Guidance of Surgical Tools by Robot Navigation Assistance

Abstract

A spinal surgery system includes a tissue protector (105) having an elongated body and a dilator (200) sized and shaped to be removably insertable into the lumen of the tissue protector. The dilator includes a connector for engaging a tracking array (300) of a robotic navigation system, and the tissue protector can also engage a robot (400) of the robotic navigation system. For example, the robot has a guide tube and the tissue protector is insertable into the guide tube. The tracking array may include a body having a plurality of arms and a tracking device (s) connectable to the plurality of arms.

Description

Technical Field

[0001] The present disclosure relates to special tools for spinal surgery, including guidance instruments, and surgical methods using the same.

Summary of the Invention

[0002] The present disclosure relates to a set of guidance instruments for use in surgical procedures, particularly spinal surgery. The device includes a tapered cannula having a tissue contact distal end, a tissue tool insertion proximal end, and a slotted through-channel from the proximal end to the distal end. The device can also include a tissue dilator insertable through the tapered cannula, the dilator having a shaped distal end for separating and penetrating tissue (and in some configurations engaging and / or penetrating a target bone structure), and a circumferential receiver near the proximal end. The device may further include a tracking array including one or more navigation tracking devices, a housing having a through-channel for receiving the proximal portion of the tissue dilator, and one or more engagement tabs for engaging the circumferential receiver in the tissue dilator to hold the tracking array to the tissue dilator.

[0003] A spinal surgery system may include: (i) a tissue protector having an elongated body with a proximal end, a distal end, and a lumen extending therethrough from the proximal end to the distal end; (ii) a dilator of a size and shape removably insertable into the lumen of the tissue protector, the dilator having an elongated body extending from the proximal end and a distal end; and (iii) a tracking array of a robotic navigation system selectively connectable to the dilator. In some configurations, the tissue protector is engageable with a robot of the robotic navigation system. , near an elongated body extending from the proximal end and for separating adjacent tissues a distal end, and may further include a tracking array of a robotic navigation system selectively connectable to the dilator. In some configurations, the tissue protector is engageable with a robot of the robotic navigation system.

[0004] According to one aspect, the tracking array of the robotic navigation system can be visualized by the camera of the robotic navigation system, enabling optical tracking and navigation of the dilator within the tissue protector and the dilator passing through the soft tissue. The robotic navigation system can provide real-time visualization and navigation of the dilator within the soft tissue and the tissue protector.

[0005] According to one aspect, the robot of the robotic navigation system comprises a guide tube and the tissue protector and / or other instruments can be inserted into the guide tube.

[0006] The dilator includes a connector for engaging with the tracking array, and the connector is disposed on the distal end side of the dilator. In other configurations, the dilator does not include a connector, and instead, the tracking array includes engagement means for selectively engaging the dilator.

[0007] In some configurations, the tissue protector comprises a plurality of relief channels formed on the outer surface of the elongated body to provide improved movement when passing through the soft tissue. In one configuration, the relief channels are longitudinally disposed around the elongated body of the tissue protector. In one configuration, the relief channels are helically disposed around the elongated body of the tissue protector. The tissue protector may have a distal end for engaging with bone, such as a toothed distal end. The tissue protector may be provided in a plurality of sizes including different lengths and circumferences.

[0008] In one aspect, the tissue protector may comprise a single outer diameter, and a plurality of inner diameters, and / or a plurality of lengths. In one aspect, the tissue protector may be provided with a plurality of outer diameters, and a plurality or a single inner diameter, and / or a plurality or a single length.

[0009] According to another aspect, the dilator may have a distal end for engaging the bone. In yet another aspect, the distal end is configured to not only engage the bone, or instead of engaging the bone, penetrate the bone. In some configurations, the dilator has a distal end for passing through soft tissue.

[0010] According to another aspect, the tracking array may include a tracking array body removably attachable to the dilator, a plurality of arms extending outwardly from the tracking array body (each of the plurality of arms having a distal end), and a plurality of tracking devices attachable to a distal end of one of the plurality of arms. The tracking devices are optically detectable by a robotic navigation system and facilitate navigation of the dilator during spinal surgery.

[0011] The tracking array body may include a mounting mechanism to securely attach the tracking array body to the dilator. In one configuration, the tracking array body includes a through-channel for selectively receiving a portion of the dilator.

Brief Description of the Drawings

[0012] The embodiments shown in the drawings are illustrative and exemplary in nature and are not intended to limit the subject matter defined by the claims. The following detailed description of the exemplary embodiments, in which like structures are denoted by like reference numerals and read in conjunction with the following drawings, will be better understood.

[0013]

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DETAILED DESCRIPTION OF THE INVENTION

[0014] The present disclosure relates to a system that can be used to create a working surgical channel for a surgeon during spinal surgery. With this channel, the surgeon can use navigated and / or non-navigated instruments in combination with a robot navigation system. In one aspect, the system includes a tissue protector having a hollow lumen and a dilator that can be inserted through the hollow lumen. The tissue protector may be insertable through the guide tube of a surgical robot. The system may also include a scalpel and / or a scalpel handle that can be inserted through the guide tube of a surgical robot to create an incision. The system may also include one or more tracking arrays that can be attached to the dilator.

[0015] FIGS. 1 and 2 show one embodiment of a tissue protector - dilator assembly 100. FIG. 1 shows a tissue protector - dilator assembly 100 including a cannula or tissue protector 105 and a dilator 200 that can be inserted into the lumen 110 (seen in FIG. 4) of the tissue protector 105. The dilator 200 is movable relative to the tissue protector 105 along the longitudinal axis of the tissue protector 105 and / or the dilator 200.

[0016] The tissue protector 105 includes an elongated body 115 that extends from a distal end 120 to a proximal end 125. The distal end 120 (including the distal edge portion 120a) is inserted into the incision, and at the proximal end 125, a tool (such as the dilator 200 and / or other tools) is typically inserted into the lumen 110. The elongated body 115 defines the lumen 110.

[0017] The tissue protector 105 can be provided in a plurality of sizes, including a plurality of diameters and / or a plurality of lengths, to accommodate various instruments and patient needs. The tissue protector 105 is engageable with a robot of a robotic navigation system. For example, the robot may include a guide tube for selectively receiving the tissue protector 105, as will be described in detail below.

[0018] The tissue protector 105 may also include a relief channel 130 to improve the movement of the tissue protector 105 through soft tissue. The relief channel 130 may be formed on the outer surface 135 of the elongated body 115 to provide improved movement when passing through soft tissue. The relief channel 130 may be formed in any desired shape or size. In some configurations, the relief channel 130 is longitudinally disposed around the perimeter (e.g., around the circumference) of the elongated body 115 of the tissue protector 105. In some configurations, the relief channel 130 may form a helical pattern along the outside of the elongated body 115.

[0019] The distal end 120 of the tissue protector 105 and the distal edge portion 120a of the distal end 120 can be provided in various configurations, for example, to improve engagement with bone. For example, FIGS. 3 and 4 show the configuration of the toothed distal end 120. When the tissue protector 105 is fully inserted into the bone incision, the teeth 140 of the distal end 120 project outward from the distal edge portion 120a and engage with the bone, reducing the slippage of the distal end 120 relative to the bone. In some configurations, the proximal end 125 can be tapped with a driver or other means to more fully engage the teeth 140 with the bone. In other configurations, the tissue protector 105 may have a smooth distal edge portion 120a to improve soft tissue dilation.

[0020] FIG. 5 shows the configuration of an expander 200 that can be used with the tissue protector 105. The expander 200 is removably insertable into the lumen 110 of the tissue protector 105 (shown in FIGS. 1 and 2) in a size and shape that is generally. The expander 200 generally includes an elongated body 205 that extends from a proximal end 210 to a distal end 215 for separating tissue. The expander 200 is also connectable to a tracking element of a robotic navigation system. In some configurations, the expander 200 includes a connector 220 or other engagement means for engaging the tracking element. In other configurations, the expander 200 has no engagement means and the tracking element is directly attached to the expander 200. The connector 220 can be, for example, a slot or recess formed near the near distal end 21 0 of the expander 200.

[0021] Similar to the tissue protector 105, the dilator 200 can be configured to have various distal end 215 configurations in addition to the design shown in FIG. 5. FIGS. 6 - 8 are examples of various distal end 215 configurations and are not limiting. The surgeon can use one or more dilators 200 with different distal ends 215 to achieve the desired surgical channel depending on the desired result. For example, the tip as shown in FIG. 5 (215, conical tip) and FIG. 6 (215a, bullet - conical tip) can improve engagement and / or penetration into bone, while blunt tips such as the conical tip 215b shown in FIG. 7 and the blunt tip 215c shown in FIG. 8 can improve soft tissue dilation.

[0022] The dilator 200 also includes a connector 220 or other suitable engagement means for engaging a tracking element of a robotic or surgical tracking system. The tracking element can be any suitable tracking element compatible with a robotic system, such as a high - frequency coil, a magnetic tracking element, an optical tracking element, and / or an ultrasonic tracking element. In one configuration, the robotic tracking system includes a camera and the tracking element connectable to the dilator is an optical tracking element such as a tracking array 300.

[0023] FIGS. 9 and 10 show perspective views of one configuration of the tracking array 300. The tracking array 300 can be any suitable shape and size that is selectively attachable to the dilator 200 and tracked by the camera of a robotic navigation system. For example, the tracking array 300 can include a body 305 having a through - channel 310 for receiving the distal end 215 of the dilator 200. The connector 220 of the dilator 200 can be engaged with the through - channel 310 of the tracking array 300 to secure the dilator 200 to the tracking array 300.

[0024] In some configurations, the tracking array 300 may also include means for engaging with the connector 220 of the expander 200. For example, the tracking array 300 may include one or more tabs 315 for engaging with the connector 220 (e.g., a slot / recess) of the expander 200. The tabs 315 may be biased inwardly, such as by a spring. When the through-channel 310 moves along the elongate body 205 of the tissue expander 200, pushing the actuator 320 can move the tabs 315 outwardly. Then, when the tracking array 300 reaches the desired position, the actuator 320 is released and the tabs 315 return to the position where they are biased inwardly. The tabs 315 can engage with the connector 220 of the expander 200. Other engagement means (active or passive) are also contemplated.

[0025] The body 305 of the tracking array 300 may include one or more arms 325 extending outwardly from the body 305. The arms 325 may have a distal end 325a for engaging with a tracking device (not shown in FIGS. 9 and 10) of any desired shape or size. Four arms 325 can be used, or fewer or more arms can be used as needed. The tracking device can be removably or non-removably attached to the distal end 325a of the arm 325. The tracking device can be any suitable tracking element compatible with a robotic system, such as a high-frequency coil, a magnetic tracking element, an optical tracking element, and / or an ultrasonic tracking element. In one configuration, the robotic navigation system includes a camera and the tracking device is an optical tracking device. For example, the tracking device can be optically detected by the robotic navigation system, facilitating navigation of the expander 2 00 during spinal surgery.

[0026] FIG. 11 shows an assembled tissue protector-expander assembly 100 having a tracking array 300 connected to the expander 200. The assembled assembly The tissue protector 100 is shown inserted into the guide tube 405 of the robot 400 of the robotic navigation system. The robotic navigation system may also include one or more cameras (not shown). The tracking array 300 shown in FIG. 11 includes a body 305, which forms a generally rectangular shape and has four arms 325 extending outwardly and has a substantially spherical tracking device 330. These tracking devices 330 enable visualization and navigation by the robotic navigation system.

[0027] In some configurations, the system may also include other surgical tools compatible with the robot 400, such as a tool that fits within the guide tube 405 of the robot. For example, a scalpel handle 500 may be provided (FIG. 12). Similar to the tissue protector 105, the scalpel handle 500 is engageable with the robot 400 of the robotic navigation system. In some configurations, the robot 400 includes the guide tube 405 and the scalpel handle 500 is insertable into the guide tube 405 of the robot 400. The scalpel handle 500 may be compatible with any type of suitable scalpel blade and may include an ergonomic ribbed handle 505. By passing through the guide tube 405 of the robot 400, the scalpel handle 500 can be aligned with the planned trajectory of the surgical channel.

[0028] During use, the assembled dilator-tissue protector assembly 100 can be inserted into the patient to create a working channel and prepare the pedicle of the spine for surgery. The working channel protects the tissue and instruments that can be navigated and instruments that cannot be navigated can be used within the channel. FIG. 13 shows a flowchart of a method that can be used with the instruments described herein.

[0029] First, a plunge incision can be made. To make a plunge incision, any suitable scalpel can be used. For example, a scalpel having a scalpel handle 500 that can pass through the guide tube 405 of the robot 400 can be used. In some embodiments, the system may include a scalpel handle sized and shaped to pass through the guide tube of the robot. Any desired disposable scalpel blade can be attached to the scalpel handle. After attaching a preferred standard disposable scalpel blade to the scalpel handle, the surgeon can make a plunge incision.

[0030] Next, the dilator - tissue protector assembly 100 can be formed. Attach a tracking array to the distal end of the dilator and insert the dilator into the lumen of the tissue protector. Then, the assembled dilator - tissue protector assembly can be inserted into the guide tube of the robot by inserting the tissue protector of the dilator - tissue protector assembly into the guide tube of the robot.

[0031] Next, the assembly can be inserted into the incision and gradually moved deeper into the incision until the target anatomical structure is reached. As the assembly moves deeper into the incision, the movement of the assembly is tracked by a robotic navigation system (including a camera for detecting and tracking the tracking device of the tracking array) and visualized on the screen. After the assembly reaches the desired position, the dilator can be removed from the tissue protector to expose the formed working channel. Thereafter, navigable instruments and non - navigable instruments can be inserted into the working channel to, for example, prepare the pedicle. Such preparation may include preparation for placing pedicle screws that function as part of the posterior fixation structure.

[0032] Embodiments The following embodiments are provided only as examples of specific configurations, materials, arrangements, etc. considered by the authors of the present disclosure.

[0033] Embodiment 1: A tissue protector comprising an elongated body having a proximal end, a distal end, and a lumen extending therethrough from the proximal end to the distal end, and a dilator sized and shaped to be removably insertable into the lumen of the tissue protector, the dilator , near having an elongated body extending from the proximal end for separating adjacent tissues and a distal end, the dilator being selectively engageable with a tracking array of a robotic navigation system, and the tissue protector being engageable with a robot of the robotic navigation system, a spinal surgery system.

[0034] Embodiment 2: The tracking array of the robotic navigation system is visible by a camera of the robotic navigation system and enables optical tracking and navigation of the dilator passing through the dilator and soft tissue within the tissue protector, the spinal surgery system according to Embodiment 1.

[0035] Embodiment 3: The dilator comprises a connector for engaging with the tracking array, the connector being near disposed on the proximal end side of the dilator, the spinal surgery system according to Embodiment 1 or 2.

[0036] Embodiment 4: The tissue protector comprises a plurality of relief channels formed on the outer surface of the elongated body to provide improved movement when passing through soft tissue, the spinal surgery system according to any one of Embodiments 1 to 3.

[0037] Embodiment 5: The relief channels are longitudinally disposed around the elongated body of the tissue protector, the spinal surgery system according to Embodiment 4.

[0038] Embodiment 6: The robotic navigation system provides real-time visualization and navigation of the dilator and the tissue protector within the soft tissue, the spinal surgery system according to any one of Embodiments 1 to 5.

[0039] Embodiment 7: The robot of the robot navigation system is provided with a guide tube, and the tissue protector can be inserted into the guide tube. The spinal surgery system according to any one of Embodiments 1 to 6.

[0040] Embodiment 8: The tissue protector has a distal end for engaging with bone. The spinal surgery system according to any one of Embodiments 1 to 7.

[0041] Embodiment 9: The tissue protector has a toothed distal end. The spinal surgery system according to Embodiment 8.

[0042] Embodiment 10: The tissue protector can be provided in various lengths and / or widths to accommodate surgical instruments and / or the needs of the patient. The spinal surgery system according to any one of Embodiments 1 to 9. .

[0043] Embodiment 11: The dilator has a distal end for engaging with bone. The spinal surgery system according to any one of Embodiments 1 to 10.

[0044] Embodiment 12: The dilator has a distal end for passing through soft tissue. The spinal surgery system according to any one of Embodiments 1 to 11.

[0045] Embodiment 13: The tracking array includes a tracking array body removably attachable to the dilator, a plurality of arms extending outward from the tracking array body and each having a distal end, and a plurality of tracking devices attachable to a distal end of one of the plurality of arms. The spinal surgery system according to any one of Embodiments 1 to 12.

[0046] Embodiment 14: The tracking device is optically detectable by a robot navigation system to facilitate navigation of the dilator during spinal surgery. The spinal surgery system according to Embodiment 13.

[0047] Embodiment 15: The tracking array body is the spinal surgery system according to Embodiment 13, which includes a mounting mechanism for securely mounting the tracking array body to the expander.

[0048] Embodiment 16: The tracking array body is the spinal surgery system according to Embodiment 15, which includes a through-channel for selectively receiving a part of the expander.

[0049] Embodiment 17: A spinal surgery system comprising a tissue protector having a proximal end, a distal end, and an elongated body with a lumen extending therethrough from the proximal end to the distal end and being insertable through a guide tube of a robot, an expander having a size and shape removably insertable into the lumen of the tissue protector and having an elongated body extending from the proximal end and a distal end for passing through tissue, a tracking array selectively connectable to the expander, and a scalpel handle insertable through the guide tube of the robot.

[0050] Embodiment 18: The tracking array is the spinal surgery system according to Embodiment 17, which can be visualized by a camera of a robot navigation system and enables optical tracking and navigation of the expander within the tissue protector and the expander passing through soft tissue.

[0051] Embodiment 19: A tissue protector having a proximal end, a distal end, and an elongated body with a lumen extending therethrough from the proximal end to the distal end, and an expander having a size and shape removably insertable into the lumen of the tissue protector 、 an elongated body extending from the proximal end and for separating adjacent tissues a distal end, and the expander is selectively engageable with a tracking array of a robot navigation system.

[0052] Embodiment 20: Selecting a robot having a guide tube, selecting a female having a female handle sized and shaped to fit within the guide tube, inserting the female into the guide tube and performing a plunger incision to form an incision, attaching a tracking array to a dilator having a size and shape removably insertable into the lumen of a tissue protector and having an elongated body extending from a proximal end and a distal end for passing through tissue, inserting the dilator into the lumen of a tissue protector having a proximal end, a distal end, and an elongated body having a lumen extending therethrough from the proximal end to the distal end and insertable through the guide tube of the robot to form an assembled dilator-tissue protector assembly, and inserting the tissue protector of the assembled dilator-tissue protector assembly into the guide tube of the robot, a method of forming a surgical working channel.

[0053] Embodiment 21: Further comprising gradually moving the dilator-tissue protector assembly within the incision until the target anatomical structure is reached and confirming that the target anatomical structure has been reached using navigation visualization based on detection of a tracking array attached to the dilator, the method according to embodiment 20.

[0054] Embodiment 22: Further comprising removing the dilator from the tissue protector and maintaining the tissue protector in position relative to the guide tube to allow one or more instruments to access the target anatomical structure through the tissue protector, the method according to embodiment 21.

[0055] Embodiment 23: A tissue protector including an elongated body having a proximal end, a distal end, and a lumen extending therethrough from the proximal end to the distal end, and a dilator sized and shaped to be removably insertable into the lumen of the tissue protector, the dilator , near having an elongated body extending from a proximal end for separating adjacent tissues and a distal end, the dilator being selectively engageable with a tracking array of a robotic navigation system, a spinal surgery kit.

[0056] Embodiment 24: The tissue protector is provided in a first length and a second length, the spinal surgery kit according to Embodiment 2 3 described in

[0057] Embodiment 25: The dilator is provided in a first configuration having a rounded distal end and a second configuration having a pointed distal end, the spinal surgery kit according to Embodiment 2 3 described in

[0058] Embodiment 26: The spinal surgery kit according to Embodiment 2, further comprising a scalpel handle sized and shaped to selectively engage the guide tube of the robot of the robotic navigation system 3 described in

[0059] Although specific embodiments have been illustrated and described herein, it should be understood that various other changes and modifications can be made without departing from the spirit and scope of the claimed subject matter. Further, although various aspects of the claimed subject matter have been described herein, such aspects need not be utilized in combination

[0060] Unless otherwise indicated, all numerical values representing measurements used in this specification and the claims are to be understood as being modified in all instances by the term "about." Accordingly, unless otherwise indicated, the numerical parameters set forth in this specification and the appended claims are approximations and depend upon the desired characteristics sought to be obtained by the embodiments of the present disclosure It may vary according to properties. At least, it is not an attempt to limit the application of the doctrine of equivalents to the scope of the claims, and each numerical parameter should be interpreted by applying ordinary rounding techniques, at least in light of the reported significant digits. Although the numerical ranges and parameters indicating the broad scope of the present disclosure are approximate values, the numerical values shown in specific examples are reported as accurately as possible. However, the numerical values inherently include certain errors inevitably arising from the standard deviation found in each test measurement. In one embodiment, the terms "about" and "approximately" refer to numerical parameters within 10% of the indicated range.

[0061] The terms "a", "an", "the", and similar referents used in the context of describing embodiments of the present disclosure (particularly, in the context of the following claims) are to be construed to cover both the singular and plural forms unless specifically indicated otherwise herein or clearly contradicted by the context. The recitation of a range of values herein is merely intended as a shorthand method of referring individually to each separate value within the range. Unless specifically indicated otherwise herein, each separate value is incorporated herein as if it were individually recited herein. All methods described herein can be executed in any suitable order unless specifically indicated otherwise herein or clearly contradicted by the context. The use of all examples, or exemplary language (e.g., "such as") provided herein is merely intended to more clearly illustrate embodiments of the present disclosure and is not intended to limit the scope of the present disclosure. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of embodiments of the present disclosure.

[0062] The grouping of alternative elements or embodiments disclosed herein should not be construed as limiting. Each group member may be referenced and claimed individually or in combination with other members of the group or other elements found herein. For reasons of convenience and / or patentability, one or more members of a group are expected to be included in or deleted from the group. If such additions or deletions are made, the specification is considered to include the group as modified so as to meet the description of all Markush groups used in the appended claims.

[0063] This specification describes specific embodiments, including the best mode known to the authors of the present disclosure, for carrying out the embodiments disclosed herein. Of course, variations of these described embodiments will be apparent to those skilled in the art upon reading the foregoing description. The authors expect those skilled in the art to adopt such variations as appropriate, and the authors intend that the embodiments of the present disclosure be practiced in ways other than those specifically described herein. Accordingly, this disclosure includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Further, unless otherwise specifically indicated herein or clearly inconsistent with the context, all possible combinations of the above elements in all possible variations are included in this disclosure.

[0064] The specific embodiments disclosed in this specification may be further limited in the claims by using the expressions "consisting of" or "consisting essentially of". When used in the claims, regardless of whether added at the time of filing or by amendment, the transitional term "consisting of" excludes elements, steps, or components not specified in the claims. The transitional term "consisting essentially of" limits the claim to the specified materials or steps and those that do not substantially affect the basic and novel characteristics. The embodiments of the present disclosure thus claimed are essentially or explicitly described and enabled herein.

[0065] Further, where references to patents and printed publications have been made throughout this disclosure, each of these documents and printed publications is hereby incorporated by reference in its entirety into this specification herein.

[0066] The embodiments disclosed herein illustrate the principles of the present disclosure. Other modifications that may be employed are within the scope of the present disclosure. Thus, by way of example and not limitation, alternative configurations of the embodiments of the present disclosure may be utilized in accordance with the teachings herein. Accordingly, the present disclosure is not limited to exactly what is shown and described.

[0067] This application claims priority to U.S. Provisional Application 63 / 345,340, filed May 24, 2022, the entire contents of which are hereby incorporated by reference herein.

Claims

1. A tissue protector comprising a proximal end, a distal end, and an elongated body having a lumen extending therethrough from the proximal end to the distal end; and an expander sized and shaped to be removably insertable into the lumen of the tissue protector. The expander comprises an elongated body extending from a proximal end for separating tissue and a distal end. The expander is selectively engageable with a tracking array of a robotic navigation system, and the tissue protector is engageable with a robot of the robotic navigation system. A spinal surgery system.

2. The tracking array of the robotic navigation system is visible by a camera of the robotic navigation system, enabling optical tracking and navigation of the expander passing through the expander and soft tissue within the tissue protector. The spinal surgery system according to claim 1.

3. The expander comprises a connector for engaging with the tracking array, and the connector is disposed on the distal end side of the expander. The spinal surgery system according to claim 1.

4. The tissue protector comprises a plurality of relief channels formed on an outer surface of the elongated body to provide improved movement when passing through soft tissue. The spinal surgery system according to claim 1.

5. The relief channels are longitudinally disposed around the elongated body of the tissue protector. The spinal surgery system according to claim 4.

6. The robotic navigation system provides real-time visualization and navigation of the expander and the tissue protector within soft tissue. The spinal surgery system according to claim 1.

7. The robot of the robotic navigation system comprises a guide tube, and the tissue protector is insertable into the guide tube. The spinal surgery system according to claim 1.

8. The tissue protector has a distal end for engaging with bone. The spinal surgery system according to claim 1.

9. The tissue protector has a toothed distal end. The spinal surgery system according to claim 8.

10. The tissue protector may be provided in various lengths and / or widths to accommodate surgical instruments and / or patient needs. The spinal surgery system according to claim 1.

11. The expander has a distal end for engaging with bone. The spinal surgery system according to claim 1.

12. ​ The spinal surgery system according to claim 1, wherein the dilator has a distal end for passing through soft tissue.

13. The tracking array according to claim 1, comprising: a tracking array body removably attachable to the dilator; a plurality of arms extending outward from the tracking array body, each having a distal end; and a plurality of tracking devices attachable to a distal end of one of the plurality of arms.

14. The spinal surgery system according to claim 13, wherein the tracking device is optically detectable by the robotic navigation system to facilitate navigation of the dilator during spinal surgery.

15. The spinal surgery system according to claim 13, wherein the tracking array body includes a mounting mechanism for securely mounting the tracking array body to the dilator.

16. The spinal surgery system according to claim 15, wherein the tracking array body includes a through-channel for selectively receiving a portion of the dilator.

17. A tissue protector having a proximal end, a distal end, and an elongated body having a lumen extending therethrough from the proximal end to the distal end, and being insertable through a guide tube of a robot; A dilator having a size and shape removably insertable into the lumen of the tissue protector, and having an elongated body and a distal end extending from the proximal end for passing through tissue; A tracking array selectively connectable to the dilator; And a scalpel handle insertable through the guide tube of the robot Comprising a spinal surgery system.

18. The spinal surgery system according to claim 17, wherein the tracking array is visible by a camera of a robotic navigation system, enabling optical tracking and navigation of the dilator within the tissue protector and the dilator passing through soft tissue.

19. A tissue protector having a proximal end, a distal end, and an elongated body having a lumen extending therethrough from the proximal end to the distal end; A dilator having a size and shape removably insertable into the lumen of the tissue protector, and having an elongated body and a distal end extending from the proximal end for separating tissue Comprising a spinal surgery system, wherein the dilator is selectively engageable with a tracking array of a robotic navigation system.

20. Selecting a robot having a guide tube Select a female having a female handle sized and shaped to fit within the guide tube; Insert the female into the guide tube and perform a plunger incision to form an incision; Attach a tracking array to a dilator having a size and shape removably insertable into the lumen of the tissue protector and having an elongated body and a distal end extending from the proximal end for passing through tissue; Insert the dilator into the lumen of the tissue protector having a proximal end, a distal end, and an elongated body having a lumen therethrough from the proximal end to the distal end and insertable through the guide tube of the robot to form an assembled dilator-tissue protector assembly; Insert the tissue protector of the assembled dilator-tissue protector assembly into the guide tube of the robot; A method of forming a working channel for surgery, comprising: Claim 21 Gradually move the dilator-tissue protector assembly into the incision until the target anatomical structure is reached; Confirming that the target anatomical structure has been reached using navigation visualization based on detection of the tracking array mounted on the dilator; The method according to claim 20, further comprising: Claim 22 The method according to claim 21, further comprising removing the dilator from the tissue protector and maintaining the tissue protector in position relative to the guide tube to allow one or more instruments to access the target anatomical structure through the tissue protector.

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