Bilateral surgical robot system

Abstract

A mobile bilateral robotic surgical system is provided. The system may be optimized for robotic spine surgery. The system includes a mobile cart configured to be deployable under a surgical table, and in particular a spine surgical table. The mobile cart may not be fixed to a floor or a surgical table. The cart includes a plurality of robotic arms that are foldable to the sides or into the cart to allow deployment under a surgical table. The robotic arms may be relatively short and lightweight compared to known systems and are deployed on both sides of a patient. This allows a wide range of surgical procedures to be performed with high precision. The mobile cart further includes a central control unit that facilitates the system knowing the position of the robotic arms. The system further includes, as an option, a robotic navigation capability that enhances the system's capabilities in locating the patient's anatomy and instruments used in the surgical procedure.

Description

[Technical field]

[0001] [Earlier related application] This application claims the benefit of priority to earlier U.S. Provisional Patent Application No. 63 / 161,716, filed March 15, 2021, and U.S. Provisional Patent Application No. 63 / 253,533, filed October 7, 2021.

[0002] The present invention relates to a mobile bilateral surgical robotic system, which may also include a robotically controlled and coordinated surgical navigation system. In particular, the present invention relates to a mobile cart having a low profile incorporating at least two robotic arms positioned on opposite sides of a surgical table, the mobile cart being deployable under the surgical table. Multiple robotic elements such as robotic arms, end effectors, cameras, imaging devices, trackers, or other devices useful in robotic surgery may be included. The positioning and movement of the robotic elements are controlled and coordinated by a single control unit, and all of the robotic elements are robotically coordinated at a single origin since they are based on a single rigid housing. Specifically, multiple robotic elements may be attached to and controlled by a single control unit and may be used in a coordinated manner to deploy trackers, cameras, and surgical instruments as part of a robotic surgical procedure. More specifically, in the context of robotic spine surgery, multiple robotic elements may be mounted and controlled by a single control unit and used in a centrally coordinated manner to deploy trackers and surgical instruments, hold one or more cameras, and perform surgical procedures, with the relative movements of each robotic element coordinated by the central control unit. If desired, this single-housed, multi-arm robotic coordination system may be augmented with robotic navigation technology. [Background technology]

[0003] Robotic surgery is well known in the art, as is the application of robotic technology to spinal surgical procedures such as pedicle screw placement. Many robotic surgical systems, such as Intuitive Surgical's da Vinci robotic surgical system, are teleoperated. Although multi-arm robotic surgical systems are available in the field, such as those provided by Cambridge Medical Robotics, these known systems are also often teleoperated, and each of them consists of a single arm deployed separately with some degree of coordination by a remotely located control unit. Systems with multiple arms on multiple carts have significant drawbacks regarding integration into the surgical workflow, as well as an unnecessarily large footprint in the operating room. Also, when these multi-arm systems utilize a single cart, coordination between the arms is still performed by the physician "closing the loop" with his eyes and hands while seated at the control unit. Moreover, control of the teleoperated units by a remotely located control unit does not provide the required level of control over the entire range of surgical procedures, especially in the case of spinal surgery. For a system in which all the robot arms are fixed and coordinated in a single housing with a control unit, accuracy would necessarily be poor.

[0004] For example, US2018 / 0193101 by Hashimoto discloses a multi-arm robotic system located under the operating table. However, such a system is not mobile and no disclosure is provided of centralized control of the movement and navigation of the robotic arms. Bed-mounted systems are also known, for example, in US2010 / 0286712 by Won. However, such systems are not mobile by definition and present significant barriers to surgical workflow and available space in the operating room. WO2020 / 079596 by Zehavi discloses another non-mobile robotic surgical system incorporating multiple arms for imaging and optional instrument deployment. However, the robotic arms are floor-mounted and large, which would suffer from reduced precision, would significantly impede surgical workflow, and would be expensive to operate. None of these known systems provide a mobile solution with centralized control of the robotic arm's movement and navigation, and all deploy relatively large robotic arms that can suffer from lack of precision and low utilization and acceptance rates due to their size and the fact that they are non-mobile.

[0005] The performance of the full range of spinal surgical procedures (beyond just pedicle screw placement, which comprises a small portion of the majority of procedures) requires a bilateral system with highly accurate robotic arms and would also benefit significantly from robotically coordinated navigation. A typical procedure may require the placement of multiple passive or active markers on the bone or soft tissue, one or more robotically controlled and operated cameras that can be placed at various distances from the surgical field, and one or more end effectors deployed by the robotic arms. Such a multi-arm / multi-camera system mounted and controlled on a single mobile cart is not available in the current state of the art. There is a strong and long felt need for such a system, as it would enable the performance of the full range of spinal surgical procedures with robotically coordinated control and navigation at a level of precision not currently possible. Summary of the Invention

[0006] A bilateral robotic surgical system is provided herein that includes a mobile cart configured to be selectively positioned beneath a surgical table, particularly beneath a spinal surgical table, the mobile cart incorporating at least two robotic arms configured to be positioned on either side of the surgical table during surgery.

[0007] The mobile cart has a significantly lower profile than previously known systems, and the robotic arms can fold down to the sides of the operating table when deployed, or actually fold into the cart itself. The low profile of the mobile cart and the ability to fold the arms into or to the sides of the cart provide for optional deployment of the mobile cart under the operating table, a critical capability given the space savings in the operating room and lack of interference with surgical workflow by the system and its arms.

[0008] The mobile cart design allows the relatively short and light robotic arms to be deployed on either side of the operating table. This bilateral approach not only allows a wider range of robotic surgical procedures to be performed, particularly robotic spinal surgical procedures, but also improves the precision of the robotic arms. The relatively short and light robotic arms of the current invention system are inherently more precise than the larger arms of systems known in the art. In particular, systems with only one robotic arm to deploy instruments would need to cover a much larger surgical field than the smaller arms of the present system, whereas in the present system, each arm carries an instrument and covers a much smaller surgical field. Moreover, it is known in the art that a single robotic arm extended to the full extent of its reach is less precise in performing tasks than the same robotic arm used in a more folded deployment.

[0009] A key feature of the system of the current invention is that the robot arms originate from a common base, which also incorporates a central control unit. In this design, the movements of the robot arms are centrally coordinated by the control unit of the common base. The advantage of the arms having a single starting point is that the system knows the spatial position and trajectory of all elements of the system, as well as their relative positions and trajectories to each other. Thus, the provided robotic system does not strictly require navigation (as a positioning method), although adding navigation can be an optional choice to enhance the system.

[0010] In an alternative embodiment of the system of the present invention, the mobile cart may optionally comprise two component mobile units that can be coupled to the operating table from both sides when deployed under the operating table. In this embodiment, by appropriate mechanical and electrical connections, two component mobile units can be coupled under the operating table to form one mobile cart. Each component mobile unit houses one or more robotic arms that can be deployed from the side or top of the unit. Furthermore, in this embodiment, one of the component mobile units houses a central control unit, which controls the deployment and movement of all the robotic arms by means of mechanical and electrical connections between the component mobile units once the mobile units are coupled. In this manner, a single-cased mobile robotic surgery system is made from two components and centrally controlled by a single control unit.

[0011] Also provided herein is a robotically controlled surgical navigation system for enhancing bilateral robotic surgical systems. Specifically, provided herein is a robotically controlled surgical navigation system for robotic spine surgery. The system is configured to perform all aspects of a robotic spine surgical procedure, going beyond simple procedures such as pedicle screw placement performed by currently known robotic systems.

[0012] In a representative embodiment, the system includes a central control unit housed by a surgical cart. At least two arms or other holders can be mounted on the cart. The at least two arms or holders are configured to hold cameras, end effectors, or other instruments to be used in surgery, more specifically spinal surgery. The at least two arms or holders can also be used to track passive or active markers in the surgical field that are attached to soft or hard tissue, specifically, preferentially, the bones of the spine, which are usually deployed by the doctor or surgeon near the beginning of the surgical procedure. The active or passive markers can also be optionally attached to various relevant surfaces, such as the surgical table, surgical and auxiliary columns or stands, and the arms or holders themselves.

[0013] The robotic collaborative surgical navigation system of the present invention provides centralized coordination of arms or other holders with a control unit housed in a surgical cart. By way of example only, this allows one arm or holder to deploy surgical instruments relative to bone markers, while another arm or holder deploys a navigation / tracking camera at the appropriate distance and angle, all of which allow for coordinated deployment of the instruments and tracking of the markers. As a further example, centralized control and coordination of multiple arms or holders with a control unit housed in a single cart allows one or more cameras deployed at the appropriate distance and angle to be used for navigation during a surgical procedure, in which one or more end effectors carried by one or more robotic arms are operated within a surgical field using guidance facilitated by positioning multiple surgical instruments and devices relative to passive or active markers.

[0014] One of the main features of various embodiments of the present invention is that one or more navigation cameras can be mounted on one or more robotic arms, and their movements are coordinated by a central control unit. Thus, the camera angles are controlled and coordinated with the robotic system and markers so that the markers can be visualized at the appropriate distance and angle. This approach avoids the disruption of the surgical workflow that would occur if multiple robotic carts were brought into the operating room. This approach also solves the problem commonly found in spine surgery, where the camera is kept at a greater distance from the surgical field (e.g., more than 2 meters) and larger markers must be used at that location, which can obscure various aspects of the spine and / or surgical field. If the bony anatomy moves and displaces the large markers during surgery, they may also move undesirably relative to the anatomy, again compromising accuracy.

[0015] There are multiple feedback loops in the robotic collaborative surgical navigation system of the present invention. For example, in a first feedback loop, multiple robotic arms carrying various instruments are deployed from the same cart as described above. These robotic arms are coordinated with each other and with radiopaque markers (e.g. made of tungsten material) on the anatomy, for example by scanning the patient (by X-ray or CT) while the radiopaque markers are attached to the bones and / or while at least one marker attached to at least one robotic arm is in the scan image.

[0016] Since multiple robotic arms are deployed on a single chassis with a single control unit, their movements can be coordinated and the feedback loop between the arms is closed. More specifically, even without the aid of navigation as a positioning method, both robotic arms can be precisely robotically controlled relative to the bone anatomy by sharing the same common axis origin and using robot kinematics.

[0017] In a second exemplary feedback loop, various robotic arms holding any desired combination of, for example, robotic navigation cameras, end effectors, and surgical navigation markers or instruments, are all mounted in a single housing that houses a single control unit that coordinates the movements of the robotic arms, thus closing the feedback loop.

[0018] In this regard, these robotically operated navigation cameras do not blindly search for fiducial navigation markers, but rather actively aim at the desired marker or location because the central controller knows the location of the object from the images (e.g., CT), and the central controller coordinates the movement of the robotic navigation system to reach the object at the optimal distance and angle.

[0019] In yet another example of a feedback loop, active or passive markers may be placed on a robot arm that is deployed on a single housing along with a robot navigation camera or other robot arms that may hold end effectors. This third example of a feedback loop is closed because the single housing has a control unit that coordinates the movement of the robot arms, and the feedback loop is closed even if, for example, a robot navigation camera visualizes markers on one or all of the robot arms and the position of one or more of the robot arms is changed accordingly.

[0020] All of these needs and factors greatly benefit from the centralized coordination and control of the single-cart, multi-arm, non-teleoperated robotic system of the present invention. [Brief description of the drawings]

[0021] [Figure 1a] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1b]1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1c] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1d] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1e] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1f] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1g] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 1h] 1a-1h show various side and top views of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 2a] 2a-b show two side views of the side door operation of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 2b] 2a-b show two side views of the side door operation of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 3a] 3a-3c show alternate side views of the wheeled deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 3b] 3a-3c show alternate side views of the wheeled deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 3c]3a-3c show alternate side views of the wheeled deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 4a] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 4b] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 4c] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 4d] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 4e] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 4f] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 4g] 4a-4g show various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 5a] 5a-5d show various top and side views of surgical tool deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 5b] 5a-5d show various top and side views of surgical tool deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 5c]5a-5d show various top and side views of surgical tool deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 5d] 5a-5d show various top and side views of surgical tool deployment of a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 6] FIG. 6 illustrates the deployment of navigation modalities for a multi-arm mobile surgical robotic system according to various embodiments of the present invention. [Figure 7a] 7a-7b show side views of an alternative methodology for deploying the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. [Figure 7b] 7a-7b show side views of an alternative methodology for deploying the robotic arms of a multi-arm mobile surgical robot system according to various embodiments of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0022] The following detailed description will now be provided with reference to the drawings and several representative embodiments of the present invention.

[0023] In one embodiment of the present invention, a mobile cart is provided incorporating at least two robotic arms, at least one arm located on each side of the operating table. The mobile cart has a significantly lower profile than previously known systems, so that the entire system can be deployed under any standard operating table (e.g., up to about one meter high) so that, when the robotic arms are folded, they can be deployed on either side of the operating table and the patient lying thereon. Locating the entire robotic system under the operating table has significant implications in terms of saving valuable operating room floor space and not interfering with the surgical team and their workflow.

[0024] In various embodiments, the robotic arms may be folded in a number of ways to the side or inside of the mobile cart. They may optionally be folded down to the side of the cart, or folded into the cart, which may be either into the side of the cart or down into the top of the cart. Regardless of the folding modality, the desired end result is that a mobile cart with foldable arms is easily deployable under a surgical table.

[0025] The cart includes at least two wheel pairs that facilitate deployment and removal of the mobile cart under a surgical table, which may be selectively folded and / or retracted to allow navigation around and traversal of obstacles, such as longitudinal bars found under a spinal surgical table. In one embodiment, the cart includes three wheel pairs, two of which are selectively retractable to allow the cart to be deployed under a spinal surgical table.

[0026] In an alternative embodiment, the mobile cart may optionally include two constituent mobile units that can be coupled to approach the operating table from either side when deployed underneath the operating table, providing an alternative methodology for deployment underneath the operating table that does not require folding and / or retracting the wheel pairs.

[0027] In this embodiment, with appropriate mechanical and electrical connections, the two component mobile units can be joined under the operating table to form one mobile cart with centralized control and communication. The connection and centralized control between the two component units allows the robotic arms to be based on a single housing, thus enjoying the benefits of true centralized robotic control.

[0028] Each constituent mobile unit houses one or more robotic arms that can be deployed from the side or top of the unit. Furthermore, in this embodiment, one of the constituent mobile units houses a central control unit that controls the deployment and movement of all of the robotic arms by means of mechanical and electrical connections between the constituent mobile units once the mobile units are mated. In this manner, a single-enclosure mobile robotic surgical system is made from two components and centrally controlled by a single control unit. The robotic arms operate from a single origin with all the benefits that come with the robotic system "knowing" where each of the arms is in three-dimensional space due to a common origin.

[0029] In various embodiments of the bilateral robotic surgical system of the current invention, there is no requirement for either the cart or the robotic surgical arms to be fixed to the operating table or floor. The wheels of the mobile cart may be locked to prevent movement, and optionally, an element of the cart may be deployed to press against the underside of the operating table when deployed underneath the table, thus allowing for patient movement and / or stabilizing the operating table in the event of external forces applied to the patient or table.

[0030] The cart serves as a common rigid base for the robotic arms, so that the exact location, trajectory, and relationships between the multiple robotic arms are known. Each robotic arm may have several degrees of freedom, including height adjustment (Z-axis) of its robotic base. The robotic bases may also have rigid, precision rails that provide an additional two degrees of freedom (XY movement) for adjusting the robotic bases for each unique case. This allows the robotic bases to be optimally positioned close to the patient's body (e.g., about 10 cm from the patient's body).

[0031] One of the important novel elements of the following robotic system is that it can provide a very large operation scale (up to 360 degrees trajectory coverage around a designated organ) while using only two relatively small and short robotic arms (e.g., arm length up to 1 meter), which is extremely important in surgical fields such as spine surgery. This is possible because each arm is required to cover only a part of the patient's body on each side of the table alone - for example, the right robotic arm is responsible for covering only the right side / part of the patient's location, and the left robotic arm is only required to reach the trajectory of the left side / part of the patient. Each robotic arm is not sufficient to cover the entire required operation scale alone, but both arms are sufficient to provide the entire coverage of the surgical volume in cooperation with each other. Moreover, even if one arm of 1 meter length can cover the required distance from one side of the table to the other for a certain task, extending the arms to their maximum length would cause a significant decrease in precision. It is well known in the art that robotic arms are much stiffer and therefore more precise in a folded position, and less stiff and precise in an extended / extended position. Other systems with independently operating (non-navigated) robotic arms require the deployment of larger, heavier, less precise robotic arms when wide surgical field coverage is desired.

[0032] Several positioning techniques can be incorporated into the robotic system, for example to provide the robot controller with the required coordinates of the robot's location relative to the surgical target (e.g., the human spine). The incorporation of a navigation system into the proposed robotic system can be either independent of the robotic system as a third-party system or integrated into the system. Another option is to perform an X-ray or CT scan while the robot holds a marker or similar markers are fixed to the bony anatomy in the area of ​​interest, thereby obtaining the location of the robot's end effector relative to the designated organ.

[0033] In further embodiments, this bilateral robot design solves several problems that have not been solved by other surgical systems, particularly in spine surgery: First, the robotic arms are not attached to the rails of the table (as in some current systems known in the art), so they do not get too close to the patient and hit the patient's body, potentially injuring the patient and / or restricting the robot's movements; On the other hand, the robotic arms are not too far from the patient, as in existing robotic systems, where the robotic arms are assembled on a cart that is placed next to the table, forcing the robotic arms to be long, heavy and cumbersome to reach both sides of the patient (left and right parts of the body) from the same location.

[0034] Also, because the system has at least one robotic arm deployed on each side of the table, each arm only needs to perform tasks on one side of the table, which allows the system to have relatively small / short and stiff robotic arms, which is extremely important from a precision standpoint, and these stiff arms also allow for additional tasks in spine surgery that require significant force (e.g., vertebral manipulation) to be performed - a topic that is discussed further in the following section.

[0035] In robotic surgery, to achieve and maintain high accuracy, it is crucial to keep the distance between the robot base, the robot end effector, and the organ being operated on as small as possible. The following design makes exactly that possible, not only on one side of the patient, but on both sides simultaneously. Thanks to this design, this crucial bilateral "triangle of accuracy" is significantly smaller than all other available systems.

[0036] In the proposed design, the short robotic arms located on the very low profile mentioned above are less likely to physically obstruct the surgical team and do not block their view / field of vision. In this proposed design, even in the highest working position, the robotic arms hardly ever block the surgeon's line of sight.

[0037] The novel bilateral robotic surgical system, by its design, can also facilitate and enable the following robotic surgical activities, by way of example only: - Performing bilateral and parallel surgical tasks (e.g. drilling vertebrae, inserting implants, etc.) simultaneously and / or sequentially on both sides of the patient. This parallel operation is of further critical importance in terms of precision. It is well known in spine surgery that when working along the spine from (for example) one vertebra to the next, precision is difficult to maintain due to the relative movements between one vertebra and the other. One reason is that precision decreases when moving away from the vertebra marked with the navigation marker (e.g. when using a navigation system for robot positioning). Another reason is that when touching / drilling one vertebra, that vertebra physically moves in rotation relative to itself and also moves relative to the other vertebra of the spine. The proposed system is able to overcome this challenge as illustrated in the following exemplary sequence: -One robotic arm drills and places pedicle screws with high precision in the first pedicle (the first vertebra selected as closest to the navigation system marker or image scan marker, or any other positioning method used in conjunction with the system). With the robotic arm still connected to the now well-fixed drill / implant, the arm is now used as a stabilizer for drilling the next vertebra / pedicle - either the same vertebra or the adjacent vertebra (above or below) - while rigidly connected to the vertebra. The system can then continue drilling and placing screws in a "zig-zag" pattern, i.e., left-right / up-down, with the right grip stabilizing the left drill and vice versa.

[0038] Due to the fact that the robotic arms of the system are short and strong and rigidly connected to the same rigid platform (cart), they can manipulate the vertebrae relative to each other, holding (for example) implants that are rigidly inserted into the pedicles of the vertebrae from both sides. This technique can be used to manipulate two vertebrae (for example, indirect decompression, compression, distraction, etc.), or several vertebrae together, or even the entire spine. By placing the arms one behind the other, they can shift two vertebrae by a few millimeters and keep this shift constant and safe while the surgeon performs delicate surgical tasks between them (for example, disk removal, decompression, etc.).

[0039] In an alternative embodiment, the system can add additional arms on each side, so that while the two opposing arms are engaged in retracting the two vertebrae as described above, a third and fourth arm is available to perform additional surgical tasks, either guided / controlled by a human surgeon or robotically controlled with software and algorithm guidance. Moreover, because the arms are short and strong and share the same rigid base, they can optionally be attached to (for example) metal rods that are part of the brace and connect the screws, and manipulated by bending the rods to achieve the desired spinal posture. This is not achievable with any other available surgical robotic system. In this surgical approach, the fact that the robotic arms are deployed on either side of the patient, have a relatively low profile, emanate from a common base that is separate from each other, and are controlled by a central controller that knows the position of each arm means that high forces and high precision can be applied to safely bend rods and manipulate the spine in vivo.

[0040] Similar techniques of high precision and robust robotic bone manipulation are relevant for further surgical areas such as hip / knee replacement surgery, where two strong robotically coordinated arms can hold and manipulate two bones (e.g. femur, tibia, etc.), while a robotically synchronized third arm provides imaging, navigation, etc. to enhance the surgery and / or assist the surgeon in multiple tasks while he performs some surgical tasks in between. The third arm may hold some kind of surgical instrument, and these three or four surgical arms can work together automatically with or without human supervision to perform the surgical tasks robotically. Mainly due to the fact that all these arms are robotically coordinated using a single rigid housing, still easy to handle under the usual economic and human machine interface (HMI) considerations, the following is achieved:

[0041] Anatomical objects and markers can be acquired by intraoperative imaging (e.g., intraoperative CT). In this example, a robotic navigation camera is used mounted on a robotic arm, which is fixed to a single housing with a control unit on the other hand. The single housing may have one or more robotic arms mounted thereon and used for surgical tasks. The control unit coordinates the movement of the multiple robotic arms and thus the navigation camera directed at the anatomical objects to generate a closed feedback loop. The use of navigation cameras provides both redundancy and diversity of information about anatomical objects of interest, which is essential for the accuracy and overall validity of the information. The cameras may employ different technologies, e.g., infrared and optical (RGB) modalities. The use of different modalities also provides diversity of information, thus improving the overall accuracy and quality of the information provided.

[0042] In the same embodiment, additional robotic navigation cameras may be mounted on additional robotic arms mounted on the same single housing, and the additional cameras may be placed at a conventional distance (e.g., 1-2 meters) from the surgical field to image the entire surgical field. Additional robotic arms may be mounted on the single housing and may hold markers or end effectors. Those skilled in the art will recognize that due to the fact that all of the robotic arms are mounted on the same housing and their movements are coordinated by a control unit housed in the housing, the movements of each of the various arms are related to the movements of the other robotic arms in a closed feedback loop. For example, if one of the robotic arms holds a navigation camera near an anatomical region of interest (e.g., a particular vertebra) based on the location of a marker, the navigation camera held at a conventional distance can visualize the entire surgical field and assist in placing other nearby navigation cameras near the anatomical region of interest (e.g., on the adjacent vertebrae where a marker has already been placed). This closed feedback loop can then be used to guide the deployment of surgical instruments, which may be robotically brought to the surgical field as end effectors on a robotic arm mounted in a single housing, or manually brought to the surgical field by the surgeon. In either robotic or non-robotic scenarios, a robotic navigation camera held at a customary distance from the surgical field can assist in the deployment of surgical instruments thanks to its view of the entire surgical field at the optimal distance and angle for any particular scenario, and its inherent ability to robotically maneuver itself to overcome obstacles and interferences that obscure its path.

[0043] Those skilled in the art will understand that the optical navigation modality specifically disclosed herein is only one possibility for enhancing the navigation capabilities of the system of the current invention, and will recognize that other navigation modalities, such as, by way of example only, EM navigation and ultrasound navigation, each of which could be similarly incorporated into the system of the current invention in accordance with techniques known in the art.

[0044] Although applicants have disclosed an embodiment of the inventive system with two surgical arms (i.e., robotic arms that deploy surgical instruments) and one navigation arm (i.e., robotic arm that holds a navigation camera), it is also possible to have an embodiment of the inventive system with one surgical arm and one navigation arm. Such a two-arm embodiment may have the navigation arm and the surgical arm located at opposite ends of the cart to provide a bilateral system, but it is also possible for the navigation arm and the surgical arm to be located at the same end of the cart. In either arm placement scenario of this two-arm system, as described above, the mobile cart of the current inventive system would still be deployed under the operating table, providing the disclosed advantages of mobility and no interference with surgical workflow.

[0045] Specific reference will now be made to the accompanying drawings. Those skilled in the art will readily appreciate that the accompanying drawings are merely exemplary embodiments of the present invention. Those skilled in the art will appreciate that the described embodiments may be readily modified without departing from the spirit or intent thereof, and that such variations would still fall within the scope of the present disclosure. By way of example only, while many of the accompanying drawings show a mobile robotic system having three robotic arms, those skilled in the art will appreciate that more or fewer robotic arms may be deployed. As a further example, many of the accompanying drawings show a mobile robotic system having three sets of retractable wheels that facilitate deployment of the mobile robotic cart under a surgical table. However, those skilled in the art will appreciate that any combination of wheels or similar features that allow a mobile cart to be deployed under a surgical table, particularly for spinal surgery, falls within the scope of the current invention.

[0046] As one of ordinary skill in the art would also understand, any known available surgical robotic arm could be deployed on the mobile robotic system of the current invention. The inventors make no proprietary claim to a specific robotic arm, but rather have invented a mobile surgical robotic system in which multiple robotic arms are deployed and controlled from a common base, which, as described herein, provides significant advantages over the current state of the art. One of ordinary skill in the art would be able to recognize and select the types of robotic arms that could be used in conjunction with the present invention.

[0047] Additionally, one of ordinary skill in the art, once reviewing the present disclosure, would be able to recognize and select the types and dimensions of materials required to assemble the systems of the present invention. One of ordinary skill in the art would know the types of materials that are commercially acceptable in surgical robotic systems, and would understand the control systems and associated software that would be required to assemble and operate the systems of the presently disclosed invention.

[0048] 1a-1h depict various side and top views of a multi-arm mobile surgical robotic system 100 according to various embodiments of the present invention. The mobile surgical robotic system 100 is shown embodied in a mobile cart 101. The cart 101 has three sets of wheels 102, 103, 104 that are selectively retractable to facilitate movement of the cart 101, for example, around an operating room. The retractable nature of the wheels 102, 103, 104 allows the cart 101 to navigate around obstacles such as longitudinal rods found under tables for spinal surgery.

[0049] The cart 101 of Figures la-h has a set of doors 105 at one end and a set of doors 106 at the other end for storage and deployment of one or more robotic arms 107, 108, 109. As shown, the cart 101 houses three robotic arms 107, 108, 109 that can be optionally folded into the cart 101 or deployed from either end of the cart 101 when the doors are open. As previously discussed herein, the cart 101 forms a common base for the robotic arms 107, 108, 109. The robotic arms 107, 108, 109 originate from the common base and their selective deployment is managed by a central control unit located within the cart 101.

[0050] 2a-b show two side views of the operation of the side doors of a multi-arm mobile surgical robotic system 200 according to various embodiments of the present invention. As shown in FIGS. 2a and 2b, a cart 201 of the mobile surgical robotic system 200 has a pair of doors 202, 203 disposed at each end of the cart 201. In the views provided here, one or more robotic arms 204 are folded into each end of the cart 201, and the doors 202, 203 are selectively openable to allow deployment of the robotic arms 204.

[0051] 3a-3c show alternate side views of wheel deployment of a multi-arm mobile surgical robot system 300 according to various embodiments of the present invention. In FIG. 3a-3c, the cart 301 of the mobile surgical robot system 300 has a first set of wheels 302 near one end of the cart 301, a second set of wheels 303 near the other end of the cart 301, and a third set of wheels 304 on the same side of the centerline as the first set of wheels 302. This design setup allows the mobile cart 301 of the current invention to be deployed under a surgical table 305 that may be in the way of obstacles such as a longitudinal bar 306 found on almost all conventional spinal surgical tables. As shown in FIG. 3a, when the cart 301 approaches the longitudinal bar 306 under the spinal surgical table, the first set of wheels 302 can be retracted while the other two sets of wheels 303, 304 remain in contact with the floor. Next, as shown in Figure 3b, the first set of wheels 302 can be moved back to contact the floor once the vertical surface of the first set of wheels 302 has cleared the bar 306. Finally, as shown in Figure 3c, the third set of wheels 304 can be retracted so that the mobile cart 301 can be advanced and centered under the operating table 305. With two sets of wheels in constant contact with the floor, the cart 301 remains mobile and stable.

[0052] 4a-4g display various top, side, and end views of the deployment of the robotic arms of a multi-arm mobile surgical robot system 400 according to various embodiments of the present invention. The various views in this series of figures show partial and full deployment as the multiple robotic arms are deployed through an open door of a cart 401. For example, FIG. 4c shows an embodiment of a mobile surgical robot system 400 of the present invention with three robotic arms 402, 403, 404 deployed. Two robotic arms 403, 404 hold a surgical instrument 405, and the third robotic arm 402 holds a navigation camera 406. Additionally, FIG. 4c shows two screens 407 that provide various options for a user to interface with the system 400 of the present invention.

[0053] Figures 4d-g show a closer top view of the deployment of the robotic arms from the mobile cart of the mobile surgical robot system 400 of the present invention. These figures provide a more general view of the various stages of arm and screen deployment when using the present invention. Figures 4d-g show three robotic arms 402, 403, 404 deployed with two screens 407 for a user to interact with the system, two of which 403, 404 hold surgical instruments 405 and one 402 holds a navigation camera 406. Those skilled in the art will understand that the number of robotic arms and screens can be modified without departing from the spirit and substance of the present disclosure.

[0054] 5a-5d show various top and side views of surgical tool deployment of a multi-arm mobile surgical robot system 500 according to various embodiments of the present invention. Two robotic arms 501, 502 are shown holding a surgical tool 504, and one robotic arm 503 is shown holding a navigation camera 505. Two screens 506 for interacting with the system 500 are also shown. These figures show that relatively short and robust robotic arms can be deployed, one on each side of the patient, and each robotic arm can independently advance a surgical tool towards the target anatomy of the patient. As discussed herein, this provides significant advantages in terms of the reach, stability, and precision of the robotic arms, allowing a much wider range of surgical procedures to be performed. As the robotic arms all originate from the same origin on the cart, the mobile surgical robotic system of the present invention allows the robotic arms to always know their positions relative to each other in space. Thus, additional navigation functionality is not strictly required.

[0055] 5a-d also show a single surgical marker 507 attached to the patient's anatomy. A navigation camera 505 mounted on one of the robotic arms 503 can visualize the marker 507. Because the navigation camera 505 is mounted on the robotic arm 503 that emanate from the same common point (cart) as the other robotic arms 501, 502, the mobile surgical robotic system 500 of the present invention can incorporate information from the navigation camera 505 into guiding the surgical robotic arms 501, 502 holding the surgical instrument 504. As discussed herein, all three robotic arms are coordinated by a central control unit of the system of the present invention, providing unified robotic coordination, which in turn provides improved accuracy and usability.

[0056] Figure 6 shows the deployment of navigation modalities of a multi-arm mobile surgical robotic system 600 according to various embodiments of the present invention. In Figure 6, a radiopaque surgical marker 601 is attached to the patient's bone anatomy. One of the robotic arms 602 of the mobile surgical robotic system 600 holds an additional marker 603 above the target bone anatomy of the patient, and an intraoperative CT system 604 is deployed to acquire images of the surgical field including said markers 601, 603. In this regard, the spatial location of the patient's bone anatomy is acquired along with the position of the end effector of the robotic arm 602 holding the marker 603. As described herein, since all of the robotic arms of the system originate from the same common origin on the system's cart, the mobile surgical robotic system of the present invention is then coordinated to the patient's target anatomy, and the central control unit can guide the movement of the robotic arms (with attached instruments and end effectors) to the target anatomy during the performance of a surgical procedure, additionally using information obtained from navigation cameras (which are also coordinated together since they are mounted on the robotic arms that also originate from the same common base on the cart). The step of coordination can be repeated as desired during a surgical procedure, for example, when the target anatomy is moved or when the surgeon desires to operate on a different region of the anatomy.

[0057] 7a-7b show side views of an alternative methodology for deploying the robotic arms of a multi-arm mobile surgical robot system 700 according to various embodiments of the present invention. FIG. 7a shows the robotic arm 702 folded into a mobile cart 701 of the mobile surgical robot system of the present invention. The robotic arm 702 on each side of the cart 701 is deployed on a platform 703, 704 selectively movable in a vertical plane and optionally deployed on the inside or outside top of the cart 701. FIG. 7b shows the platform 703, 704 elevated from the cart 701 and the robotic arm 702 deployed thereby outside the cart 701. Those skilled in the art will appreciate that this deployment strategy may provide advantages in some use cases. Deploying the robotic arm 702 in this manner may be simpler from a mechanical standpoint since multiple side doors are not required. Deploying the arms 702 in this manner may also allow the top door to be more easily closed after the robotic arms are deployed to protect the interior of the cart from liquids and debris that may be generated during a surgical procedure.

[0058] Those skilled in the art will appreciate that numerous modifications can be made to the disclosed embodiments while remaining within the outer boundaries of the current invention. By way of example only, variations in the number of navigation cameras, robotic arms, markers, and end effectors can be used without departing from the invention. As another example, markers of various sizes can be used. The embodiments provided are representative in nature.

Claims

1. 1. A mobile surgical robot system, comprising: A single housing; At least two robotic arms mounted on the single housing; a central control unit mounted on the single housing and robotically coordinating the movements of the at least two robotic arms; Equipped with The mobile surgical robotic system is configured to be selectively positioned under and removed from under a surgical table before, during, or after a surgical procedure.

2. The mobile surgical robot system of claim 1, wherein one of the robotic arms is configured to hold a surgical instrument and one of the robotic arms is configured to provide a navigation modality.

3. A mobile surgical robot system as described in claim 1 or 2, wherein the at least two robotic arms are configured to be accommodated within the single housing when stored and during positioning under the operating table, and the at least two robotic arms are deployable from the single housing after the single housing is positioned under the operating table for use during the surgical procedure.

4. The mobile surgical robot system of claim 3, wherein the at least two robotic arms are deployed such that at least one robotic arm is deployed on one side of the operating table and at least one robotic arm is deployed on another side of the operating table for use during the surgical procedure.

5. A mobile surgical robot system as described in claim 4, wherein the at least two robotic arms are folded into respective sides of the single housing during storage and placement of the system under the operating table.

6. A mobile surgical robot system as described in claim 4, wherein the at least two robotic arms are mounted on a platform within the single housing, the platform being capable of being raised and lowered to selectively deploy the robotic arms from each side of the single housing.

7. A mobile surgical robot system as described in any one of claims 1 to 6, further comprising a monitor screen for a user interface with the mobile surgical robot system.

8. A mobile surgical robotic system as described in claim 7, wherein the system is capable of performing a range of bilateral spinal surgical procedures without the assistance of a navigation camera or other imaging equipment.

9. The mobile surgical robot system of claim 7, further comprising at least three robotic arms, at least one of the at least three robotic arms being equipped with a robotic navigation camera.

10. The mobile surgical robot system of claim 9, wherein one of the at least three robotic arms coordinates the mobile surgical robot system to the patient's anatomy by placing a marker between a radiopaque marker and the robot navigation camera.

11. A mobile surgical robot system as described in claim 10, wherein after aligning the mobile surgical robot system with the patient, the central control unit robotically coordinates the movements of the at least two robotic arms holding surgical instruments and the at least one arm carrying a robotic navigation camera during performance of the surgical procedure.

12. A mobile surgical robot system as described in any one of claims 1 to 11, further comprising at least three sets of wheels for moving the mobile surgical robot system, wherein one or more of the at least three sets of wheels may be selectively retractable.

13. A mobile surgical robot system as described in claim 12, wherein the system is configured such that the one or more sets of retractable wheels can be retracted and redeployed during positioning of the system under the operating table.

14. A mobile surgical robot system as described in any one of claims 1 to 13, further comprising a modality that applies pressure to an underside of the operating table to fix the position of the system relative to the operating table.

15. A mobile surgical robot system as described in any one of claims 1 to 14, wherein the system is not remotely operated or controlled.

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