connector 112 of the ultrasound instrument 15, which extends from the proximal end of the handpiece 86 for receiving a flushing line 114. The flushing line 114 may be coupled via a housing 118 to a fluid supply source 116, which may be configured to insert into a corresponding slot 120 of the console 80. During operation of the ultrasound ablation system 11, a pump 122 of the console 80 may be operated on the housing 118 to draw fluid from the fluid supply source 116 into the flushing line 114, and then into the flushing conduit 110.

[0076] The flushing sleeve 104 may similarly include a flushing conduit 124 in fluid communication with a lumen 108 defined by the sleeve body 106. The flushing conduit 124 extends from the proximal end of the sleeve body 106 and adjacent to the lumen 108 to an orifice 126 formed in the wall of the lumen 108. The orifice 126 may be positioned at an intermediate location between the proximal and distal ends of the lumen 108 and may be configured to supply flushing fluid from the flushing conduit 124 into a gap between the tip 82 and the sleeve body 106. When the flushing sleeve 104 is coupled to the handheld device 86, the proximal end of the flushing conduit 124 of the flushing sleeve 104 may be adapted to fluidly engage the distal end of the flushing conduit 110 of the handheld device 86.

[0077] Thus, during operation of the ultrasonic instrument 15, flushing fluid can flow from the fluid supply source 116 through the flushing line 114, connector 112, and conduits 110, 124, and exit through orifice 126 into lumen 108. This flushing fluid can then flow distally along lumen 108 and exit at the distal end of the opening of sleeve body 106. In an alternative example, instead of being configured to receive flushing fluid passing through handpiece 86, flushing sleeve 104 may include a connector in fluid communication with flushing conduit 124 and disposed on the outer surface of sleeve body 106 for receiving flushing line 114 extending outside handpiece 86. In this case, during operation of the ultrasonic instrument 15, flushing fluid can similarly flow via the connector through the gap between tip 82 and sleeve body 106 and exit at the distal end of the opening of sleeve body 106.

[0078] The ultrasound instrument 15 may also define an aspiration path for providing aspiration at the surgical site via the distal region 84 of the tip 82. For example, the tube 94 of the transducer 90 may define a lumen extending from the proximal end to the distal end of the transducer 90 to form a fluid passage through the transducer 90. Similarly, the amplitude rod 96 may define a lumen extending from the proximal end to the distal end of the amplitude rod 96 to form a fluid passage through the amplitude rod 96, and the tip 82 may also define a lumen extending from the proximal end to the distal end of the tip 82 to form a fluid passage through the tip 82. In general, these lumens may form at least a portion of the aspiration path extending from the distal region 84 of the tip 82 to the proximal end of the handpiece 86.

[0079] The ultrasound instrument 15 may also include a connector 128, which is coupled to the tube 94 and extends proximally from the handpiece 86 for receiving the aspiration line 130. During the procedure, aspiration or suction can be applied via the connector 128 and the aspiration line 130 to a fluid path defined by the tube 94, the amplitude rod 96, and the tip 82 to aspirate and remove irrigation fluid applied to the surgical site and surgical debris entrained in the fluid toward and from the proximal end of the handpiece 86. More specifically, the console 80 may include a vacuum pump 132, which is in fluid communication with the waste container 134 via the container 118 when the container 118 is inserted into the console 80, wherein the waste container 134 is positioned separately in fluid communication with the fluid path defined by the tube 94, the amplitude rod 96, and the tip 82 via the fluid path defined by the connector 128, the aspiration line 130, and the container 118. In this manner, the vacuum pump 132 can apply suction through the waste container 134, connector 128, suction line 130, and cartridge 118 to the fluid channel defined by tube 94, amplitude rod 96, and tip 82, thereby drawing material from the surgical site through the aforementioned fluid channel into the waste container 134. This suction can also be used to aspirate or pull tissue toward the tip 84, which can improve the effectiveness of the tip 82 in handling patient tissue.

[0080] The console 80 may also include a user interface 28B for receiving user input and providing information to the user. Figure 5 For example, console 80 may include a display 136 for presenting information to the practitioner, forming components of user interface 128B. Non-limiting examples of the presented information may include identification of the ultrasound instrument 15 currently connected to console 80, or more specifically, the handheld device 86 and / or tip 82, and the operational status of the ultrasound ablation system 11. Display 136 may be a touchscreen display, enabling the practitioner to provide input to console 80, such as via on-screen controls.

[0081] The operator can interact with on-screen controls to set operating parameters of the ultrasound resection system 11, such as the ultrasound energy level, aspiration level, irrigation level, and / or pulse level of the ultrasound instrument 15, as described in PCT Publication WO 2022 / 072903 A1, the entire contents of which are incorporated herein by reference. In some embodiments, the console 80 can be configured to determine a predefined maximum level for one or more of these operating parameters (e.g., based on data read from the ultrasound instrument 15 when it is connected to the console 80), and the setting (value) of each such operating parameter entered by the practitioner can indicate the percentage of the predefined maximum level that the ultrasound instrument 15 will actually use relative to that operating parameter. The operator can also interact with on-screen controls to select a set of one or more tissue types involved in a given type of surgery and / or a given aspect of a surgery, as described in more detail below.

[0082] The user interface 128B of the ultrasonic ablation system 11 may also include one or more actuators coupled to the console 80. When triggered by a practitioner, each actuator causes the console 80 to generate an AC drive signal and provide it to the ultrasonic instrument 15, which induces ultrasonic energy in the ultrasonic instrument 15 to vibrate the tip 82.

[0083] For example, one or more actuation devices may include a foot pedal 138. The foot pedal 138 may be wirelessly connected to the console 80, such as via an adapter 140 connected to the console 80. When pressed, the foot pedal 138 may change from an off position to an active position, and a corresponding signal indicating the pressing may be transmitted to the console 80. In some cases, the transmitted signal may also vary with the degree to which the foot pedal 138 is pressed, such as to allow the practitioner to change the target ultrasound energy level (e.g., target power level) of the ultrasound instrument 15 up to the maximum ultrasound energy level of the ultrasound instrument 15. The maximum ultrasound energy level of the ultrasound instrument 15 may be a predefined maximum level of the ultrasound instrument 15, such as indicated by data read from the ultrasound instrument 15, or a maximum level set by the practitioner, such as a percentage of the predefined maximum level as described above. In response to receiving an actuation signal, the console 80 may generate an AC drive signal and provide it to the ultrasound instrument 15, which causes the tip 82 to vibrate according to the current setting of the console 80 and / or the degree of pressing indicated by the actuation signal.

[0084] The user interface 128B of the ultrasound resection system 11 may also include a remote control 142 coupled to the console 80. Similar to the display 136, the remote control 142 may provide practitioner-selectable elements for enabling the practitioner to input data into the console 80. For example, the remote control 142 may include buttons for setting operating parameters of the ultrasound resection system 11, such as the ultrasound energy level, aspiration level, irrigation level, and / or pulse level of the ultrasound instrument 15. The remote control 142 may also include a main power switch for turning the console 80 on and off. Additionally or alternatively, the console 80 may include a main power switch 144 for turning the console 80 on and off.

[0085] Figure 4A and 4B The diagram illustrates the circuitry of the ultrasonic instrument 15 when an AC drive signal is supplied from the console 80. As shown in the example, the current flowing through the ultrasonic instrument 15 from the supplied AC drive signal... It can be decomposed into two components: the current applied to the driver 92 of the ultrasonic instrument 15. and the current applied to the mechanical components of the ultrasonic instrument 15 The equivalent value (also referred to in this paper as "mechanical current") The mechanical components of the ultrasound device 15 may include those components that vibrate in response to a provided AC drive signal to treat patient tissue, such as, but not limited to, the actuator 92, tube 94, amplitude rod 96, tip 82, and proximal mass block described above.

[0086] Impedance provided by driver 92 It can be primarily capacitive. Therefore, the driver 92 can be composed of capacitors. The capacitor is represented by [capacitor name]. The capacitor of driver 92 [is also mentioned]. The capacitance of the ultrasound device 15 can remain substantially constant during operation and can therefore be determined and provided to the console 80 before operation or surgery (such as when the ultrasound device 15 is connected to the console 80) so that the operation of the console 80 can be adjusted to suit the specific handpiece 86 of the ultrasound device 15. Alternatively or additionally, the console 80 may be configured to periodically measure the capacitance of the driver 92 during operation of the ultrasound device 15. This allows for the achievement of even greater precision.

[0087] Impedance provided by the mechanical components of the ultrasonic instrument 15 The equivalent value (also referred to in this paper as "mechanical impedance") This can include inductive, resistive, and capacitive components. Therefore, mechanical components can be made of materials with inductive properties. Inductors with resistance Resistors and resistors with capacitance The capacitor is represented by its mechanical impedance. It can vary as the ultrasonic instrument 15 is operated. For example, at least the resistance (also referred to as "mechanical resistance" in this article) The capacitance can vary in relation to (or as a function of) the mechanical damping exerted by the tissue in contact with the distal region 84 of the tip 82, and at least the capacitance This can vary in relation to (or as a function of) the mechanical stiffness of the tissue in contact with the distal region 84 of the tip 82. Therefore, in some embodiments, mechanical resistance can be used. To determine whether there is tissue load in the distal region 84 of the tip 82, as described in more detail below.

[0088] The ultrasonic energy induced in the ultrasonic instrument 15 and the corresponding vibration of the tip 82 can be combined with the mechanical current induced in the ultrasonic instrument 15. Proportional. More specifically, the frequency of the vibration at the 84 points on the tip can be equal to the mechanical current. The frequency, and the amplitude of the vibration can be related to the mechanical current. The amplitude is proportional. For example, when the ultrasonic instrument 15 operates at resonance, the peak-to-peak or inter-peak displacement (in micrometers) of the tip 84, depending on the gain of the tip 82, can be a mechanical current. Approximately 180% to 220% of the amplitude (in milliamperes). As an example, a mechanical current with an amplitude of 150 milliamperes at the resonant frequency of the ultrasonic instrument 15. This can cause the tip 84 of a given tip 82 to vibrate back and forth along a travel path of approximately 330 micrometers. Therefore, the console 80 can induce vibrations in the tip 82 with a target frequency and displacement level by providing the ultrasonic instrument 15 with an AC drive signal induced in the ultrasonic instrument 15 by the mechanical current induced by this AC drive signal. It has the target frequency and the amplitude corresponding to the target displacement level.

[0089] See you again Figure 5 The console 80 may include an ultrasound controller 150, a console storage device 152, and a power supply 154, the power supply being used to generate an AC drive signal (such as based on a control signal from the ultrasound controller 150) to provide to the ultrasound instrument 15. Specifically, the ultrasound controller 150 may be configured to apply a control signal to the power supply 154, the control signal adjusting the frequency and voltage of the AC drive signal output to the ultrasound instrument 15.

[0090] Power supply 154 may include a DC power supply 156, an amplifier 158, and a transformer 160. During operation of the ultrasonic ablation system 11, DC power supply 156 may output a DC signal to the center tap of the primary winding 162 of transformer 160. The opposite end of the primary winding 162 may be connected to amplifier 158, which may be configured to generate an AC signal on the primary winding 162 from the applied DC signal by applying a varying resistance level to both ends of the primary winding 162. The AC signal generated on the primary winding 162 may induce a proportional AC drive signal on the secondary winding 164 of transformer 160, which may be connected to ultrasonic instrument 15 via electrical contact 166. Further understanding of the components of power supply 154 can be found in PCT Publication WO 2016 / 183084 A1, the contents of which are incorporated herein by reference in their entirety.

[0091] like Figure 6 As shown, electrical contact 166 can be integrated with socket 102 of console 80. Corresponding electrical contact 168 can be integrated with adapter 100 of cable 98. When adapter 100 is fully seated in socket 102, electrical contacts 166 and 168 can be aligned and form an electrical path through which AC drive signals from both ends of secondary winding 164 of transformer 160 are provided to ultrasonic instrument 15 to vibrate tip 82. Drivers 92 can be disposed within handheld component 86 such that AC drive signals are applied in parallel to each driver 92, thereby causing vibration of tip 82 according to the received AC drive signal.

[0092] See you again Figure 5The ultrasound controller 150 may be configured to implement the functions, features, processes, and methods of the console 80 described herein. For example, the ultrasound controller 150 may be configured to determine whether the operation of the ultrasound instrument 15 is in tissue sensing mode or tissue resection mode, and accordingly adjust the AC drive signal generated on the secondary winding 164. The ultrasound controller 150 may be configured to adjust the AC drive signal generated on the secondary winding 164 by adjusting the AC signal generated on the primary winding 162, such as by supplying a control signal to the DC power supply 156 to set the potential of the signal applied to the center tap of the primary winding 162, and / or by supplying a control signal to the amplifier 158 corresponding to a target AC drive signal to be generated on the secondary winding 164.

[0093] For example, the ultrasound controller 150 can be configured to sense a target AC drive signal on (or across) the secondary winding 164 by supplying a control signal to the amplifier 158, the control signal including at least one frequency corresponding to the frequency of the target AC drive signal and at least one amplitude proportional to the amplitude of the target AC drive signal. In some embodiments, the ultrasound controller 150 may be configured with a digital signal synthesis (DDS) component for generating the control signal. In response to receiving the control signal, the amplifier 158 can be configured to generate an AC signal proportional to the target AC drive signal on the primary winding 162, which in turn senses the target AC drive signal on the secondary winding 164 for supply to the ultrasound instrument 15. By adjusting the AC signals generated on the primary winding 162 and the secondary winding 164 of the transformer 160 in this way, the ultrasound controller 150 can be configured to control both the frequency and amplitude of the vibration of the tip 82.

[0094] In some embodiments, the ultrasound controller 150 may be configured to provide a pulsed AC drive signal to the ultrasound instrument 15, such that the amplitude of the AC drive signal varies between an upper amplitude and a lower amplitude over time. For this purpose, the ultrasound controller 150 may be configured, for example using a DDS, to generate a base AC signal having an ultrasonic frequency and a constant amplitude, and a modulation signal for amplitude modulation of the base AC signal. The ultrasound controller 150 may then be configured, for example using a multiplier, to combine these signals to generate a control signal for the power supply 154 corresponding to the target pulsed AC drive signal.

[0095] The ultrasound controller 150 can be configured to determine whether to initiate vibration of the tip 82 of the ultrasound instrument 15 by monitoring the state of the foot pedal 138. In response to the pressing of the foot pedal 138, the ultrasound controller 150 can be configured, for example via a corresponding control signal from the ultrasound controller 150, to cause the power supply 154 to provide an AC drive signal to the ultrasound instrument 15 corresponding to a target ultrasound energy level of the ultrasound instrument 15, such as determined in relation to: the degree of pressing of the foot pedal 138, the settings of the control console 80, the predefined maximum ultrasound instrument level of the ultrasound instrument 15, and / or the operating mode of the ultrasound ablation system 11 as described herein.

[0096] As previously described, the ultrasound controller 150 can be configured to induce vibrations with a target frequency and displacement level in the tip 82 by generating a control signal for the power supply 154. This control signal causes the power supply 154 to provide an AC drive signal to the ultrasound instrument 15, which induces a mechanical current in the ultrasound instrument 15 with a target frequency and an amplitude corresponding to the target displacement level. To this end, the ultrasonic controller 150 can be configured to implement two control loops to induce target vibration in the tip 82, namely, to regulate the mechanical current induced in the ultrasonic instrument 15 by the AC drive signal. The frequency control loop, and the mechanical current induced in the ultrasonic instrument 15 by the AC drive signal. The control loop is for the level (e.g., amplitude). Each control loop may contain a PID controller for efficiently regulating the AC drive signal to achieve the desired value, and may have an iteration cycle time of approximately 400 microseconds.

[0097] Using Ohm's law, the ultrasonic controller 150 can be configured to calculate the mechanical current induced in the ultrasonic instrument 15 using the following formula. Level: (1) in It is the current that provides the AC drive signal to the ultrasonic instrument 15. It is the frequency of the AC drive signal provided to the ultrasonic instrument 15. It is the capacitor of driver 92, and This is the voltage of the AC drive signal supplied to the ultrasonic instrument 15. An explanation of formula (1) is provided in the applicant's U.S. Patent 10,16,209, the contents of which are incorporated herein by reference in their entirety. Assume the frequency of the AC drive signal... Previously configured to achieve the target vibration characteristics (e.g., resonance) of the ultrasonic instrument 15, the ultrasonic controller 150 can, by setting the voltage of the AC drive signal... Make formula (1) generate the target level of mechanical current. The mechanical current at the target level should be sensed. This causes the target at tip 82 to vibrate accordingly.

[0098] As described above, an integral (or inherent) feature of the ultrasonic instrument 15 is its resonant frequency. The resonant frequency can be the frequency at which the distal region 84 of the tip 82 experiences vibrational motion within a peak range. In other words, assuming other electrical characteristics remain constant, the motion that the tip 82 can experience at the resonant frequency is greater in amplitude than the motion that occurs when the actuator 92 vibrates at frequencies less than or greater than that resonant frequency. For a longitudinally vibrating tip 82, the peak range can be understood as the maximum anterior-posterior distance of the distal end of the tip 82. The resonant frequency of the ultrasonic instrument 15 can vary during operation of the ultrasonic instrument 15.

[0099] The ultrasound controller 150 can be configured to adjust the frequency of the AC drive signal during operation of the ultrasound instrument 15 to track target vibration characteristics of the ultrasound instrument 15, such as resonance. Applicant U.S. Patent 10,16,209 discloses an exemplary means for adjusting the frequency of the AC drive signal to track the resonant frequency of the ultrasound instrument 15. Specifically, when the current through the driver 30... With mechanical current When the real part of the ratio is essentially zero, the ultrasonic instrument 15 can be considered to operate at resonance. Therefore, the ultrasonic controller 150 can be configured to determine the frequency of the AC drive signal. A value for makes the following formula hold: (2) in It is the current supplied to the AC drive signal of the ultrasonic instrument 15, and This is the capacitor of driver 92. In response to determining this value, ultrasound controller 150 can be configured to set the frequency of the AC drive signal to this value, thereby causing ultrasound device 15 to operate at or near resonance. Each value to which the frequency of the AC drive signal is adjusted in order to track the resonant frequency of ultrasound device 15 may generally be referred to as the determined or calculated resonant frequency of ultrasound device 15.

[0100] Additionally or alternatively, the ultrasound controller 150 may be configured to adjust the frequency of the AC drive signal using other means to track the resonant frequency of the ultrasound instrument 15. For example, the ultrasound controller 150 may be configured to determine the value of the frequency of the AC drive signal such that the current of the AC drive signal... Voltage of AC drive signal The phase difference between them is approximately zero, for example by implementing a phase-locked loop (PLL) for these signals. Alternatively or alternatively, the ultrasound controller 150 may be configured to target alternative vibrational characteristics of the ultrasound instrument 15 other than resonance, such as the anti-resonant frequency of the ultrasound instrument 15 (in which case, as an example, the right-hand side of equation (2) may be set to 1) or a target frequency between the resonant frequency and the anti-resonant frequency.

[0101] As the frequency of the AC drive signal is adjusted to follow the target vibration characteristics (such as resonance) of the ultrasonic instrument 15, a mechanical current is induced in the ultrasonic instrument 15. The level can vary. Therefore, in order to sense the target ultrasonic energy in the ultrasonic instrument 15, the ultrasonic controller 150 can be configured to repeatedly alternate or perform the following operations in parallel: adjusting the frequency of the AC drive signal to the target vibration characteristics, such as based on formula (2), and setting the voltage of the AC drive signal. This results in mechanical current (such as that calculated according to formula (1)). Corresponding to the target ultrasonic energy level.

[0102] For this purpose, the ultrasound controller 150 may be configured to receive feedback data corresponding to the AC drive signal provided to the ultrasound instrument 15, such as via one or more sensors of the console 80. For example, the console 80 may include a voltage for measuring the AC drive signal provided to the ultrasound instrument 15. The sensor may include a feedback coil 174 integrated with the transformer 160. The feedback coil 174 may be connected to a voltage measurement circuit 176 of the control console 80, which in turn may be connected to the ultrasound controller 150. The signal across the feedback coil 174 may be compared with the voltage of the AC drive signal supplied to the ultrasound instrument 15. There is a known relationship. Based on the signal across the feedback coil 174, the voltage measurement circuit 176 can generate and transmit to the ultrasound controller 150 a signal representing the voltage of the AC drive signal applied to the ultrasound device 15. The potential and phase of the AC drive signal. Therefore, the ultrasonic controller 150 can be configured to measure the voltage of the supplied AC drive signal via the voltage measurement circuit 176 and the feedback coil 174. And take action based on that.

[0103] As another example, the console 80 may include a current for measuring the AC drive signal supplied to the ultrasonic instrument 15. The sensor may include a coil 178 arranged adjacent to one of the conductors extending from the secondary winding 164 of the transformer 160 to the ultrasonic instrument 15. The coil 178 may be connected to a current measurement circuit 180 of the console 80, which in turn may be connected to the ultrasonic controller 150. The signal across the two ends of the coil 178 may be compared with the current of the AC drive signal supplied to the ultrasonic instrument 15. There is a known relationship. Based on the signal across coil 178, current measurement circuit 180 can generate and transmit to ultrasound controller 150 a current representing the AC drive signal applied to ultrasound instrument 15. The signal has both amplitude and phase. Therefore, the ultrasonic controller 150 can be configured to measure the current of the supplied AC drive signal via the current measurement circuit 180 and the coil 178. And take action based on that.

[0104] As described above, the ultrasonic controller 150 can be configured to operate based on the voltage of the acquired AC drive signal. and / or current The measurement results are used to adjust the frequency and voltage of the provided AC drive signal. Furthermore, during operation of the ultrasound device 15, the console 80, or more specifically the ultrasound controller 150, can be configured based on the voltage of the provided AC drive signal. and / or current The measurement results determine whether the ultrasound instrument 15 is under load (e.g., in contact with patient tissue), and if so, the type of tissue being contacted is determined using a set frequency of the AC drive signal (e.g., the determined resonant frequency of the ultrasound instrument 15). The ultrasound controller 150 (such as in cooperation with the navigation controller 24 and / or the manipulator controller 70) can then be configured to adjust the operation of the surgical system 10 based on the determined tissue type (e.g., according to a predefined ultrasound energy distribution associated with the determined tissue type, stored in the console storage device 152 or the navigation storage device 25).

[0105] For example, but not limited to, in response to determining a tissue type corresponding to the tissue being the target for resection, the ultrasound controller 150 may be configured to switch the operation of the ultrasound instrument 15 from tissue sensing mode to tissue resection mode. Conversely, in response to determining a tissue type corresponding to tissue that is not the target for resection, the ultrasound controller 150 may be configured to switch the operation of the ultrasound instrument 15 from tissue resection mode to tissue sensing mode. Additionally or alternatively, in response to determining a tissue type corresponding to tissue that is the target for resection but is located near a critical structure or other non-target tissue, such as when the ultrasound instrument 15 is resecting bone and is about to cut through the outer wall of the bone, the ultrasound controller 150 may be configured to stop the operation of the ultrasound instrument 15, or to operate the ultrasound instrument 15 in tissue resection mode at a reduced power level, such as by reducing the target ultrasound energy level and / or pulsed the AC drive signal to induce vibration pulses extending between a set target ultrasound energy level and a lower level, as disclosed in PCT application PCT / US2023 / 017790.

[0106] Additionally or alternatively, as described above, the navigation controller 24 may be configured to track the orientation of the ultrasound instrument 15 relative to a virtual object associated with patient tissue in a known coordinate system, or more specifically, to track the position of the distal region 84 of the tip 82, such as for displaying guidance information, controlling the operation of the ultrasound instrument 15, and / or controlling the movement of the robotic manipulator 14 based on the tracked orientation. The virtual object may typically correspond to the boundary of one or more tissue types. Accordingly, in response to determining that the ultrasound instrument 15 is in contact with a given tissue type, the navigation controller 24, cooperating with the ultrasound controller 150 of the ultrasound ablation system 11, may be configured to determine whether the determined tissue type corresponds to the tissue type indicated by the position of the distal region 84 of the tracked tip 82 relative to the virtual object. If they do not correspond, the navigation controller 24 may be configured to adjust the parameters (e.g., shape, position, orientation) of the virtual object in the known coordinate system based on the determined tissue type, such that the adjusted virtual object represents the determined tissue type at the corresponding tracked position of the distal region 84 of the tip 82.

[0107] As described above, in some embodiments, one or more virtual objects may be tactile objects used to control the robot manipulator 14, such as to guide the movement of the ultrasonic instrument 15. In this case, the navigation controller 24 may be configured to adjust the parameters of the virtual object based on a determined tissue type by adjusting the position, posture, and / or torque / force associated with the tactile object, as described in more detail below.

[0108] As another example, in response to the determined tissue type corresponding to the patient anatomy of interest (e.g., bone), the navigation controller 24 can be configured to automatically begin tracking the patient anatomy by movement of the distal region 84 of the tracking tip 82, such as as long as the determined tissue type continues to correspond to the patient anatomy of interest, in order to generate a virtual model of the patient anatomy.

[0109] Alternatively or concurrently, the navigation controller 24 may be configured to cooperate with the ultrasound controller 150 to track the surgical resection status based on the determined tissue type indicated by the ultrasound controller 150 and the tracking posture of the ultrasound instrument 15 corresponding to the determined tissue type. More specifically, based on the tissue type determined with the ultrasound instrument 15, the navigation controller 24 may be configured to calculate an estimated volume of the target resection tissue that has been removed with the ultrasound instrument 15 and compare the calculated volume with the planned resection volume (e.g., determined based on preoperative images of the target site). The navigation controller 24 may then be configured to display the resection status via a user interface 28A, such as as a percentage or as a graph displaying a virtual model or patient image corresponding to the target site, wherein the portions that have been removed and / or have not yet been removed, indicating the target volume, are highlighted.

[0110] The console storage device 152 may store data supporting the functions, features, processes, and methods of the console 80 or more specifically the ultrasound controller 150 described herein. For example, but not limited to, the console storage device 152 may store waveform data 170 and tissue type data 172. Waveform data 170 may include one or more DDS arrays, each representing a different waveform, such as a sine wave, and said waveform data may be used by the ultrasound controller 150 to generate control signals as described above. Tissue type data 172 may map different potential operating characteristics of the ultrasound instrument 15 (such as characteristics related to the determined resonant frequency of the ultrasound instrument 15) to different tissue types, such as determining the tissue type being contacted by the distal region of the tip 82 by indicating one or more thresholds. Examples of tissue type data 172 are described in more detail below.

[0111] The console 80 may also include a memory reader 182 for communicating with one or more electronic memory storage devices integrated with the ultrasound instrument 15. The ultrasound instrument 15 may include one or more electronic memory storage devices for storing data that identifies the ultrasound instrument 15 or more specifically, the handpiece 86 and / or tip 82. The stored data may also define operational data specific to the ultrasound instrument 15 or more specifically, the handpiece 86 and / or tip 82. Non-limiting examples of operational data may include the maximum current of the provided AC drive signal and the maximum mechanical current of the provided AC drive signal. The data includes the maximum voltage of the provided AC drive signal, the minimum and maximum frequencies of the provided AC drive signal, the PID coefficients used to adjust the provided AC drive signal, the capacitance of the driver 92, and usage history. In some embodiments, the operational data may also include data indicating whether the ultrasound instrument 15 or more specifically the handpiece 86 and / or tip 82 is available for tissue sensing mode and / or tissue resection mode with sensing capabilities, as well as ultrasound instrument 15-specific data for facilitating such modes, as described in more detail below.

[0112] For example, see again Figure 6 The handheld device 86 of the ultrasound device 15 may include a handheld device (HP) memory 184 disposed therein. As a non-limiting example, the HP memory 184 may be an EPROM, EEPROM, or an RFID tag. In response to the ultrasound device 15 being connected to the console 80, the ultrasound controller 150 may be configured to read data stored in the HP memory 184 using a memory reader 182 and adjust the operation of the console 80 based on the read data. More specifically, the console 80 may include a communication interface, such as a coil 186, connected to the memory reader 182. The coil 186 may be integrated with the socket 102 of the console 80. The HP memory 184 may be similarly connected to the coil 188, which may be integrated with the adapter 100 of the cable 98. When the ultrasound device 15 is connected to the console 80 via the power cable 98, the coils 186 and 188 may be aligned and able to inductively exchange signals. The ultrasound controller 150 may then be configured to read data from and write data to the HP memory 184 via the coils 186 and 188.

[0113] More specifically, the memory reader 182 can be configured to convert the signal across coil 186 into a data signal readable by the ultrasound controller 150. The memory reader 182 can also be configured to receive data to be written to the HP memory 184 from the ultrasound controller 150 and generate a signal across coil 186 that causes the data to be written to the HP memory 184. The structure of the memory reader 182 can be complementary to the structure of the HP memory 184. Therefore, continuing with the above non-limiting example, the memory reader 182 can be a component capable of reading data from and writing data to an EPROM, EEPROM, or RFID tag.

[0114] As an addition to or alternative to the HP memory 184, the ultrasound instrument 15 may include a tip memory 190. As described above, the tip 82 can be removed from the handpiece 86, so the handpiece 86 can be used with different interchangeable tips 82, and the different tips 82 can have different structural features and operational limitations. Therefore, the HP memory 184 can store data identifying the handpiece 86 and operating parameters specific to the handpiece 86, including the capacitance of the driver 92 and operating parameters specific to the secondary drive component (which can be powered by the handpiece 86) of the provided AC drive signal, and the tip memory 190 can store data identifying the tip 82 currently connected to the handpiece 86 and operating parameters specific to that tip 82. Because the tip 82 and the sleeve 42 can be shipped together as a single package, the tip memory 190 can be placed in the sleeve 42. When the ultrasound instrument 15 has sensing capabilities, the tip memory 190 may also store tissue type data 172A and tissue sensing data 191 specific to the tip 82, as described in more detail below. The tip memory 190 can be the same type of memory as HP memory 184 (e.g., EPROM, EEPROM, or RFID tag).

[0115] In response to the connection of the ultrasound device 15 to the console 80, the ultrasound controller 150 can thus be configured to read data stored in the HP memory 184 and the tip memory 190 using the memory reader 182, and adjust the operation of the console 80 to adapt to a specific combination of handpiece 86 and tip 82 coupled to the console 80. In some cases, the tip memory 190 may include values ​​of the same operating parameters as the HP memory 184. Where the values ​​of a given operating parameter differ between the HP memory 184 and the tip memory 190, the ultrasound controller 150 can be configured to manage the operation of the ultrasound device 15 using the more stringent value. Alternatively or additionally, where both the HP memory 184 and the tip memory 190 include values ​​of a given operating parameter, the ultrasound controller 150 can be configured to derive a value (e.g., the maximum current of the main drive component of the AC drive signal) based on a combination of values ​​stored in these memories (e.g., summing or averaging these values) to manage the operation of the ultrasound device 15.

[0116] Similar to the HP memory 184, the ultrasound controller 150 can read data from and write data to the tip memory 190 via the memory reader 182 and the coil 186. Specifically, the handheld device 86 may include two conductors 192 extending from a proximal region to a distal region of the handheld device 86. The proximal end of the conductor 192 may be coupled to a coil 188, which may be integrated with the adapter 100 of the cable 98. The distal end of the conductor 192 may be coupled to another coil 194 located in the distal region of the handheld device 86. A corresponding coil 196 may be located in the proximal region of the sleeve 42. When the sleeve 42 is positioned around the tip 82 and fitted to the handheld device 86, the coils 194 and 196 can be aligned and can inductively exchange signals. When the handheld device 86 is connected to the console 80 via the cable 98, the coils 186 and 188 can also be aligned and can inductively exchange signals. Then, the ultrasound controller 150 can read data from and write data to the tip memory 190 via conductor 192 through inductive communication provided by coils 186, 188 and coils 194, 196.

[0117] Refer again Figure 5 The ultrasound controller 150 can also be connected to and configured to drive the display 136 of the console 80, and can be connected to the remote controller 142. As previously described, the ultrasound controller 150 can be configured to generate information and user interface (UI) components for presentation on the display 136, and when the display 136 is a touchscreen display, the ultrasound controller 150 can also be configured to cause the display 136 to depict images of buttons and other user-selectable components for setting desired operating parameters of the ultrasound ablation system 11. The remote controller 142 may also include user-interactive elements for setting desired operating parameters of the ultrasound ablation system 11 from a location remote from the console 80.

[0118] Figure 7 and 8 Procedures 700 and 800 for sensing and removing tissue using an ultrasonic instrument 15 are illustrated. Procedures 700 and 800 may be implemented by one or more controllers of the surgical system 10. Although the following description relates to determining a frequency corresponding to the resonant frequency of the ultrasonic instrument 15, it should be understood that other targeted vibrational characteristics of the ultrasonic instrument 15 may be used.

[0119] First see Figure 7 At box 702, data can be read from the ultrasound device 15, or more specifically from the HP memory 184 and / or tip memory 190 of the ultrasound device 15, such as via the ultrasound controller 150. As described above, the read data can indicate the capacitance of at least one driver 92, the maximum mechanical current of the ultrasound device 15, etc. Tissue type data 172A and / or tissue sensing data 191. Tissue type data 172A may indicate the no-load resonant frequency of the ultrasound device 15, i.e., the expected resonant frequency of the ultrasound device 15 when the tip 82 vibrates in free air and / or does not contact tissue. Additionally or alternatively, tissue type data 172A may include data that maps different potential operating characteristics of the ultrasound device 15 (such as characteristics associated with the determined resonant frequency of the ultrasound device 15) to different tissue types, such as determining the type of tissue being contacted by the distal region 84 of the tip 82 based on the determined resonant frequency by indicating one or more thresholds specific to the tip 82. Tissue sensing data 191 may indicate one or more parameters (e.g., target mechanical current) of the AC drive signal provided to the ultrasound device 15, at least in tissue sensing mode. This includes pulse parameters, such as those for each of the different tissue types and / or surgical types that can be selected by the operator. The ultrasound controller 150 can be configured to read such data from the ultrasound instrument 15 and temporarily store it in the console storage device 152 for adjusting the operation of the ultrasound instrument 15. Therefore, references to tissue type data 172 below may refer to tissue type data 172A that has been read from the ultrasound instrument 15.

[0120] At box 704, objects of interest (such as the distal region 84 of the tip 82 of the ultrasound instrument 15 and patient tissue in and around the target site) can be tracked in a known coordinate system (such as the locator coordinate system LCLZ) and, as described above, in cooperation with the navigation controller 24 and the tracker 16 set relative to each object. A virtual object corresponding to the tracked object of interest can then be generated in the known coordinate system.

[0121] At box 706, it can be determined whether the ultrasound device 15 is actuated (e.g., by the ultrasound controller 150). For example, the ultrasound controller 150 may be configured to monitor the pressing of the foot pedal 138, as described above.

[0122] At box 708, it can be determined whether the ultrasound device 15 is operated in tissue resection mode or tissue sensing mode. As previously described, tissue resection mode can induce vibrations in tip 82 that are configured to ablate patient tissue. Conversely, tissue sensing mode can induce vibrations in tip 82 that are configured to detect the type of tissue contacted by the distal region 84 of tip 82 without inducing resection. In some embodiments, determining whether the ultrasound device 15 is operated in tissue resection mode or tissue sensing mode can be based on user settings input to surgical system 10, such as via console 80. Alternatively or additionally, in response to initial actuation of ultrasound device 15, process 700 can be configured to operate ultrasound device 15 in tissue sensing mode by default. Alternatively or additionally, determining which mode to operate ultrasound device 15 in can be based on the tracking position of the distal region 84 of tip 82 relative to patient tissue, and / or on the type of tissue previously detected to be contacted by the distal region 84 of tip 82. For example, in response to the tracking position or the previously detected tissue type indicating contact with non-target tissue, ultrasound controller 150 can be configured to operate ultrasound device 15 in tissue sensing mode.

[0123] In response to determining in block 708 that the ultrasound instrument 15 is operating in tissue-sensing mode, process 700 may proceed to block 710, whereby the ultrasound instrument 15 may be driven with a low-power AC drive signal, which may induce vibrations in the tip 82 insufficient to remove patient tissue. By way of example and not limitation, the low-power AC drive signal provided in tissue-sensing mode may be configured to induce a mechanical current in the ultrasound instrument 15 of no more than 10 mA, or more specifically no more than 5 mA, or further more specifically no more than 2 mA. This induces vibrations with an amplitude of no more than 30 micrometers, or more specifically no more than 10 micrometers, or even more specifically no more than 3 micrometers at the distal region 84 of the tip 82. In some embodiments, irrigation and aspiration can be disabled during operation of the ultrasound instrument 15 in tissue sensing mode, which can help improve the accuracy of tissue sensing.

[0124] The optimal vibration of the tip 82 used for tissue sensing mode operation can typically depend on the type of surgery and / or the type of patient tissue involved in the surgery, as well as the geometry, sharpness, and surface area of ​​the tip 82. To this end, the read tissue sensing data 191 can indicate multiple sets of one or more different drive signal parameters (e.g., target mechanical current). The pulse parameters and frequency are used in tissue sensing mode for each of the different groups of one or more tissue types and / or surgical procedures. Each group of one or more different drive signal parameters can be selected by the operator via user interface 28 and / or indicated in surgical plan data 56. Therefore, the ultrasound controller 150 can be configured to generate the AC drive signal provided in tissue sensing mode using the group of one or more drive signal parameters associated with the indicated set of tissue types and / or surgical procedures.

[0125] At block 712, voltage and current measurements of the provided low-power AC drive signal can be obtained, for example, using the voltage and current sensors described above. At block 714, it can be determined whether the ultrasonic instrument 15 is under load or not, for example, based on load measurements of the ultrasonic instrument 15 determined according to one or more of the above measurements. In some embodiments, voltage measurements can be used as load measurements. More specifically, when the vibrating tip 82 of the ultrasonic instrument 15 is placed against tissue, the tissue can apply a vibration-suppressing load to the tip 82, and correspondingly generate a mechanical current that induces a mechanical current in the ultrasonic instrument 15. The mechanical impedance. In response, the ultrasonic controller 150 can be configured to adjust the voltage of the AC drive signal to take into account the increased mechanical impedance (factor), thereby reducing the induced mechanical current. Maintain at the target level.

[0126] Accordingly, it can be determined whether the ultrasound device 15 is in contact with tissue based on the voltage measurement of the obtained low-power AC drive signal. Specifically, the obtained voltage measurement can be compared with a threshold voltage corresponding to the contact between the distal region 84 of the tip 82 and the tissue. In some embodiments, this threshold may be specific to the ultrasound device 15 and can therefore be included in data read from the ultrasound device 15 or more specifically from the tip memory 190. In response to a voltage measurement result greater than or equal to the voltage threshold, it can be determined that the ultrasound device 15 is under load. Otherwise, it can be determined that the ultrasound device 15 is currently in an unloaded state.

[0127] As another example, load measurements can be calculated based on the obtained voltage and current measurements. For instance, these measurements can be used to calculate the mechanical impedance of the ultrasonic instrument 15. When the ultrasonic instrument 15 operates at resonance, the mechanical impedance can be substantially equal to the mechanical resistance of the ultrasonic instrument 15. Specifically, when the ultrasonic instrument 15 operates at resonance, the mechanical impedance of the ultrasonic instrument 15... inductive component and capacitance components They can cancel each other out, thus reducing the mechanical impedance of the ultrasonic instrument 15. Basically equal to the mechanical resistance of an ultrasonic instrument 15 Since the ultrasonic controller 150 is configured to set the frequency of the supplied AC drive signal to track resonance, the mechanical resistance of the ultrasonic instrument 15 can be calculated as follows. The mechanical current induced in the ultrasonic instrument 15 is calculated based on the current and voltage measurement results obtained as described above. Furthermore, according to Ohm's law, the obtained voltage measurement result is divided by the determined mechanical current. Then the calculated mechanical resistance can be... The resistance threshold (e.g., 2 kΩ) corresponding to the distal region 84 of the tip 82 in contact with tissue is compared, similar to the resistance threshold indicated by data read from the ultrasound instrument 15 in the previous example. In response to mechanical resistance... If the resistance value is greater than or equal to the resistance threshold, it can be determined that the ultrasonic instrument 15 is under load. Otherwise, it can be determined that the ultrasonic instrument 15 is currently under no load.

[0128] In some implementations, load measurements (e.g., voltage) can be used. Mechanical resistance The load is compared to multiple thresholds, one corresponding to tip 82 contacting tissue (e.g., 2 KΩ) and another corresponding to tip 82 not contacting tissue (e.g., 600 Ω). In response to a load measurement greater than or equal to one of the thresholds, it can be determined that the ultrasound device 15 is under load. Conversely, in response to a load value less than or equal to the other threshold, it can be determined that the ultrasound device 15 is under no-load. In response to a load value between the aforementioned thresholds, process 700 can be configured to return to block 710 and continue attempting to determine whether the ultrasound device 15 is under no-load or under load, as described above. In some embodiments, the aforementioned thresholds may be specific to tip 82 and can therefore be indicated in data read from tip memory 190 when the ultrasound device 15 is connected.

[0129] In response to determining that the ultrasonic instrument 15 is in an unloaded state, process 700 may proceed to block 716 to determine the unloaded resonant frequency of the ultrasonic instrument 15. As described above, the ultrasonic controller 150 may be configured to perform the following loop: tracking the resonant frequency of the ultrasonic instrument 15 based on the measured current and voltage of the AC drive signal, and setting the frequency of the AC drive signal based on the same current and voltage measurements. In the conventional process of tracking the resonant frequency as described above, the ultrasonic controller 150 may therefore be configured to determine the resonant frequency of the ultrasonic instrument 15 based on the voltage and current measurements obtained in block 712. In response to determining that the ultrasonic instrument 15 is in an unloaded state based on these voltage and / or current measurements, the resonant frequency calculated from these measurements may be set as the unloaded resonant frequency of the ultrasonic instrument 15. After determining the unloaded resonant frequency, process 700 may return to blocks 712 and 714 to obtain other voltage and current measurements and determine whether tip 82 has become loaded.

[0130] As described above, in some embodiments, the no-load resonant frequency can be indicated and determined by data read from the ultrasonic instrument 15 in block 702. In this case, block 716 can be omitted from process 700. Alternatively, because the resonant frequency of the ultrasonic instrument 15 can fluctuate with temperature, process 700 may still include block 716, such as to verify or adjust the no-load resonant frequency indicated by the read data as needed.

[0131] In response to determining in block 714 that the ultrasound instrument 15 is under load, process 700 may proceed to block 718 to determine the load resonant frequency of the ultrasound instrument 15, which, as described above, may have already been calculated based on the current and voltage measurements obtained in block 712 to set the frequency of the provided AC drive signal. Subsequently, the type of tissue contacted by the distal region 84 of the tip 82 can be determined based on the load resonant frequency and the unloaded resonant frequency. Specifically, at block 718, the difference between the load resonant frequency and the unloaded resonant frequency can be calculated, and at block 720, the tissue type can be determined based on this difference.

[0132] More specifically, the difference can be queried against tissue type data 172 stored in the console storage device 152, which may indicate one or more thresholds, each corresponding to a different tissue type. In some embodiments, the stored tissue type data 172 may correspond to tissue type data 172A previously read from the ultrasound device 15, and thus define at least one threshold specific to the tip 82.

[0133] In some examples, tissue type data 172 may indicate a threshold for performing binary tissue type determination (e.g., hard tissue vs. soft tissue). For example, tissue type data 172 may indicate a threshold such that a difference greater than or equal to the threshold indicates hard tissue, and a difference less than or equal to the threshold indicates soft tissue.

[0134] In other examples, tissue type data 172 can provide multiple thresholds to indicate the type of tissue being contacted with finer granularity, such as very hard tissue (e.g., tooth enamel), hard tissue (e.g., bone), moderately hard tissue (e.g., skin, muscle tissue, organ tissue, and arteries), and soft tissue (e.g., fat). For example, tissue type data 172 can indicate that a frequency difference greater than or equal to a first threshold (e.g., 350 Hz) corresponds to very hard tissue; a frequency difference greater than or equal to a second threshold (e.g., 175 Hz) and less than the first threshold corresponds to hard tissue; a frequency difference greater than or equal to a third threshold (e.g., 40 Hz) and less than the second threshold corresponds to moderately hard tissue; and a frequency difference less than the third threshold corresponds to soft tissue.

[0135] In some examples, and as described above, the determined load resonant frequency of the ultrasound device 15 can be compared with the determined unload resonant frequency of the ultrasound device 15 to determine the type of patient tissue being contacted. In an alternative embodiment, instead of utilizing the unload resonant frequency of the ultrasound device 15 (which may vary depending on the temperature of the ultrasound device 15), process 700 may determine the type of tissue being contacted based on the difference between two determined load resonant frequencies of the ultrasound device 15, as described below.

[0136] To determine the type of contacted tissue based on the difference between two defined load resonant frequencies, the low-power AC drive signal provided to the ultrasound instrument 15 in block 710 can be generated as a pulse signal comprising multiple pulses, each extending between an upper target amplitude (e.g., 8 mA) and a lower target amplitude (e.g., 3 mA). In some cases, the lower and upper target amplitudes of the AC drive signal can be indicated by tissue sensing data 191 read from the tip memory 190, and / or can correspond to a user selection for a given tissue type or procedure, as described above. Assuming the low-power AC drive signal is a pulse signal, the load measurement result used in block 714 to determine whether the ultrasound instrument 15 is under load can correspond to the upper amplitude portion of the AC drive signal. In other words, the load measurement result can be based on the value of an obtained voltage measurement result corresponding to the upper amplitude portion of each pulse, or the values ​​of an obtained voltage and current measurement result.

[0137] Furthermore, in this case, block 718 of process 700 may include determining multiple load resonant frequencies of the ultrasonic instrument 15 based on the obtained voltage and current measurements, i.e., one corresponding to the upper amplitude of the AC drive signal and another corresponding to the lower amplitude of the AC drive signal. Generally speaking, the effects of different contact tissues on the resonant frequencies of the ultrasonic instrument 15 can be more similar when the tip 82 vibrates more slowly (i.e., at the lower amplitude of the AC drive signal) than when the tip 82 vibrates more quickly (i.e., at the higher amplitude of the AC drive signal). Specifically, when the tip 82 vibrates rapidly against relatively hard tissue, the distal region 84 of the tip 82 may tend to bounce off the tissue during vibration, and when the tip 82 vibrates rapidly against relatively soft tissue, the tissue may tend to move along with the distal region 84 of the tip 82 during vibration. Therefore, when the distal region 84 of the tip 82 vibrates against hard tissue, the difference between the resonant frequencies at the upper and lower amplitudes of the AC drive signal can be greater than the difference when the distal region 84 of the tip 82 vibrates against soft tissue.

[0138] Therefore, the difference between these load resonant frequencies can be calculated in box 720, and the type of contact tissue can then be determined based on this frequency difference in box 722. More specifically, this difference can be queried against tissue type data 172, which may indicate one or more thresholds for determining the tissue type, as described above.

[0139] In some embodiments, the ultrasound controller 150 may be configured to determine the contact tissue type using the no-load resonant frequency determined as described above, such as the number of times this operation is performed, upon initial activation of the ultrasound instrument 15, and thereafter determine the contact tissue type using the difference between the determined load resonant frequencies. In some embodiments, an event may trigger alternation between these no-load and load methods. For example, in response to determining the contact tissue type using the no-load method a set number of times, the ultrasound controller 150 may be configured to implement the load method until it is detected that the ultrasound instrument 15 is again in a no-load state, in which case the ultrasound instrument 15 may resume a cycle of the no-load method a set number of times, and then continue with the load method, and so on.

[0140] See still Figure 7At box 724, the operation of the surgical system 10 can be controlled based on the determined tissue type. In some examples, box 724 may include instructing the operator on the determined tissue type, such as through a user interface in the user interface 28 of the surgical system 10, or by inducing a specific vibration pulse pattern associated with the determined tissue type within the tissue type data 172 in the ultrasound instrument 15. Alternatively or additionally, such as when the determined tissue type corresponds to the target tissue to be removed, box 724 may include switching the operation of the ultrasound instrument 15 from a tissue sensing mode to a tissue removal mode, as discussed in more detail below.

[0141] In some embodiments, different tissue types (such as different target tissue types) can be associated, within tissue type data 172, with different ultrasonic energy distributions sensed in the ultrasound instrument 15 operating in tissue resection mode in response to the determined tissue type corresponding to a given tissue type. The ultrasonic energy distributions can each define one or more parameters (e.g., target mechanical current) of the AC drive signal provided to the ultrasound instrument 15 in tissue resection mode. (Pulse parameters). For example, relatively hard tissues (such as bone) can be associated with an ultrasound energy distribution that operates the ultrasound instrument 15 at a relatively high power level, which can cause vibrations with greater amplitude and thus provide greater resection power compared to relatively soft tissues. In response to the recognition of contact with the tissue type targeted for resection, the ultrasound controller 150 can thus be configured to operate the ultrasound instrument 15 automatically in tissue resection mode and according to the ultrasound energy distribution associated with that tissue type.

[0142] In some implementations, for example when the ultrasound instrument 15 has been set to operate in tissue resection mode to remove patient tissue, the ultrasound controller 150 may be configured to periodically alternate the operation of the ultrasound instrument 15 between tissue resection mode and tissue sensing mode to check whether the tip 82 of the ultrasound instrument 15 is contacting target tissue or non-target tissue. In response to determining a target tissue type, block 724 may include returning operation to tissue resection mode. Conversely, in response to a determined tissue type indicating non-target tissue, block 724 may include deactivating the ultrasound instrument 15 or continuing operation of the ultrasound instrument 15 in tissue sensing mode until the detected tissue type corresponds to target tissue, and / or may include providing an indication that the distal region 84 of the tip 82 is contacting non-target tissue, as described herein.

[0143] In some implementations, the determined tissue type can indicate when the distal region 84 of tip 82 has moved from the inner portion to the outer portion of the anatomical structure being removed. For example, because bone stiffness decreases as it thins, the determined tissue type can indicate when the bone being removed is very thin and about to be cut through, a situation that may be undesirable or desirable without removing sensitive structures or other non-target tissue adjacent to the bone. Therefore, in response to the determined tissue type indicating that the distal region 84 of tip 82 has moved from the inner portion to the outer portion of the patient's anatomy and is about to be cut through, box 724 may include performing a corresponding pre-cutting plan, such as disabling the operation of ultrasound instrument 15, or using a tissue removal mode but at a reduced power level (e.g., a lower target mechanical current). Ultrasonic instruments are operated in pulse mode.

[0144] In some implementations, such as when the distal region 84 of tip 82 is being tracked relative to a virtual object in a known coordinate system, block 724 may include adjusting parameters, such as the position, orientation, or shape of the virtual object in the known coordinate system, based on the determined patient tissue type. For example, in response to determining that the determined tissue type differs from the expected tissue type based on the tracking position of the distal region 84 of tip 82 relative to the virtual object, the virtual object may be adjusted such that the tissue type indicated by the virtual object at the tracking position of the distal region 84 of tip 82 corresponds to the determined tissue type.

[0145] In some implementations, this adjustment may be based on multiple data points of tissue type determined at different tracking positions of the distal region 84 of the tip 82 relative to the virtual object. For example, in response to a mismatch between the tissue type indicated by the tracking position of the distal region 84 of the tip 82 relative to the virtual boundary and the tissue type detected in tissue sensing mode (or tissue resection mode, as described below), the navigation controller 24 and the ultrasound controller 150 may cooperate to operate the ultrasound instrument 15 in tissue sensing mode and obtain a series of tracking positions of the distal region 84 of the tip 82 in a known coordinate system, and the tissue type detected by the ultrasound instrument 15 at each position. For example, an operable user interface 28 in either the navigation controller 24 or the ultrasound controller 150 may instruct the operator to track the surrounding area with the ultrasound instrument 15. The navigation controller 24 may then be configured to adjust the virtual object, such as according to constraints associated with the tracked object, such that the virtual object indicates the tissue type determined at each tracking position of the distal region 84 of the tip 82 according to the tissue sensing mode.

[0146] As previously described, the surgical system 10 may include a robotic manipulator 14 coupled to the ultrasound instrument 15 and configured to guide the movement of the ultrasound instrument 15 to treat patient tissue, such as by tracking the distal region 84 of the tip 82 relative to a virtual object associated with the patient tissue. In some embodiments, block 724 may include controlling the operation of the robotic manipulator 14 based on the determined tissue type, for example by adjusting the virtual object as described above. This, in turn, can alter how the robotic manipulator 14 guides the movement of the ultrasound instrument 15, for example, to remove target patient tissue while avoiding non-target patient tissue.

[0147] In some cases, at least one of the virtual objects used to control the operation of the robotic manipulator 14 may be a tactile object configured to cause the robotic manipulator 14 to apply force to the movement of the ultrasonic instrument 15, the force simulating attraction or repulsion sensations, such as guiding the distal region 84 of the tip 82 to treat target tissue while avoiding contact with non-target tissue. In some embodiments, block 724 may include adjusting parameters of such virtual objects based on the determined tissue type by adjusting one or more of the position, orientation, shape, or force associated with such objects. As an example, when the ultrasonic instrument 15 is used to perform endplate preparation, a given tactile object may be configured to attract the distal region 84 of the tip 82 from its position within the intervertebral disc space toward the endplate to facilitate cartilage removal from the endplate. However, once the determined tissue type indicates that the distal region 84 of the tip 82 is contacting the endplate, the surgical navigation system 12 may be configured to adjust the tactile object to force the distal region 84 of the tip 82 to move away from the endplate, for example, to avoid undesirable resection of the endplate.

[0148] In some implementations, block 724 may include automatically initiating tracking of the patient's anatomy upon detection of contact with a given type of tissue, such as bone associated with an anatomical structure. This can be used to generate a virtual object corresponding to that anatomy, and subsequently track the position of the distal region 84 of tip 82 relative to that anatomy. Specifically, as long as the detected tissue type continues to correspond to the patient's anatomy, navigation controller 24 may be configured to track and store different positions of the distal region 84 of tip 82 relative to a known coordinate system, which can form a virtual model of the patient's anatomy used by navigation controller 24 as described above.

[0149] See still Figure 7 In response to determining in box 708 that the ultrasound instrument 15 is operated in tissue resection mode, process 700 may proceed to box 802 of process 800, such as Figure 8As shown. In block 802, an ultrasound device 15 can be driven with a high-power AC drive signal, which induces vibrations in the tip 82 of the ultrasound device 15 for the removal of patient tissue. The high-power AC drive signal can be configured to drive the ultrasound device 15 according to desired removal parameters set by the operator, such as a target ultrasound energy level set via foot pedal 138 and console settings as described above. For example, the high-power AC drive signal can be configured to induce a mechanical current greater than 100 mA. And / or induce vibrations with an amplitude greater than 100 micrometers. While driving the ultrasound device with a high-power AC drive signal, the frame 802 may also include supplying fluid to the distal region 84 of the tip 82 through at least a portion of the ultrasound device 15, and / or providing suction at the distal region 84 of the tip 82 through at least a portion of the ultrasound device 15, such as rinsing the surgical site and / or aspirating fragmented tissue from the surgical site.

[0150] In some embodiments, the tissue resection mode may also include tissue sensing features that can be performed simultaneously with tissue fragmentation. In other words, the tissue sensing features of the tissue resection mode can be utilized during the provision of a high-power AC drive signal to the ultrasound device 15.

[0151] To this end, process 800 may include blocks 804 and 806 for obtaining voltage and current measurements of the high-power AC drive signal and determining whether the ultrasound device is in a no-load state, respectively. The operation of blocks 804 and 806 may be similar to the operation described above with respect to blocks 712 and 714 of process 700, and therefore will not be repeated in detail here. It should be noted that, in response to determining in block 806 that the ultrasound device 15 is in a no-load state, process 800 may switch the operation of the ultrasound device 15 to a tissue sensing mode, such as by advancing to… Figure 7 Frame 710.

[0152] In block 808, one or more frequency characteristics of the high-power AC drive signal can be determined (e.g., based on the obtained current measurement results), each frequency characteristic corresponding to a frequency or frequency range other than the fundamental drive frequency of the high-power AC drive signal (e.g., the determined resonant frequency of the ultrasonic instrument 15). As an example, a Fourier transform can be applied to the obtained current measurement results, and the amplitude characteristics (or amplitude properties) of the Fourier transform can be determined for each of one or more frequency intervals (or frequency bins), each interval comprising a frequency range spaced apart from the fundamental drive frequency.

[0153] In some cases, each interval may correspond to or include different harmonics of the fundamental drive frequency of the AC drive signal, and / or may be predefined in tissue type data 172 or predefined in tissue type data 172A read from the tip memory 190 of the ultrasound instrument 15. For example, the frequency interval may include an interval separated from the fundamental drive frequency by a predefined amount, and may include another frequency interval separated from the fundamental drive frequency by twice the predefined amount, or separated by the predefined amount and by the difference between the highest and lowest frequencies of the other interval. In some cases, one of the intervals may be centered on or include the first harmonic of the fundamental drive frequency, and another of the intervals may be centered on or include the second harmonic of the fundamental drive frequency. In some embodiments, each interval may have a size of approximately 5 kHz, and / or the intervals may be mutually exclusive. The amplitude characteristics of each interval may generally correspond to the amplitude of the frequency of that interval. For example, the amplitude of each interval can be determined as the peak amplitude of that interval, the integral of the amplitude of that interval, or the average amplitude of that interval.

[0154] At box 812, the type of patient tissue contacted by the distal region 84 of tip 82 can be determined based on the determined frequency characteristics. More specifically, tissue type data 172 (which may be tissue type data 172A previously read from ultrasound instrument 15) can indicate one or more thresholds corresponding to each determined frequency characteristic, such as in the form of one or more amplitude thresholds for each frequency interval, for determining contact with different tissue types. Thus, each determined frequency characteristic can be compared with the corresponding threshold to determine the tissue type.

[0155] In some examples, tissue type data 172 may indicate a threshold for each frequency feature / interval used to perform binary tissue type determination (e.g., hard tissue vs. soft tissue). For example, tissue type data 172 may indicate a threshold for each frequency feature / interval such that each frequency feature greater than or equal to its corresponding threshold indicates contact with hard tissue, and otherwise indicates contact with soft tissue.

[0156] In other examples, tissue type data 172 may provide multiple thresholds for each frequency feature / interval to indicate the tissue being contacted, such as very hard tissue, hard tissue, medium-hard tissue, and soft tissue, with finer granularity. For example, tissue type data 172 may indicate a first threshold for each frequency feature / interval, such that each frequency feature greater than its corresponding first threshold indicates contact with very hard tissue; may indicate a second threshold for each frequency feature / interval, such that each frequency feature greater than its corresponding second threshold and less than its corresponding first threshold indicates contact with hard tissue; may indicate a third threshold for each frequency feature / interval, such that each frequency feature greater than its corresponding third threshold and less than its corresponding second threshold indicates contact with medium-hard tissue; and each frequency feature less than its corresponding third threshold indicates contact with soft tissue.

[0157] In some implementations, where different frequency features indicate different tissue types based on comparisons with corresponding thresholds, the tissue type can be determined as the softest tissue indicated by the comparison. Continuing the example above, assuming two frequency features, in response to one frequency feature being greater than its corresponding first threshold and another frequency feature being greater than its second threshold but less than its first threshold, it can be determined that the distal region 84 of the tip 82 is in contact with hard tissue.

[0158] In some embodiments, tissue type data 172 may indicate multiple sets of thresholds, each set of thresholds serving as the aforementioned thresholds, and each set of thresholds corresponding to different tissue types and / or surgical types selectable by the user. In some embodiments, the determination of each frequency characteristic may be based on the amplitude of a frequency range corresponding to that characteristic and the corresponding amplitude of a frequency range corresponding to the fundamental frequency of the provided AC drive signal. For example, the frequency characteristic of each frequency range may be determined by subtracting the amplitude of the frequency range corresponding to the fundamental frequency from the amplitude of that range. In some embodiments, instead of determining the frequency characteristics by applying a Fourier transform to the current measurement results of the obtained AC drive signal, the frequency characteristics may be determined by applying a Fourier transform to the determined mechanical current of the ultrasound instrument 15 induced by the AC drive signal. To determine the frequency characteristics, the mechanical current can be calculated as described above based on the obtained current and voltage measurements.

[0159] At box 812, the operation of the surgical system 10 can be controlled based on the patient tissue type determined in box 810. As a non-limiting example, box 812 may include switching the operation of the ultrasound instrument 15 from a tissue resection mode to a tissue sensing mode, such as in response to determining contact with a non-target tissue type, a tissue type indicating breakthrough (or puncture), and / or a tissue type indicating pre-breakthrough, as described above. Additionally or alternatively, box 812 may include any one or more other actions discussed above with respect to box 724. The process 800 can then proceed to... Figure 7 The frame 706 is used to determine whether the ultrasound device 15 continues to be actuated, etc.

[0160] In some embodiments, block 812 may also include adjusting the suction provided at the distal region 84 of the tip 82 based on the type of tissue determined in block 810. Such suction may also be adjusted in block 722 based on the determined tissue type, such as when the ultrasound instrument 15 is subsequently operated in tissue resection mode. More specifically, tissue type data 172 may indicate different suction parameters to be implemented by the ultrasound controller 150 according to the determined tissue type. For example, tissue type data 172 may indicate a vacuum level to be implemented for each tissue type, configured to improve resection and suction for that tissue type, and / or may indicate a blockage threshold for each tissue type to determine whether the suction path is blocked by that tissue type. Regarding the latter, the ultrasound controller 150 may be configured to measure parameters of the suction provided at the distal region of the tip when operating in tissue resection mode, such as using pressure or flow sensors included in the console 80, and determine the blockage status based on a comparison between the measured parameters and the blockage threshold associated with the determined tissue type.

[0161] In some embodiments, a given tip 82 may operate in different vibration modes (e.g., bending, longitudinal, torsional-longitudinal, torsional). In this case, the ultrasound controller 150 may be configured to induce different vibration modes of the tip 82 for a tissue sensing mode and a tissue resection mode. Specifically, each vibration mode may be associated with a different drive signal frequency, and the ultrasound controller 150 may be configured to induce a given vibration mode of the tip 82 by providing an AC drive signal to the ultrasound instrument 15, the AC drive signal including a frequency component corresponding to the frequency of the vibration mode. Examples of such tips 82 are described in U.S. Patents 10,786,275 and 10,561,435, the disclosure of each of which is incorporated herein by reference in its entirety. In some embodiments, tissue sensing data 191 read by the ultrasound instrument 15 may indicate the vibration mode to be induced for each of the tissue resection mode and the tissue sensing mode, for example by indicating the drive signal frequency associated with that mode.

[0162] For example, a given tip 82 may have a longitudinal vibration mode and a bending vibration mode, in which the vibration at the distal region 84 of the tip 82 is substantially longitudinal, and in the bending vibration mode, the vibration at the distal region 84 of the tip 82 is substantially bending. In this case, the ultrasound controller 150 (such as based on read tissue sensing data 191) may be configured to cause the tip 82 to vibrate in a bending vibration mode, such as by generating and providing a low-power AC drive signal having a frequency component corresponding to the frequency associated with the bending vibration mode, when the ultrasound instrument 15 is operated in tissue sensing mode, and to cause the tip 82 to vibrate in a longitudinal vibration mode for tissue resection mode, such as by generating and providing a high-power AC drive signal having a frequency component corresponding to the resonant frequency associated with the longitudinal vibration mode.

[0163] As another example, a given tip 82 may have a first torsional-longitudinal vibration mode and a second torsional-longitudinal vibration mode, in which the distal region 84 of the tip 82 rotates clockwise when vibrating in the proximal direction and counterclockwise when vibrating in the distal direction, and in the second torsional-longitudinal vibration mode, the distal region 84 of the tip 82 rotates counterclockwise when vibrating in the proximal direction and clockwise when vibrating in the distal direction. The first torsional-longitudinal mode can be considered to cause torsional-longitudinal vibration in the opposite direction to the second torsional-longitudinal mode. In this case, the ultrasound controller 150 (such as based on the read tissue sensing data 191) may be configured to cause the tip 82 to vibrate in the first longitudinal-torsional mode, such as by generating and providing a low-power AC drive signal having a frequency component corresponding to the frequency associated with the first longitudinal-torsional mode, when the ultrasound instrument 15 is operated in tissue sensing mode, and to cause the tip 82 to vibrate in the second longitudinal-torsional mode for tissue resection mode, such as by generating and providing a high-power AC drive signal having a frequency component corresponding to the frequency associated with the second longitudinal-torsional mode.

[0164] Alternatively or concurrently, in some embodiments, such as when adjusting the frequency of the AC drive signal to track a target vibrational characteristic (such as resonance) of the ultrasound device 15, the ultrasound controller 150 may be configured to limit the frequency of the AC drive signal to different permissible frequency ranges depending on whether the ultrasound device 15 is operating in tissue resection mode or tissue sensing mode. More specifically, when operating in tissue resection mode, the ultrasound controller 150 may be configured to limit the high-power AC drive signal to a permissible frequency range associated with tissue resection mode (e.g., 25 kHz, +200 Hz, -300 Hz), and when operating in tissue sensing mode, to a low-power AC drive signal to a permissible frequency range associated with tissue sensing mode (e.g., 25 kHz, ±2 kHz). As illustrated in the examples above, the permissible frequency range associated with tissue sensing mode may be greater than the permissible frequency range associated with tissue resection mode. In other words, the difference between the upper and lower limits of the permissible frequency range associated with tissue resection mode may be less than the difference between the upper and lower limits of the permissible frequency range associated with tissue sensing mode. In this way, the ultrasound controller 150 can detect larger frequency jumps in the tissue sensing mode while preventing the tip 82 from unintentionally exhibiting unwanted vibration patterns in the tissue resection mode. In some embodiments, the permissible frequency ranges of the tissue resection mode and the tissue sensing mode can be indicated by the read tissue sensing data 191.

[0165] The foregoing description is illustrative in nature and is in no way intended to limit this disclosure, its application, or its use. The broad teachings of this disclosure can be implemented in various forms. Therefore, while this disclosure includes specific examples, its true scope should not be so limited, as other modifications will become apparent upon examination of the drawings, specification, and appended claims. It should be understood that one or more steps within a method may be performed in a different order (or simultaneously) without altering the principles of this disclosure. Furthermore, although each example is described above as having certain features, any one or more of those features described with respect to any example of this disclosure may be implemented in and / or combined with features of any other example, even if such combination is not explicitly described. In other words, the described examples are not mutually exclusive, and permutations and combinations of one or more examples with each other remain within the scope of this disclosure.

[0166] Spatial and functional relationships between components (e.g., between controllers, circuit elements, semiconductor layers, etc.) are described using various terms, including “connected,” “joined,” “linked,” “adjacent,” “next to,” “above,” “below,” and “set.” Unless explicitly described as “direct,” when describing the relationship between the first and second components in the foregoing disclosure, the relationship can be a direct relationship in which no other intermediate components exist between the first and second components, or an indirect relationship (spatial or functional) in which one or more intermediate components exist between the first and second components.

[0167] As used herein, the phrase "at least one of A, B, and C" should be interpreted as referring to the logic of using non-exclusive OR (A OR B OR C), and should not be interpreted as referring to "at least one of A, at least one of B, and at least one of C". A subset of terms does not necessarily require an appropriate subset. In other words, the first subset of the first group can be extended together with the first group (equal to the first group).

[0168] In the accompanying diagrams, as indicated by the arrows, the direction of the arrows typically illustrates the flow of information (such as data or instructions) of interest. For example, when components A and B exchange various types of information, but the information sent from component A to component B is relevant to the illustration, the arrow can point from component A to component B. This unidirectional arrow does not imply that no other information is being transmitted from component B to component A. Furthermore, for information sent from component A to component B, component B can send a request for or confirmation of receipt of that information to component A.

[0169] In this application, including the following definitions, the term "controller" or "module" may be replaced by the term "circuit". The term "controller" may refer to, be part of, or include the following: at least one application-specific integrated circuit (ASIC); at least one programmable system-on-chip (PSoC); at least one digital, analog, or mixed-signal analog / digital discrete circuit; at least one digital, analog, or mixed-signal analog / digital integrated circuit; at least one combinational logic circuit; at least one field-programmable gate array (FPGA); at least one processor (shared, dedicated, or grouped) that executes code; at least one memory circuit (shared, dedicated, or grouped) that stores code executed by at least one processor; other suitable hardware components that provide the described functionality; or some or all of the above, such as in a system-on-chip.

[0170] The controller may include one or more interface circuits with one or more transceivers, such as radio frequency (RF) or optical-based transceivers (e.g., infrared (IR)). In some examples, the interface circuits may implement wired or wireless interfaces for connection to a local area network (LAN) or wireless personal area network (WPAN). Examples of LANs are the Institute of Electrical and Electronics Engineers (IEEE) standard 802.11-2016 (also known as the Wi-Fi wireless network standard) and the IEEE standard 802.3-2015 (also known as the Ethernet wired network standard). Examples of WPANs are the BLUETOOTH wireless network standard from the Bluetooth Special Interest Group and the IEEE standard 802.15.4.

[0171] The controller can communicate with other controllers using interface circuitry. Although the controller may be depicted in this disclosure as communicating directly with other controllers logically, in various embodiments, the controller may actually communicate via a communication system. The communication system may include physical and / or virtual networking devices such as hubs, switches, routers, gateways, and transceivers. In some embodiments, the communication system is connected to or traverses a wide area network (WAN) such as the Internet. For example, the communication system may include multiple LANs interconnected via the Internet or peer-to-peer leased lines using technologies including Multiprotocol Label Switching (MPLS) and Virtual Private Networks (VPNs).

[0172] In various implementations, the functionality of the controller can be distributed among multiple controllers connected via a communication system. For example, multiple controllers can perform the same functionality distributed by a load balancing system. In another example, the functionality of the controller can be divided between a server (also known as a remote or cloud) controller and a client (or user) controller.

[0173] Some or all of the hardware characteristics of the controller can be defined using a language for hardware description, such as IEEE Standard 1364-2005 (commonly referred to as "Verilog") and IEEE Standard 1076-2008 (commonly referred to as "VHDL"). Hardware description languages ​​can be used to fabricate and / or program hardware circuitry. In some implementations, some or all of the controller's characteristics can be defined by a language such as IEEE 1666-2005 (commonly referred to as "SystemC"), which includes both code (described below) and hardware description.

[0174] As used above, the term "code" can include software, firmware, and / or microcode, and can refer to programs, routines, functions, classes, data structures, and / or objects. The term "shared processor circuitry" covers a single processor circuitry that executes some or all of the code from multiple controllers. The term "group processor circuitry" includes processor circuitry that, in combination with other processor circuitry, executes some or all of the code from one or more controllers. References to multiple processor circuitry include multiple processor circuitry on a discrete die, multiple processor circuitry on a single die, multiple cores of a single processor circuitry, multiple threads of a single processor circuitry, or combinations thereof. The term "shared memory circuitry" covers a single memory circuitry that stores some or all of the code from multiple controllers. The term "group memory circuitry" covers memory circuitry that, in combination with other memories, stores some or all of the code from one or more controllers.

[0175] The term memory circuit is a subset of the term computer-readable medium. As used herein, the term computer-readable medium does not cover transient electrical or electromagnetic signals propagating through a medium (such as on a carrier wave); therefore, the term computer-readable medium can be considered tangible and non-transient. Non-limiting examples of non-transient computer-readable media are non-volatile memory circuits (such as flash memory circuits, erasable programmable read-only memory circuits, or mask read-only memory circuits), volatile memory circuits (such as static random access memory circuits or dynamic random access memory circuits), magnetic storage media (such as analog or digital magnetic tape or hard disk drives), and optical storage media (such as CDs, DVDs, or Blu-ray discs).

[0176] The apparatus and methods described in this application can be implemented, in part or in whole, by a special-purpose computer created by configuring a general-purpose computer to perform one or more specific functions embodied in a computer program. The aforementioned function blocks and flowchart elements can be used as software specifications, which can be converted into computer programs through the routine work of skilled technicians or programmers.

[0177] A computer program may include processor-executable instructions stored on at least one non-transitory computer-readable medium. A computer program may also include or depend on stored data. A computer program may include a basic input / output system (BIOS) for interacting with the hardware of a special-purpose computer, device drivers for interacting with specific devices of the special-purpose computer, one or more operating systems, user applications, background services, background applications, etc.

[0178] Computer programs may include: (i) descriptive text to be parsed, such as HTML (Hypertext Markup Language), XML (Extensible Markup Language), or JSON (JavaScript Object Notation); (ii) assembly code; (iii) object code generated from source code by a compiler; (iv) source code executed by an interpreter; and (v) source code compiled and executed by a just-in-time (JIT) compiler, etc. As an example only, source code may be written using syntax from languages ​​including: C, C++, C#, Objective C, Swift, Haskell, Go, SQL, R, Lisp, Java®, Fortran, Perl, Pascal, Curl, OCaml, JavaScript®, HTML5 (Hypertext Markup Language, 5th Revision), Ada, ASP (Active Server Pages), PHP (PHP: Hypertext Preprocessor), Scala, Eiffel, Smalltalk, Erlang, Ruby, Flash®, Visual Basic®, Lua, MATLAB, SIMULINK, and Python®.

Claims

1. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: The ultrasound device is operated in tissue resection mode, in which a first AC drive signal is provided to the ultrasound device, the first AC drive signal causing vibration in the tip of the ultrasound device used to resect patient tissue. The ultrasound device is operated in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound device, the second AC drive signal causing vibrations in the tip for sensing patient tissue, the power of the second AC drive signal being lower than the power of the first AC drive signal. Obtain at least one measured first electrical characteristic of the second AC drive signal; A first frequency corresponding to the target vibration characteristic of the ultrasonic instrument is determined based on the first electrical characteristic measured at least once; The type of patient tissue contacted by the distal region of the tip is determined based on the determined first frequency; as well as The operation of the surgical system is controlled based on the type of patient tissue identified.

2. The system according to claim 1, wherein the target vibration characteristic is the resonant frequency of the ultrasonic instrument.

3. The system according to claim 1 or 2, wherein the one or more controllers are configured to adjust the frequency characteristics of the second AC drive signal based on a determined first frequency.

4. The system according to any one of claims 1-3, wherein the vibration induced in the tip by the second AC drive signal is insufficient to remove the patient tissue.

5. The system according to any one of claims 1-4, wherein the amplitude of the vibration induced by the first AC drive signal in the tip of the ultrasonic instrument is greater than the amplitude of the vibration induced by the second AC drive signal in the tip of the ultrasonic instrument.

6. The system according to any one of claims 1-5, wherein the first electrical characteristic of the at least one measured second AC drive signal includes a first voltage measurement result of the second AC drive signal and / or a first current measurement result of the second AC drive signal.

7. The system according to any one of claims 1-6, wherein the one or more controllers are configured to: Read data from the memory of the ultrasound device; and The second AC drive signal with the determined electrical characteristics is generated based on the read data.

8. The system according to any one of claims 1-7, wherein the first AC drive signal includes frequency characteristics corresponding to a first vibration mode of the tip, and the second AC drive signal includes frequency characteristics corresponding to a second vibration mode of the tip.

9. The system of claim 8, wherein the first vibration mode of the tip is a longitudinal vibration mode of the tip, and the second vibration mode of the tip is a bending vibration mode of the tip.

10. The system of claim 8, wherein the first vibration mode of the tip is a torsional-longitudinal vibration mode of the tip in a first direction, and the second vibration mode of the tip is a torsional-longitudinal vibration mode of the tip in a second direction opposite to the first direction.

11. The system according to any one of claims 1-10, wherein the one or more controllers are configured to: The first AC drive signal is limited to a first permissible frequency range associated with the tissue resection mode, the first permissible frequency range being defined by a first upper limit frequency and a first lower limit frequency; as well as The second AC drive signal is limited to a second permissible frequency range associated with the tissue sensing mode, the second permissible frequency range being defined by a second upper limit frequency and a second lower limit frequency; The difference between the first upper limit frequency and the first lower limit frequency is less than the difference between the second upper limit frequency and the second lower limit frequency.

12. The system according to any one of claims 1-11, wherein the one or more controllers are configured to: When operated in the tissue resection mode, suction is provided by at least a portion of the ultrasound instrument at the distal region of the tip; and When operating in the tissue sensing mode, suction is prohibited through at least a portion of the ultrasound device at the distal region of the tip.

13. The system according to any one of claims 1-12, wherein the one or more controllers are configured to: The contact between the distal region of the tip and the patient tissue is determined based on the first electrical characteristics measured at least once; and In response to determining that the distal region of the tip is in contact with the patient tissue, the type of patient tissue in contact with the distal region of the tip is determined based on a determined first frequency.

14. The system according to any one of claims 1-13, wherein the one or more controllers are configured to: When operating in the tissue sensing mode, a second frequency corresponding to the target vibration characteristic of the ultrasound device is determined; and The type of patient tissue is determined based on the first and second frequencies.

15. The system of claim 14, wherein the one or more controllers are configured to determine the type of the patient tissue based on the difference between a determined first frequency and a determined second frequency.

16. The system of claim 14 or 15, wherein the determined second frequency corresponds to the no-load resonant frequency of the ultrasonic instrument.

17. The system of claim 16, wherein the one or more controllers are configured to read the second frequency from the memory included in the tip.

18. The system according to any one of claims 14-16, wherein the one or more controllers are configured to: Obtain at least one measured second electrical characteristic of the second AC drive signal; The ultrasonic instrument is determined to be in an unloaded state based on the second electrical characteristic measured by at least one of the above-mentioned measurements; and In response to determining that the ultrasonic instrument is in the no-load state, the frequency corresponding to the target vibration characteristic of the ultrasonic instrument and determined based on the at least one measured second electrical characteristic is determined as the second frequency. in, Optionally, the second electrical characteristic of the at least one measurement includes the measured voltage of the AC drive signal and / or the measured current of the AC drive signal.

19. The system of claim 14 or 15, wherein the second AC drive signal comprises a plurality of pulses extending between an upper amplitude and a lower amplitude, the at least one measured first electrical characteristic corresponding to the second AC drive signal at the upper amplitude, and the one or more controllers are configured to: Obtain at least one measured electronic and electrical characteristic of the second AC drive signal, each corresponding to the second AC drive signal at the lower amplitude; and The second frequency is determined based on the second electrical characteristic measured by at least one of the above-mentioned measurements. in, Optionally, the at least one measured second electrical characteristic includes a second voltage measurement result of the second AC drive signal and / or a second current measurement result of the AC drive signal.

20. The system according to any one of claims 1-19, wherein the one or more controllers are configured to switch the operation of the ultrasound device from the tissue sensing mode to the tissue resection mode based on the determined type of patient tissue.

21. The system according to any one of claims 1-20, wherein the one or more controllers are configured to cause the operation of the ultrasound instrument to periodically alternate between the tissue resection mode and the tissue sensing mode.

22. The system according to any one of claims 1-21, wherein the one or more controllers are configured to: Track the position of the distal region of the tip relative to a virtual object associated with the patient tissue in a known coordinate system; and The pose of the virtual object in the known coordinate system is adjusted based on the determined type of patient tissue.

23. The system according to any one of claims 1-22, wherein the one or more controllers are configured to control the robotic manipulator to guide the movement of the ultrasound instrument to process the patient tissue based on the determined type of patient tissue.

24. The system of claim 23, wherein the one or more controllers are configured to: Controlling the robotic manipulator to guide the movement of the ultrasound instrument to treat the patient tissue based on a virtual object associated with the patient tissue; and The parameters of the virtual object are adjusted based on the type of patient tissue identified.

25. The system of claim 24, wherein the virtual object is a tactile object for controlling the robotic manipulator, and the one or more controllers are configured to adjust the position, posture, and / or force associated with the tactile object based on the determined type of patient tissue.

26. The system according to any one of claims 1-25, wherein the one or more controllers are configured to: Based on the identified type of patient tissue, it is determined that the distal region of the tip has moved from the internal to the external portion of the anatomical object; and In response to determining that the distal region of the tip has moved from the internal part to the external part of the anatomical object, operation of the ultrasound device is deactivated or the ultrasound device is operated at a reduced power level in the tissue resection mode.

27. The system according to any one of claims 1-26, wherein the one or more controllers are configured to: Track the position of the distal region of the tip of the ultrasonic instrument in a known coordinate system; and A virtual model of the anatomical object is generated in the known coordinate system based on the location of the distal region of the tracked tip and the determined type of patient tissue.

28. The system of any one of claims 27, wherein the one or more controllers are configured to: Based on the first frequency, it is determined that the distal region of the tip is contacting bone; and In response to determining that the distal region of the tip is in contact with bone, a virtual model of the bone is generated based on the tracked position of the distal region of the tip.

29. The system according to any one of claims 1-28, wherein, The identified patient tissue type is defined as a first identified patient tissue type, and the one or more controllers are configured to: When the ultrasound device is operated in the tissue resection mode, at least one measured third electrical characteristic of the first AC drive signal is obtained; One or more frequency characteristics of the first AC drive signal are determined based on the at least one measured third electrical characteristic, each of the frequency characteristics corresponding to a frequency of the first AC drive signal other than the fundamental frequency of the first AC drive signal. The type of patient tissue contacted by the distal region of the tip is determined based on one or more frequency characteristics, and the type of patient tissue determined based on the one or more frequency characteristics is defined as a second determined type of patient tissue. as well as The operation of the surgical system is controlled based on a second, definitive type of patient tissue. Optionally, the at least one measured third electrical characteristic includes a first voltage of the first AC drive signal and / or a first current of the first AC drive signal.

30. The system of claim 29, wherein the one or more frequency features each include at least one feature of a frequency range, the frequency range excluding the fundamental frequency of the first AC drive signal.

31. The system according to claim 29 or 30, wherein the one or more frequency features each include at least one feature of a frequency range, the frequency range including the harmonic frequency of the fundamental frequency of the first AC drive signal.

32. The system according to any one of claims 29-31, wherein the one or more frequency features comprise a plurality of frequency features, each frequency feature comprising at least one feature in a different frequency range, the different frequency ranges comprising different harmonic frequencies of the fundamental frequency of the first AC drive signal, wherein, Optionally, the frequency ranges are mutually exclusive.

33. The system according to any one of claims 29-32, wherein each of the one or more frequency features comprises an amplitude feature of the frequency range.

34. The system according to any one of claims 29-33, wherein the one or more controllers are configured to determine at least one phase characteristic of the first AC drive signal based on the at least one measured third electrical characteristic, wherein the second determination type of the patient tissue is determined based on the one or more frequency characteristics and the at least one phase characteristic.

35. The system according to any one of claims 29-34, wherein the one or more controllers are configured to: When operated in the tissue resection mode, suction is provided by at least a portion of the ultrasound instrument at the distal region of the tip; and The aspiration provided at the distal region of the tip is adjusted when operating in the tissue resection mode based on at least one of a first determined type or a second determined type of the patient tissue.

36. The system according to any one of claims 29-35, wherein the one or more controllers are configured to: When operating in the tissue resection mode, suction is provided at the distal region of the tip by at least a portion of the ultrasound instrument; When operating in the tissue resection mode, the parameters of the aspiration provided at the distal region of the tip are measured; as well as The occlusion status is determined based on at least one of a first determined type or a second determined type of the patient's tissue and the measured parameters.

37. The system according to claim 36, wherein, The one or more controllers are configured to trigger an alarm and / or disable the tissue detection function of the surgical system in response to determining the blockage condition.

38. The system according to any one of claims 29-37, wherein the one or more controllers are configured to switch the operation of the ultrasound instrument from the tissue resection mode to the tissue sensing mode based on a second determined type of the patient tissue.

39. The system according to any one of claims 26-38, wherein the one or more controllers are configured to: Obtain at least one measured fourth electrical characteristic of the first AC drive signal; The ultrasonic instrument is determined to be in an unloaded state based on the fourth electrical characteristic measured by at least one of the above measurements; as well as In response to determining that the ultrasound device is in the no-load state based on the fourth electrical characteristic measured by the at least one, the operation of the ultrasound device is switched from the tissue resection mode to the tissue sensing mode. Optionally, the at least one measured third electrical characteristic includes a second voltage of the first AC drive signal and / or a second current of the first AC drive signal.

40. The system according to any one of claims 29-39, wherein the one or more controllers are configured to: Track the position of the distal region of the tip relative to a virtual object associated with the anatomical object in a known coordinate system; and The pose of the virtual object is adjusted in the known coordinate system based on a second determined type of the patient's tissue.

41. The system according to any one of claims 29-40, wherein the one or more controllers are configured to control a robotic manipulator based on a second determined type of the patient tissue to guide the movement of the ultrasound instrument to process the patient tissue.

42. The system of claim 41, wherein the one or more controllers are configured to: Controlling the robotic manipulator to guide the movement of the ultrasound instrument based on a virtual object associated with the patient tissue to process the patient tissue; and The parameters of the virtual object are adjusted based on a second determined type of patient tissue.

43. The system of claim 42, wherein the virtual object is a tactile object for controlling the robotic manipulator, and includes adjusting the position, posture, and / or force associated with the tactile object based on a second determined type of patient tissue.

44. The system according to any one of claims 29-43, wherein the one or more controllers are configured to: Based on a second determining type of patient tissue, it is determined that the distal region of the tip has moved from the internal portion to the external portion of the anatomical object; and In response to determining that the distal region of the tip has moved from the internal part to the external part of the anatomical object, the operation of the ultrasound device is deactivated, the ultrasound device is operated at a reduced power level in the tissue resection mode, or the operation of the ultrasound device is switched to the tissue sensing mode.

45. The system according to any one of claims 29-44, wherein the one or more controllers are configured to: Track the position of the distal region of the tip of the ultrasonic instrument in a known coordinate system; and Based on the location of the distal region of the tracked tip and a second determined type of the patient's tissue, a virtual model of the patient's anatomy is generated in the known coordinate system.

46. ​​The system of claim 45, wherein the one or more controllers are configured to: Based on the one or more frequency characteristics, it is determined that the distal region of the tip is contacting bone; and In response to determining that the distal region of the tip is in contact with bone, a virtual model of the bone is generated based on the tracked position of the distal region of the tip.

47. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: An AC drive signal is provided to the ultrasound instrument, which induces vibration in the tip of the ultrasound instrument used to remove patient tissue; Obtain at least one measured first electrical characteristic of the AC drive signal; One or more frequency characteristics of the AC drive signal are determined based on the first electrical characteristics measured at the at least one, wherein each frequency characteristic corresponds to a frequency other than the fundamental frequency of the AC drive signal; The type of patient tissue contacted by the distal region of the tip is determined based on one or more frequency characteristics identified. as well as The operation of the surgical system is controlled based on the identified type of patient tissue. Optionally, each frequency feature includes a frequency range that does not include the base frequency of the AC drive signal.

48. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: An AC drive signal is provided to the ultrasound instrument, the AC drive signal causing vibrations in the tip insufficient to remove the patient tissue; Determine a first frequency corresponding to the target vibration characteristics of the ultrasonic instrument when it is in an unloaded state; Obtain at least one measured first electrical characteristic of the AC drive signal; Determine a second frequency corresponding to the target vibration characteristics of the ultrasonic instrument when it is under load; The type of patient tissue contacted by the distal region of the tip is determined based on the first frequency and the second frequency; as well as The operation of the surgical system is controlled based on the identified type of patient tissue. Optionally, the target vibration characteristic is the resonant frequency of the ultrasonic instrument.

49. The system of claim 48, wherein the one or more controllers are configured to read the first frequency from the memory included in the tip.

50. The system of claim 48 or 49, wherein the one or more controllers are configured to: Obtain at least one measured second electrical characteristic of the AC drive signal; The ultrasonic instrument is determined to be in the no-load state based on the at least one measured second electrical characteristic of the AC drive signal; and In response to determining that the ultrasonic instrument is in the no-load state, the frequency corresponding to the target vibration characteristic of the ultrasonic instrument calculated based on the at least one measured second electrical characteristic of the AC drive signal is determined as the first frequency.

51. The system according to any one of claims 48-50, wherein the determined type of patient tissue is defined as a first determined type of patient tissue, and the one or more controllers are configured to: In response to determining the type of patient tissue contacted by the distal region of the tip based on the first frequency and the second frequency, a second AC drive signal is provided to the ultrasound device, the second AC drive signal being configured to induce vibrations in the distal region of the tip insufficient to remove the patient tissue and comprising a plurality of pulses extending between an upper amplitude and a lower amplitude, respectively. Obtain at least one measured third electrical characteristic of the second AC drive signal corresponding to the second AC drive signal at the upper amplitude; Obtain at least one measured fourth electrical characteristic of the second AC drive signal corresponding to the second AC drive signal at the lower amplitude; A third frequency, which is associated with the upper amplitude and corresponds to the target vibration characteristic of the ultrasonic instrument, is determined based on the at least one measured third electrical characteristic. A fourth frequency, which is associated with the upper amplitude and corresponds to the target vibration characteristic of the ultrasonic instrument, is determined based on the at least one measured fourth electrical characteristic; The type of patient tissue contacted by the distal region of the tip is determined based on the third frequency and the fourth frequency associated with the upper amplitude, and the type of patient tissue determined based on the third frequency and the fourth frequency is defined as a second determined type of patient tissue. as well as The operation of the surgical system is controlled based on a second, definitive type of patient tissue.

52. The system of claim 51, wherein the one or more controllers are configured to: Obtain at least one measured fifth electrical characteristic of the second AC drive signal; The distal region of the tip is determined to be in an unloaded state based on the fifth electrical characteristic measured by the at least one of the second AC drive signals. The first frequency is adjusted based on the at least one measured fifth electrical characteristic of the second AC drive signal; The type of patient tissue contacted by the distal region of the tip is determined based on the adjusted first frequency, and the type of patient tissue determined based on the adjusted first frequency is defined as a third determined type of patient tissue. as well as The operation of the surgical system is controlled based on a second, definitive type of patient tissue. Optionally, the fifth electrical characteristic of the at least one measured value of the second AC drive signal corresponds to the second AC drive signal at the upper amplitude.

53. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: The ultrasound device is operated in a tissue resection mode, in which a first AC drive signal is provided to the ultrasound device, the first AC drive signal causing vibration in the tip of the ultrasound device for resection of patient tissue, wherein the first AC drive signal includes a frequency component corresponding to a first resonant mode of the tip. The ultrasound device is operated in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound device, the second AC drive signal causing vibrations in the tip insufficient to remove the patient tissue, wherein the second AC drive signal includes a frequency component corresponding to a second resonant mode of the tip; Obtain at least one measured first electrical characteristic of the second AC drive signal; The type of patient tissue contacted by the distal region of the tip is determined based on the first electrical characteristics measured at least one of the above. as well as The operation of the surgical system is controlled based on the type of patient tissue identified.

54. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: The ultrasound device is operated in a tissue resection mode, in which a first AC drive signal is provided to the ultrasound device, the first AC drive signal causing vibration in the tip of the ultrasound device for resection of patient tissue, the first AC drive signal being limited to a first permissible frequency range associated with the tissue resection mode. The ultrasound device is operated in a tissue sensing mode, in which a second AC drive signal is provided to the ultrasound device, the second AC drive signal causing vibrations in the tip for sensing patient tissue, the second AC drive signal being limited to a second permissible frequency range associated with the tissue sensing mode; Obtain at least one measured first electrical characteristic of the second AC drive signal; The type of patient tissue contacted by the distal region of the tip is determined based on the first electrical characteristics measured at least once; as well as The operation of the surgical system is controlled based on the identified type of patient tissue. Optionally, the first allowed frequency range is defined by a first upper limit frequency and a first lower limit frequency, the second allowed frequency range is defined by a second upper limit frequency and a second lower limit frequency, and the difference between the first upper limit frequency and the first lower limit frequency is less than the difference between the second upper limit frequency and the second lower limit frequency.

55. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: The ultrasound device is operated in a tissue resection mode, in which a first AC drive signal is provided to the ultrasound device, the first AC drive signal causing vibration in the tip of the ultrasound device for resecting patient tissue, and wherein suction is provided by at least a portion of the ultrasound device in a distal region of the tip. The ultrasound device is operated in a tissue sensing mode in which a second AC drive signal is provided to the ultrasound device, the second AC drive signal causing vibrations in the tip for sensing patient tissue and insufficient to remove patient tissue, and wherein the suction provided by the at least a portion of the ultrasound device at the distal region of the tip is disabled. Obtain at least one measured first electrical characteristic of the second AC drive signal; The type of patient tissue contacted by the distal region of the tip is determined based on the first electrical characteristics measured at the at least one. as well as The operation of the surgical system is controlled based on the type of patient tissue identified.

56. A surgical system for detecting tissue type using ultrasound instruments for removing patient tissue, the system comprising: A power supply configured to provide a varying AC drive signal to the ultrasonic instrument to induce varying vibrations in the tip of the ultrasonic instrument. At least one sensor for measuring at least one electrical characteristic of the AC drive signal; as well as One or more controllers are connected to the at least one sensor and the power supply and are configured to: The ultrasound device is operated in a tissue resection mode, in which an AC drive signal is provided to the ultrasound device, the AC drive signal causing vibration in the tip of the ultrasound device for resecting patient tissue, and wherein suction is provided by at least a portion of the ultrasound device in a distal region of the tip. Obtain at least one measured first electrical characteristic of the AC drive signal; The type of patient tissue contacted by the distal region of the tip is determined based on the first electrical characteristics measured at the at least one. as well as The suction provided at the distal region of the tip is adjusted based on the determined type of patient tissue during operation in the tissue resection mode.

57. The system of claim 56, wherein the one or more controllers are configured to: Parameters of the aspiration provided at the distal region of the tip are measured when operating in the tissue resection mode; and The degree of blockage is determined based on the type of patient tissue identified and the parameters measured.

58. The system of claim 57, wherein the one or more controllers are configured to trigger an alarm and / or disable the tissue detection function of the surgical system in response to determining the blockage condition.

59. The surgical system according to any one of claims 1-59, comprising: A first tracker positioned relative to the patient tissue and a second tracker positioned relative to the ultrasound device; as well as A locator, configured to generate data indicating the attitudes of the first and second trackers in a known coordinate system, The one or more controllers are configured to track the posture of the ultrasound instrument relative to a virtual object associated with the patient tissue in the known coordinate system, based on the locator data.

60. The surgical system according to any one of claims 1-60, comprising a robotic manipulator coupled to the ultrasound instrument and configured to guide the ultrasound instrument to treat the patient tissue.

61. The surgical system according to any one of claims 1-61, comprising the ultrasonic instrument, the ultrasonic instrument including a driver coupled to the tip and configured to vibrate the tip upon application of an AC drive signal, and the tip defining a first path for providing the aspiration at the distal region of the tip and a second path for supplying flushing fluid to the distal region of the tip.

62. A sleeve for an ultrasonic surgical tool, the ultrasonic surgical tool including a tip and at least one actuator, the tip being coupled to the at least one actuator and an AC drive signal being provided from a console to the at least one actuator to cause the tip to vibrate, the tip being operable in a tissue sensing mode for sensing patient tissue and in a tissue resection mode for removing patient tissue, the sleeve comprising: A body comprising a proximal and distal end of an opening and a conduit for allowing flushing fluid to flow along the sleeve and out of the distal end of the opening during operation of the ultrasonic surgical tool to vibrate the tip, the body being adapted to be disposed around the tip and positioned in an operating position for operating the ultrasonic surgical tool to vibrate the tip, wherein the tip extends from the proximal end of the opening and protrudes from the distal end of the opening. and A tip memory, disposed in the body, stores data for controlling the actuation of the tip in the tissue resection mode and the tissue sensing mode, wherein the data for controlling the actuation of the tip indicates at least one of the following: a drive signal frequency for the tissue sensing mode, a drive signal frequency for the tissue resection mode different from the drive signal frequency for the tissue sensing mode, a permissible drive signal frequency range for the tissue sensing mode, a permissible drive signal frequency range for the tissue resection mode different from the permissible drive signal frequency range for the tissue sensing mode, a drive signal frequency corresponding to the target vibration characteristics of the ultrasonic surgical tool in an unloaded state, data for identifying different tissue types in contact with the distal region of the tip based on the electrical characteristics of the drive signal, and aspiration parameters for different tissue types.

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