Female Guide

Abstract

A scalpel guide for use with a tool guide of a surgical system is described. In one variation, the scalpel guide includes a body defining a first guide slot sized and shaped to receive a scalpel body and guide the scalpel blade along a central axis without any lateral movement of the scalpel. The body also defines a second guide slot arranged to allow a scalpel body inserted therein to be guided vertically by the sides of the second guide slot and to move horizontally across the channel along a track surface. Other variations of scalpel guides are also described.

Description

[Technical Field]

[0001] (Incorporated by reference) This application claims the benefit of priority to U.S. Non-Provisional Patent Application No. 18 / 061779, filed December 5, 2022, and U.S. Provisional Patent Application No. 63 / 385,288, filed November 29, 2022, the entire contents of which are incorporated herein by reference. [Background technology]

[0002] A computer-assisted surgical system may include a robotic arm, a controller, and a navigation system. Robotic or robot-assisted surgery has many associated advantages, particularly with regard to the precise placement of surgical tools and / or implants. For example, during robotic spine surgery, a trajectory is planned for a tool or set of tools attached to the robotic arm via a tool guide based on a surgical plan. During surgery, once the robotic arm guides the tool guide to the planned trajectory, the first interaction with the patient is for the surgeon to create a skin incision at the intersection of the planned trajectory and the skin. Typically, this is done by a simple stab incision through a scalpel guide positioned within the tool guide. However, because this incision must be longer than the diameter of the tool guide, the surgeon must manually enlarge the initial stab incision made through the scalpel guide, which disrupts the flow of the surgical procedure. Summary of the Invention [Means for solving the problem]

[0003] To overcome this undesirable need for manual enlargement, the presently disclosed systems, devices, and methods improve computer-assisted surgical systems, for example, by providing various embodiments of a scalpel guide. In one embodiment, the scalpel guide enables precise marking of the intersection of a planned trajectory for a surgical procedure with the skin by making a stab incision with the scalpel using a first guide slot and a guided single-plane incision longer than the diameter of the tool guide using a second guide slot that allows pivotal movement of the scalpel along a single plane. In another embodiment, the scalpel guide includes a handle and guide prongs that guide the scalpel according to the handle settings, allowing the stab incision and the guided single-plane incision to be made on the patient, as described below.

[0004] The systems, methods, and devices of the present disclosure are described in terms of robotic surgical systems. Some embodiments of the present invention provide a surgical robot (and, optionally, a navigation system) that utilizes a positioning system that enables movement of a tool support to a planned trajectory, with the longitudinal axis of the tool support coaxially aligned with the planned trajectory. The tool support has a first surface, a second surface, and an opening from the first surface to the second surface. The opening is coaxially aligned with the longitudinal axis and may be sized and shaped to receive a scalpel guide.

[0005] In some embodiments, the scalpel guide has a body defining a first guide slot configured to receive a scalpel and guide the tip of the scalpel blade to form a puncture incision through the patient's skin along a planned trajectory. The body may also have a second guide slot. The second guide slot may be sized and shaped to receive the scalpel and allow the scalpel to move laterally to allow the scalpel guided by the scalpel guide to move in an arc along a single plane, thereby forming a single-plane incision that is longer than the width of the second guide slot and / or the inner diameter of the tool support.

[0006] In another embodiment, a scalpel guide having a variable guidance system configured in accordance with an embodiment of the present disclosure is described.

[0007] In another embodiment, a scalpel guide is described having an elongated portion with a trajectory marker formed therein, the trajectory marker indicating a planned trajectory. The scalpel guide may also have a guide slot sized and shaped to allow the scalpel to be moved laterally only along an arc in a single plane that intersects the planned trajectory. [Brief explanation of the drawings]

[0008] [Figure 1] FIG. 1 is a schematic diagram of a computer-assisted surgical system including a robotic base, a robotic arm, a tool guide attached to the robotic arm, and a scalpel guide secured within the tool guide, the scalpel guide having first and second guide slots each adapted to receive a scalpel, according to one embodiment of the present disclosure. [Figure 2] 2 is a bottom perspective view of the tool guide and scalpel guide of FIG. 1 with a scalpel inserted into the first guide slot of the scalpel guide so that the tip of the scalpel blade is directed only along the planned trajectory. [Figure 3A] FIG. 2 is a perspective view of the female guide of FIG. 1 showing a first guide slot and a second guide slot constructed in accordance with one embodiment of the present disclosure. [Figure 3B] FIG. 2 is a perspective view of the female guide of FIG. 1 showing a first guide slot and a second guide slot constructed in accordance with one embodiment of the present disclosure. [Figure 4] FIG. 2 is a front view of the tool guide and scalpel guide of FIG. 1, with the scalpel inserted into the second guide slot of the scalpel guide such that the scalpel blade is oriented along and constrained by the track surface, allowing for an incision longer than the inner diameter of the opening in the tool guide. [Figure 5A] FIG. 10 is a perspective view of another scalpel guide having a variable guidance system constructed in accordance with an embodiment of the present disclosure; [Figure 5B]FIG. 10 is a perspective view of another scalpel guide having a variable guidance system constructed in accordance with an embodiment of the present disclosure; [Figure 6A] FIG. 10 is a perspective view of another scalpel guide constructed in accordance with the present disclosure and having an elongated portion formed with trajectory markers indicative of a planned trajectory, and a guide slot sized and shaped to permit lateral movement of the scalpel only along a single planar arc that intersects the planned trajectory. [Figure 6B] FIG. 10 is a perspective view of another scalpel guide constructed in accordance with the present disclosure and having an elongated portion formed with trajectory markers indicative of a planned trajectory, and a guide slot sized and shaped to permit lateral movement of the scalpel only along a single planar arc that intersects the planned trajectory. DETAILED DESCRIPTION OF THE INVENTION

[0009] Before describing at least one embodiment of the present disclosure in detail, it is to be understood that, unless otherwise stated, the present disclosure is not limited in its application to the details of construction, experiments, illustrative data, and / or the arrangement of the components set forth in the following description or illustrated in the drawings.

[0010] The systems and methods as described in this disclosure are capable of other embodiments or of being practiced or carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting.

[0011] The following detailed description refers to the accompanying drawings, in which the same reference numbers in different drawings may identify the same or similar elements.

[0012] As used herein, the terms "comprises," "comprising," "includes," "including," "has," "having," or any other variation thereof, are intended to be non-exclusive inclusive. For example, unless otherwise specified, a process, method, article, or apparatus that includes listed elements is not necessarily limited to only those elements but may also include other elements not expressly listed or that are not inherent to such process, method, article, or apparatus.

[0013] Furthermore, unless expressly stated to the contrary, "or" is inclusive and not exclusive. For example, condition A or B is satisfied by one of the following: A is true (or exists) and B is false (or does not exist), A is false (or does not exist) and B is true (or exists), and both A and B are true (or exist).

[0014] Additionally, the use of "a" or "an" is used herein to describe elements and components of embodiments. This is done merely for convenience and to give a general sense of the inventive concepts. This description should be read to include one or more, and the singular also includes the plural unless clearly meant otherwise. Furthermore, the use of the term "plurality" is meant to convey "more than one" unless expressly stated to the contrary.

[0015] As used herein, any reference to "one embodiment," "embodiment," "some embodiments," "an example," "for example," or "an example" means that a particular element, feature, structure, or characteristic described in connection with an embodiment is included in at least one embodiment. Note that appearances of the phrase "in some embodiments" or "an example" in various places throughout this specification do not necessarily all refer to the same embodiment, for example.

[0016] A circuit, as used herein, may be analog and / or digital components, or one or more appropriately programmed processors (e.g., microprocessors) and associated hardware and software, or hardwired logic. Also, a "component" can perform one or more functions. The term "component" can include hardware, such as a processor (e.g., microprocessor), a combination of hardware and software, and / or the like. Software can include one or more computer-executable instructions that, when executed by one or more components, cause the components to perform a specified function. It should be understood that the algorithms described herein can be stored in one or more non-transitory memories. Exemplary non-transitory memories can include random access memory, read-only memory, flash memory, and / or the like. Such non-transitory memories can be electrical-based, optical-based, and / or the like.

[0017] As used herein, the term "substantially" means that the subsequently described event or circumstance occurs completely, or that the subsequently described event or circumstance occurs to a great extent or degree. As used herein, the modifier "substantially" is intended to include not only an exact value, amount, degree, direction, or other qualified characteristic or value, but also some slight variations due to measurement error, control loop error, manufacturing tolerances, stresses on various parts or components, observer error, wear and tear, and combinations thereof. For example, when describing the longitudinal axis of a tool support being substantially coaxially aligned with at least one planned trajectory, the term "substantially" refers to alignment within tracking tolerances.

[0018] 1-3B, there is shown an overview of an exemplary computer-assisted surgical system 100. The computer-assisted surgical system 100 may include a surgical robot 101 having a robot base 102 supporting a robotic arm 104 and a navigation system 120. A tool guide 140 is attached to the robotic arm 104 and may be configured to receive a scalpel guide 160 configured to receive a scalpel 180.

[0019] Although the robot base 102 is depicted as a movable base, a fixed base is also contemplated. The robot arm 104 includes multiple arm segments 105 a, 105 b, and 105 c connected by rotatable or otherwise articulated joints and can be moved by actuation of the joints. One of the arms 105 forms the distal end 107 b of the robot arm 104. In the example shown in FIG. 1 , the robot arm 105 c of the robot arm 104 forms the distal end 107 b. The robot arm 104 also includes a proximal end 107 a attached to and supported by the robot base 102 and a distal end 107 b. The robot arm 104 can be adapted to move in all six degrees of freedom during a surgical procedure. The robot arm 104 can be configured to change increments (e.g., in each of the six degrees of freedom) to ensure the required precision during surgery. The robotic arm 104 may actively move about the joints to position the arm in a desired position relative to a patient (not depicted), or the robotic arm 104 may be set and locked in a position. For example, the present disclosure is intended to include use of the tool by a surgical robot, use of the tool by a user with some degree of robotic assistance, and use of the tool without the involvement of a surgical robot or robotic assistance (e.g., once positioned and locked).

[0020] The control unit or controller 106 enables various features of the system 100 and the execution of various methods disclosed herein in accordance with some embodiments of the present disclosure. In some embodiments, the controller 106 can control the operation of the robotic arm 104 and associated navigation system 120. In some embodiments, control can include calibrating a relative coordinate system, generating a planned trajectory, monitoring the position of various units of the surgical robot 101 and / or units operatively coupled thereto, enforcing safety protocols or restrictions, etc. The controller 106 can be one or more systems capable of embodying and / or executing logic of the processes described herein. The controller 106 can be configured to execute logic embodied in the form of software instructions and / or firmware. In some embodiments, the logic described herein can be executed in a standalone environment, such as on the controller 106, and / or the logic can be implemented in a networked environment, such as a distributed system using multiple computers and / or processors.

[0021] Various embodiments of the present disclosure may be operational with other computing systems, environments, and / or configurations that may be suitable for use with the systems and methods of the present invention, including personal computers, server computers, laptop or handheld devices, and multiprocessor systems configured to execute logic embodied in the software instructions and / or firmware described herein. Other examples include mobile devices, programmable consumer electronics, network PCs, minicomputers, mainframe computers, distributed computing environments that include any of the above systems or devices, and the like.

[0022] The controller 106 may include one or more processors 108 (hereinafter, "processors 108"), one or more communication devices 110 (hereinafter, "communication devices 110"), one or more non-transitory memories 112 (hereinafter, "memory 112") that store processor executable code and / or software applications such as applications 111, and a system bus 113 that couples various components, including, for example, the processors 108, to the memory 112.

[0023] Generally, processor 108 refers to any computing processing unit or processing device, including, but not limited to, a single-core processor, a single processor with software multithreading execution capabilities, a multi-core processor, a multi-core processor with software multithreading execution capabilities, a multi-core processor with hardware multithreading techniques, and a parallel platform with distributed shared memory. Additionally or alternatively, processor 108 may be an integrated circuit, an application specific integrated circuit (ASIC), a digital signal processor (DSP), a field programmable gate array (FPGA), a programmable logic controller (PLC), a complex programmable logic device (CPLD), discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. The processors or processing units referred to herein may utilize nanoscale architectures, such as molecular and quantum dot-based transistors, switches, and gates, to optimize space usage or improve performance of computing devices capable of implementing various aspects of the present invention. In some embodiments, the processor 108 may be implemented as a combination of computing processing units.

[0024] The external device 114 may communicate with the controller 106. The external device 114 may be a touchscreen display, a computing device, a remote server, etc. configured to allow a surgeon or other user to input data directly into the controller 106. Such data may include patient information and / or surgical procedure information. The external device 114 may display information from the controller 106, such as alerts. Communication between the external device 114 and the controller 106 may be wireless or wired. While the illustrated external device 114 is shown attached to the robot base 102, in some embodiments, the external device 114 may be The navigation system 120 may include a tracking unit 122. The system 100 may monitor, track, and / or determine changes in the relative position and / or orientation of one or more portions of the robotic arm 104, the tool guide 140, and / or a tool (such as scalpel 180) inserted in the tool guide 140, and various portions of the patient's body B, within a common coordinate system, by utilizing various types of fiducials 123 (e.g., multi-degree-of-freedom optical, inertial, and / or ultrasonic sensing devices), navigation systems (e.g., machine vision systems, charge-coupled device cameras, tracking sensors, surface scanners, and / or range finders), anatomical computer models (e.g., magnetic resonance imaging scans of the lower lumbar region of the spine), data from previous surgical procedures and / or previously performed surgical techniques (e.g., data recorded by the system 100 while performing previous steps of a surgical procedure), etc. Tracking may be performed in several ways, for example, using stereoscopic optical detectors 127, ultrasonic detectors, sensors configured to receive position information from an inertial measurement unit, etc. Real-time tracking means, in some embodiments, high frequencies above 20 Hz, in some embodiments, low latency in the 100-500 Hz range, and in some embodiments, less than 5 milliseconds. Regardless of how collected, position and orientation data may be transferred between components (e.g., to controller 106) via any suitable connection, e.g., wired or wireless, using a low-latency transfer protocol. Controller 106 may perform real-time control algorithms at moderately high frequencies with additional low latency to coordinate the movement of robotic arm 104 of system 100. Tracking unit 122 may also include a camera or use a stereoscopic optical detector 127, for example, to detect characteristics of tool guide 140 attached to robotic arm 104.

[0025] The fiducials 123 of the navigation system 120 may be attached to the navigation arrays (e.g., the first navigation array 124, the second navigation array 126, and the optional navigation array 128 (and / or other navigation arrays)). The fiducials 123 may be disposed at predetermined positions and orientations relative to one another. The fiducials 123 may be aligned to lie in a plane of known orientation (e.g., a vertical plane) to enable the establishment of a Cartesian reference frame. The fiducials 123 may be positioned within the field of view of the navigation system 120 and may be identified in images captured by the navigation system 120. The fiducials 123 may be single-use reflective navigation markers. Exemplary fiducials 123 include infrared reflectors, light emitting diodes (LEDs), spherical reflective markers, flashing LEDs, augmented reality markers, etc. First navigation array 124, second navigation array 126, and optional navigation array 128 may be or include inertial measurement units (IMUs), accelerometers, gyroscopes, magnetometers, other sensors, or combinations thereof. The sensors may transmit position and / or orientation information to navigation system 120. In other embodiments, the sensors may be configured to transmit position and / or orientation information to an external controller, which may be, for example, controller 106.

[0026] The second navigation array 126 may be mounted on the robotic arm 104 or on the tool guide 140 and may be used to determine the position of the robotic arm 104 or a distal portion thereof (indicating the position of the tool guide 140). The structure and operation of the second navigation array 126 may vary depending on the type of navigation system 120 used. In some embodiments, the second navigation array 126 may include one or more spherical or other fiducials 123 for use with an optical navigation system, e.g., the second navigation array 126 illustrated in FIG. 2 having spherical fiducials 123. The navigation system 120 facilitates registration and tracking of the position and / or orientation of the second navigation array 126 and, therefore, the tool guide 140, as well as the relative distance of the tool guide 140 to other objects in the operating room, e.g., the patient, the surgeon, etc. Position and / or orientation data may be collected, determined, or otherwise processed by the navigation system 120 using registration / navigation techniques to determine the coordinates of each navigation array and / or fiducial 123 within a coordinate system. These coordinates can be communicated to the controller 106, which uses the coordinates of each navigation array and / or fiducial 123 to calculate the position and orientation of the tool guide 140 in a coordinate system, as well as the position of the tool guide 140 relative to the patient, to facilitate articulation of the robotic arm 104.

[0027] The application 111 can configure the controller 106 or its processor 108 to perform automated control of the position of the robotic arm 104 in accordance with aspects of the present invention. Such control can be enabled, at least in part, by the navigation system 120. In some embodiments, when the controller 106 is operatively coupled to the robotic arm 104, the application 111 can configure the controller 106 to perform functions described in this disclosure. In some embodiments, the application 111 can be retained or stored in the memory 112 as a group of computer-accessible instructions (e.g., computer-readable instructions, computer-executable instructions, or computer-readable computer-executable instructions). In some embodiments, the group of computer-accessible instructions can encode methods of the inventive concepts of the present disclosure. In some embodiments, the application 111 can encode various formats (e.g., image segmentation) for computer vision tracking using the navigation system 120. In some embodiments, application 111 may be a compiled instance of such computer-accessible instructions stored in memory 112, a linked instance of such computer-accessible instructions, a compiled and linked instance of such computer-executable instructions, or an otherwise executable instance of a group of computer-accessible instructions.

[0028] Memory 112 may include any available media accessible to controller 106, including, but not limited to, both volatile and nonvolatile media, removable and non-removable media. In some embodiments, memory 112 includes computer-readable media in the form of volatile memory, such as random access memory (RAM), and / or non-volatile memory, such as read-only memory (ROM). In some embodiments, memory 112 may store data (e.g., groups of tokens used for code buffers) and / or program modules, such as applications 111, that are immediately accessible to and / or currently operating by controller 106. In some embodiments, memory may store an operating system (not shown), such as the Windows operating system, Unix, Linux, Symbian, Android, Apple iOS operating system, Chromium, and virtually any operating system for wireless or tethered computing devices. Apple® is a trademark of Apple Computer, Inc., registered in the U.S. and other countries. iOS® is a registered trademark of Cisco Systems, Inc., used under license by Apple Inc. Microsoft® and Windows® are either registered trademarks or trademarks of Microsoft Corporation in the United States and / or other countries. Android® and Chrome® operating systems are registered trademarks of Google Inc. Symbian® is a registered trademark of Symbian Ltd. Linux® is a registered trademark of Linus Torvalds. UNIX® is a registered trademark of The Open Group.

[0029] In some embodiments, memory 112 may be a mass storage device capable of providing non-volatile storage of computer code (e.g., computer-executable instructions such as application 111), computer-readable instructions, data structures, program modules, and other data for controller 106. For example, in some embodiments, memory 112 may be a hard disk, a removable magnetic disk, a removable optical disk, a magnetic cassette or other magnetic storage device, a flash memory card, a CD-ROM, a digital versatile disk (DVD) or other optical storage device, random access memory (RAM), read-only memory (ROM), electrically erasable programmable read-only memory (EEPROM), and the like.

[0030] In some embodiments, any number of program modules may optionally be stored in memory 112, including, by way of example, an operating system and tracking software (not shown). In some embodiments, data and code (e.g., computer-executable instructions, patient-specific trajectories, and patient anatomical data) may be retained and stored on memory 112. In some embodiments, the data and / or code may be stored in any of one or more databases known in the art. Examples of such databases include DB2®, Microsoft® Access, Microsoft® SQL Server, Oracle®, mySQL, PostgreSQL, and the like. Further examples include mem-based databases and flat file databases. Databases may be centralized or distributed across multiple systems.

[0031] DB2® is a registered trademark of IBM in the United States.

[0032] Microsoft®, Microsoft® Access®, and Microsoft® SQL Server® are either registered trademarks or trademarks of Microsoft Corporation in the United States and / or other countries.

[0033] Oracle® is a registered trademark of Oracle Corporation and / or its affiliates.

[0034] MySQL® is a registered trademark of MySQL AB in the United States, the European Union, and other countries.

[0035] PostgreSQL® and the PostgreSQL® logo are trademarks or registered trademarks of PostgreSQL Global Development Group in the United States and other countries.

[0036] In some embodiments, a user (e.g., a surgeon or other user, or equipment) can use an input device (not shown) to input commands and information into the controller 106 via the external device 114. Examples of such input devices include, but are not limited to, a keyboard, a pointing device (e.g., a mouse), a microphone, a joystick, a scanner (e.g., a barcode scanner), a reader device such as a radio frequency identification (RFID) reader or a magnetic stripe reader, a gesture-based input device such as a tactile input device (e.g., a touchscreen, gloves and other body coverings or wearable devices), a voice recognition device, or a natural interface.

[0037] In some embodiments, external device 114 may be operatively coupled to system bus 113 via interface 116. In some embodiments, controller 106 may be configured with more than one external device 114. For example, in some embodiments, external device 114 may be a monitor, LCD display, or projector. Further, in addition to external device 114, some embodiments may include other output peripheral devices, which may include components such as speakers (not shown) and a printer (not shown), which may be connected to controller 106 via interface 116. In some embodiments, a pointing device may be either tethered or wirelessly coupled to controller 106 to receive input from a user. In some embodiments, any process and / or result of a method may be output in any format to an output device, such as external device 114. In some embodiments, this output may be visually represented in any form, including, but not limited to, text, graphics, video, audio, tactile sensations, and the like.

[0038] In certain embodiments, one or more cameras may be included in or operatively coupled to the navigation system 120, which is operatively coupled to the system bus 113 via the input / output interface 115. Such a functional coupling may enable the one or more cameras to be coupled to other functional elements of the controller 106. In one embodiment, the input / output interface 115, at least a portion of the system bus 113, and the memory 112 may embody a frame grabber unit that may enable receiving imaging data acquired by at least one of the one or more cameras. In some embodiments, the frame grabber may be an analog frame grabber, a digital frame grabber, or a combination thereof. In some embodiments, if the frame grabber is an analog frame grabber, the processor 108 may provide analog-to-digital conversion and decoder functions to enable the frame grabber to operate with medical imaging data. Furthermore, in some embodiments, the input / output interface 115 may include circuitry for collecting analog signals received from at least one of the one or more cameras. In some embodiments, in response to execution by the processor 108, the application 111 may operate a frame grabber to receive imaging data in accordance with various aspects described herein.

[0039] The tool guide 140 may be coupled to the robotic arm 104 using conventional means known in the art, such as a threaded connection. As can be appreciated, there should be no play between the tool guide 140 and the robotic arm 104.

[0040] While system 100 may utilize tool guides of various shapes, sizes, and functionality, the illustrated tool guide 140 includes a tool support 141 having an opening 142 (see FIG. 2 ) for holding, guiding, positioning, supporting, and / or positioning at least one tool or guide, such as scalpel guide 160. Advantageously, tool support 141 may be configured to guide, position, support, or position a series of tools used in a surgical procedure, such as spinal surgery, relative to a surgical site ST. Robotic arm 104 may be configured to assist a user (e.g., a surgeon) in using tool guide 140 to guide, position, support, or position tools and / or guides along at least one planned trajectory 199. Exemplary tools include, but are not limited to, dilators with dilator tips (e.g., sharp or blunt), probes, cutting instruments, taps, screws, etc. Cutting instruments may be, for example, drills, saw blades, burrs, reamers, mills, scalpel blades, or any other instrument capable of cutting bone or other tissue and suitable for use in a particular surgical procedure. The tool may be secured within the tool guide 140 using a locking mechanism (not shown), which may be a slider lock mechanism or other feature.

[0041] In some embodiments, tool guide 140 includes a tool support 141 having an opening 142 extending from a first surface 144 of the tool support 141 to a second surface 146 of the tool support 141, and has a longitudinal axis 148 extending through the center of opening 142. In some embodiments, tool support 141 can be a tube.

[0042] As described herein, some embodiments include a controller 106 that can control the movement of the robotic arm 104. The controller 106 can be configured to execute an application 111 to control the robotic arm 104. In some embodiments, the application 111, in response to execution by the processor 108, can utilize trajectories (e.g., tip and tail coordinates) that can be planned and / or configured remotely or locally before and / or during a surgical procedure. A trajectory planned before or during a surgical procedure may be referred to herein as a “planned trajectory,” such as planned trajectory 199. In additional or alternative aspects, in response to execution by the processor 108, the application 111 can be configured to implement one or more of the methods described herein in the controller 106 to cause movement of the robotic arm 104 according to one or more planned trajectories, such as planned trajectory 199. It should be noted that for spinal surgery, there are multiple planned trajectories. For example, it is common to have six trajectories (three pairs of two trajectories, i.e., one trajectory for each vertebra involved in the surgery). In some embodiments, four planned trajectories may be used to fuse two vertebral bodies together. Each planned trajectory may be identified in the application 111 and planned to be performed in a specific order. For example, in an exemplary surgical procedure to fuse a first vertebral body and a second vertebral body together, four planned trajectories may be used and may be identified as a first planned trajectory, a second planned trajectory, a third planned trajectory, and a fourth planned trajectory. A user, such as a surgeon, may initially plan to work on one side of a patient. For example, the first planned trajectory may be directed toward a first side of the first vertebral body, and the second planned trajectory may be directed toward a first side of the second vertebral body. The surgeon may then plan to move to the other side of the patient, with the third planned trajectory directed toward a second side of the first vertebral body, and the fourth planned trajectory directed toward a second side of the second vertebral body.However, it should be noted that the user may plan the surgical procedures in any order, and the application 111 may be programmed to cause the robotic arm 104 to move between the planned trajectories in the planned order.

[0043] The scalpel guide 160 may include a body 165 having a first surface 161, a second surface 163, a first guide slot 162, a second guide slot 164, and a shoulder 166 extending outward from a portion of the body 165. The body 165 has a first central axis 167 extending through the center of the body.

[0044] First guide slot 162 may be sized and shaped to receive scalpel 190 and guide scalpel 190 along a planned trajectory, such as planned trajectory 199. In some embodiments, first guide slot 162 is sized and shaped to guide scalpel 190 with only slight lateral movement. First guide slot 162 is defined by a first side 168, a second side 169 spaced apart from first side 168, a third side 170, and a fourth side 171 spaced apart from third side 170. First guide slot 162 is disposed within knife guide 160 such that, when knife guide 160 is secured within tool support 141 of tool guide 140, a center of first guide slot 162 (also referred to herein as a second central axis) is aligned with longitudinal axis 148 of tool support 141, and the center of first guide slot 162 is equidistant between first side 168 and second side 169 and equidistant between third side 170 and fourth side 171. The center of first guide slot 162 is aligned substantially coaxially with first central axis 167 of body 165.

[0045] Second guide slot 164 may also be sized and shaped to receive knife 190 and guide knife 190 along a planned trajectory, such as planned trajectory 199. Second guide slot 164 may include an upper portion 172 extending from first surface 144 to a lower end of shoulder 166 and a lower portion 173 extending from the lower end of shoulder 166 to second surface 146. Upper portion 172 may include guide slot 174 defined by a first side 175, a second side 176 spaced apart from first side 175, a third side 177, and a fourth side 178 spaced apart from third side 177. The guide slot 174 of the second guide slot 164 is disposed within the knife guide 160 such that, when the knife guide 160 is secured within the tool support 141 of the tool guide 140, the center of the guide slot 174 (also referred to herein as the third central axis) is aligned with the longitudinal axis 148 of the tool support 141, and the center of the guide slot 174 is equidistant between the first side 175 and the second side 176 and equidistant between the third side 177 and the fourth side 178. The second guide slot 164 has a center (e.g., the third central axis) that is substantially coaxially aligned with the first central axis 167 of the knife guide 160 and the second central axis of the first guide slot 162.

[0046] The lower portion 173 of the second guide slot 164 may include a channel 178 that extends across the body 165 of the knife guide 160 from the lower end of the shoulder 166 to the second face 146 of the knife guide 160 and is defined by a first side 179 and a second side 180 spaced from the first side 179. A track surface 185 extends laterally through the center of the channel 178 and intersects the longitudinal axis 148 of the tool support 141 when the knife guide 160 is secured within the tool support 141 of the tool guide 140. The channel 178 is sized and shaped to orient the body 192 of the knife between the first side 179 and the second side 180 of the channel 178, thereby directing movement of the blade 194 of the knife 190 along the track surface 185.

[0047] The size and shape of the first guide slot 162 is designed to only allow the scalpel 190 to move vertically along the Z-axis (which may be referred to as the "vertical axis" for illustrative purposes), while restricting horizontal movement of the scalpel 190 along the X-axis and Y-axis. This allows a user (e.g., a surgeon) to use the first guide slot 162 to make a stab incision on a planned trajectory 199 using the scalpel 190.

[0048] The size and shape of the second guide slot 164 are designed to allow the scalpel 190 to move vertically along the Z-axis while also allowing it to move side-to-side or horizontally along a track surface 185 (see FIG. 4 ). Because the scalpel guide 160 is rotatable within the tool support 141, the track surface 185 can be aligned with a patient's anatomical structures, such as the spine and / or muscle fibers, to allow a user to open an incision that intersects the planned trajectory 199 to access a surgical site ST and expose a patient's anatomical structure, such as a bone surface. As seen in FIG. 4 , the size and shape of the second guide slot 164 allows for an incision in the patient's body B having a length 197 that is longer than the inner diameter ID of the opening 142 in the tool support 141. The length 197 of the incision can be controlled by increasing or decreasing the height 198 between the second surface 146 of the tool support 141 and the patient's body B. For example, an increase in the height 198 results in a longer incision length 197, and a decrease in the height 198 results in a shorter incision length 197. However, it should be noted that the user may, if desired, make an incision having a length 197 that is shorter than the total possible length 197. That is, the user may make an incision having a shorter length 197 if the user determines that sufficient access to the patient's anatomy can be obtained using the shorter length 197.

[0049] In some embodiments, a transition (not shown) may be formed between first and second sides 175, 176 of upper portion 172 and lower portion 173 of channel 178. At least a portion of first and second sides 175, 176 of upper portion 172 may have a shape (e.g., arcuate or angled) that forms the transition and allows a greater range of movement of knife 190 within channel 178 along track surface 185.

[0050] In some embodiments, the scalpel guide 160 may include a second guide slot 164 that is not separated into an upper portion 172 and a lower portion 173. In such embodiments, the second guide slot 164 may be provided with the shape and dimensions of the lower portion 173 of the second guide slot 164 described above, which extends from the first surface 161 to the second surface 163 of the scalpel guide 160. In such embodiments, the second guide slot 164 allows the body 192 of the scalpel 190 to move horizontally along the track surface 185 throughout the entire length of the second guide slot 164.

[0051] In use, the surgeon positions the scalpel guide 160 within the opening 142 of the tool support 141 and aligns the longitudinal axis 148 with the planned trajectory. The surgeon then places the scalpel 190 within the first guide slot 162 and moves the scalpel 190 vertically along axis 167 to create a stab incision in the patient. The surgeon then removes the scalpel 190 from the first guide slot 162 and places the scalpel 190 within the second guide slot 164. The surgeon moves the scalpel 190 vertically until it engages the patient, and then moves the scalpel 190 laterally along the trajectory surface 185 to widen the stab incision.

[0052] 5A and 5B, a scalpel guide 250 having a variable guidance system is shown. The scalpel guide 250 may include a body 256 having a first surface 252 (sometimes referred to as the "upper surface 252"), a second surface 254 (sometimes referred to as the "lower surface 254"), a shoulder 258, and a guide slot 260. The scalpel guide 250 also includes a handle 262 and guide prongs 264 (only one of which is numbered) attached to and / or extending from the handle 262. The body 256 has a first central axis 265 extending through the center of the body 256.

[0053] The body 256 of the knife guide 250 may be sized and shaped to be received by the opening 142 of the tool support 141 and secured within the tool support 141. A shoulder 258 may extend outwardly from a portion of the body 256 and be configured to contact the first surface 144 of the tool support 141 when the knife guide 250 is secured within the tool support 141.

[0054] Guide slot 260 may be sized and shaped to receive knife 190 and guide knife 190 along a planned trajectory, such as planned trajectory 199. Guide slot 260 may include an upper portion 280 extending from first surface 252 to shoulder 258 and a lower portion 290 extending from shoulder 258 to second surface 254.

[0055] The upper portion 280 of the guide slot 260 may include a first guide slot 282 defined by a first side 284, a second side 286 spaced from the first side 284, a third side 288, and a fourth side 290 spaced from the third side 288. The first guide slot 282 extends through a central region within the knife guide 250 and is disposed within the knife guide 250 such that, when the knife guide 250 is secured within the tool support 141 of the tool guide 140, the center of the first guide slot 282 is aligned with the longitudinal axis 148 of the tool support 141, and the center of the first guide slot 282 is equidistant between the first side 284 and the second side 286 and equidistant between the third side 288 and the fourth side 290.

[0056] The lower portion 290 of the guide slot 260 may include a channel 302 that extends across the body 256 of the knife guide 250 from the shoulder 258 to the second face 254 of the knife guide 250 and is defined by a first side 304 and a second side 306 spaced from the first side 304. A track surface 308 extends laterally through the center of the channel 302 and intersects the longitudinal axis 148 of the tool support 141 when the knife guide 250 is secured within the tool support 141 of the tool guide 140. The channel 302 is sized and shaped to matingly engage and thereby direct the body 192 of the knife 190 for lateral movement between the first side 304 and the second side 306 of the channel 302, such that movement of the blade 194 of the knife 190 is directed laterally only along the track surface 308.

[0057] Guide prongs 264 may include guide portions 320 (only one of which is numbered). Guide prongs 264 may be slidably inserted into openings 310 (only one of which is numbered) extending through scalpel guide 250 from first surface 252 to second surface 254. Opening 310 is disposed within scalpel guide 250 in alignment with first side 284 and second side 286 such that, when guide prongs 264 are in a first position with handle 262 positioned in the upper position (shown in FIG. 5A ), opening 310 positions guide portion 320 of guide prong 264 to orient body 192 of scalpel 190 and limit movement of scalpel 190 laterally along track surface 308. When the scalpel guide 250 is secured within the opening 142 of the tool support 141 and the guide prongs 264 are in the first position, the guide prongs 264 engage opposite sides of the scalpel 190, limiting lateral movement of the blade 194 of the scalpel 190. Thus, the blade 194 of the scalpel 190 is oriented only along the planned trajectory 199, allowing the stab incision to be made on the planned trajectory 199. In the first position, the guide portion 320 of the guide prong 264 may be in contact with the second surface 254 of the scalpel guide 250. In some embodiments, the second surface 254 may include notches 324 (only one of which is numbered) sized and shaped to at least partially receive and nest the guide portion 320 of the guide prong 264 when the guide prong 264 is in the first position.

[0058] The guide prongs 264 are shown as extending substantially perpendicularly from the body 322 of the guide prongs 264 (only one of which is numbered). However, it should be noted that the guide prongs 264 may be provided with other arrangements or angles, so long as the guide prongs 264 extend substantially across the channel 302 and orient the body 192 of the scalpel 190 as described above.

[0059] In a second position, with the handle 262 positioned in the lower position (shown in FIG. 5B ), the guide portion 320 of the guide prong 264 moves away from the second surface 254, allowing limited lateral movement of the blade 194 of the scalpel 190 to make an incision that intersects the planned trajectory 190. As the scalpel 190 is moved laterally, it engages the guide prong 264, limiting its lateral movement along the trajectory surface 308. In some embodiments, a spring bias in the guide prong 264 pushes the guide portion 320 away from the center of the scalpel guide 250. In the second position, when the scalpel 190 is inserted into the guide slot 260, the channel 302 guides the body 192 of the scalpel 190 laterally along the trajectory surface 308, allowing an incision to be made that intersects the planned trajectory 199 but is longer than the inner diameter ID of the opening 142 in the tool support 141. In some embodiments, the track surface 308 extends laterally substantially through the center of the channel 302 .

[0060] The guide prongs 264 can be moved between a first position and a second position by pushing or pulling the handle 262, allowing a user (e.g., a surgeon) to make a puncture incision along the planned trajectory 199 and / or to make an incision that intersects the planned trajectory 199 but may be longer than the inner diameter ID of the opening 142 in the tool support 141.

[0061] The guide prongs 264 may be made of any known material that is biocompatible, resists deformation, and tends to return to its original shape when an applied force, such as compression, tension, etc., is removed. For example, the guide prongs 264 may be formed from spring steel.

[0062] In use, the surgeon positions the scalpel guide 250 within the opening 142 of the tool support 141 and aligns the longitudinal axis 148 with the planned trajectory. The surgeon moves the guide prong 264 to a first position and then places the scalpel 190 within the guide slot 260. The surgeon then moves the scalpel 190 vertically along axis 265 to create a stab incision in the patient. Next, the surgeon moves the guide prong 264 to a second position and then moves the scalpel 190 laterally along the trajectory surface 308 to widen the stab incision.

[0063] 6A and 6B, there is shown a scalpel guide 350. The scalpel guide 350 may include a body 356 having a first surface 352 (sometimes referred to as the "first end 352"), a second surface 354 (sometimes referred to as the "second end 354"), a shoulder 358, a guide slot 360, and a trajectory marker 362 formed within the body 356.

[0064] The shoulder 358 may extend outward from a portion of the body 356 and be configured to contact the first surface 144 of the tool support 141 when the knife guide 350 is secured within the tool support 141. The shoulder 358 may be configured to have a predetermined depth extending from the first surface 352 to a lower surface 359 of the shoulder 358. The body 356 may also have a central axis 363 extending through the center of the body 356.

[0065] Guide slot 360 may be sized and shaped to receive knife 190 and guide knife 190 laterally along trajectory plane 370 that intersects a planned trajectory, such as planned trajectory 199. Guide slot 360 may include an upper portion 380 that extends from first face 352 to lower surface 359 of shoulder 358 and a lower portion 391 that extends from lower surface 359 of shoulder 358 to elongated portion 368 of body 356.

[0066] Upper portion 380 may include a first guide slot 382 defined by a first side 384, a second side 386 spaced from first side 384, a third side 388, and a fourth side 390 spaced from third side 388. In some embodiments, first guide slot 382 extends through a central region within knife guide 350 along a central axis 363 and is positioned within knife guide 350 such that when knife guide 350 is secured within tool support 141 of tool guide 140, central axis 363 is aligned with longitudinal axis 148 of tool support 141, and central axis 363 is equidistant between outer boundaries of first side 384 and second side 386 and equidistant between third side 388 and fourth side 390.

[0067] Lower portion 391 of guide slot 360 may include an opening 392 defined by a first side 394, a second side 395 spaced from first side 394, a third side 396, and a fourth side 397 spaced from third side 396. Guide slot 360 extends through a central region within knife guide 350 and is disposed within knife guide 350 such that when knife guide 350 is secured within tool support 141 of tool guide 140, a central axis of second guide slot 392 is aligned with longitudinal axis 148 of tool support 141, and the central axis of second guide slot 392 is equidistant between outer boundaries of first side 394 and second side 395 and equidistant between third side 396 and fourth side 397. The opening 392 may be wider, as measured from the third side 388 to the fourth side 390, than the first guide slot 382, ​​as measured from the third side 396 to the fourth side 397. In other words, the guide slot 360 tapers from the upper portion 380 to the lower portion 391 and is sized and shaped to orient the body 192 of the scalpel 190 between the first side 394 and the second side 395 of the opening 392, allowing the scalpel 190 to travel in an arc and make a single-plane incision along a track surface 370 that is longer than the inner diameter of the tool support 141.

[0068] In some embodiments, the scalpel guide 350 may include a guide slot 360 that is not separated into an upper portion 380 and a lower portion 391. In such embodiments, the guide slot 360 may be provided with the shape and dimensions of the opening 392 described above that extends from the first surface 352 to the elongated portion 368 of the body 356. In such embodiments, the guide slot 360 allows the body 192 of the scalpel 190 to move horizontally, i.e., laterally, along the track surface 370 throughout the length of the guide slot 360.

[0069] The body 356 may include a seat portion 400, a tension portion 402, an elongated portion 404, and an insertion marker 406. Optionally, the body may include an angled portion 408 at the lower end of the tension portion 402.

[0070] The seat 400 of the body 356 extends from the shoulder 358 to the insertion marker 406 and may be sized and shaped to be received by and secured within the opening 142 of the tool support 141. In the illustrated embodiment of the knife guide 350, the seat 400 is cylindrical and has an outer diameter that is substantially the same as the inner diameter of the opening 142 of the tool support 141. However, it should be noted that the seat 400 may be formed to have any shape and / or size that is related to the opening 142 of the tool support 141.

[0071] The tensioning section 402 may include a tensioning element 420 extending from the insertion marker 406 to the elongated portion 404 and designed to maintain tension between the scalpel guide 350 and the opening 142 of the tool support 141 when the scalpel guide 350 is partially inserted into the opening 142 of the tool support 141 so that the scalpel guide 350 can be positioned to a desired depth within the opening 142 of the tool support 141.

[0072] In the illustrated embodiment, the tension element 420 comprises a first spring element 422 and a second spring element 424. The first spring element 422 may comprise a first protrusion 426 and the second spring element 424 may comprise a second protrusion 428, which extend beyond the outer diameter of the seat 400 such that when the knife guide 350 is inserted into the opening 142 of the tool support 141, the first protrusion 426 and the second protrusion 428 contact the inner surface of the opening 142 and compress the first spring element 422 and the second spring element 424 to provide tension between the knife guide 350 and the opening 142 of the tool support 141.

[0073] In the illustrated embodiment of the knife guide 350, the first spring element 422 and the second spring element 424 are generally rounded and follow the outer diameter of the seat 400. However, it should be noted that the first spring element 422 and the second spring element 424 may be provided having any shape and / or configuration that enables the first spring element 422 and the second spring element 424 to provide tension between the knife guide 350 and the opening 142 of the tool support 141, as described herein. The first spring element 422 and the second spring element 424 may be made of any known or future-developed material that resists deformation and tends to return to its original shape when an applied force, such as compression or tension, is removed. For example, the first spring element 422 and the second spring element 424 may be constructed of a composite plastic or spring steel.

[0074] The elongated portion 404 may include a marker surface 430 having a trajectory marker 362 formed therein. The marker surface 430 may be an extension of the first side 394 of the lower portion 391 of the guide slot 360. The marker surface 430 may be offset from the trajectory surface 370 by a predetermined distance 440. The predetermined distance 440 may be designed to align the blade 194 of the scalpel 190 with the trajectory surface 370. In some embodiments, for example, the predetermined distance 440 may be half the width of the body 192 of the scalpel 190 and may be aligned with the blade 194 of the scalpel 190. In some embodiments, the width of the scalpel body may be 4 millimeters (mm), and the predetermined distance 440 may be 2 mm.

[0075] The trajectory marker 362 is aligned with, but may be offset from, the central axis 361 of the guide slot 360, which is coaxially aligned with the planned trajectory 199 when the knife guide 350 is inserted into the opening 142 of the tool support 141. The trajectory marker 362 is offset from the central axis 361 of the guide slot 360 by a predetermined distance 440.

[0076] In an exemplary use of the scalpel guide 350, the scalpel guide 350 may be inserted into the opening 142 of the tool support 141 aligned with the planned trajectory 199. A user (e.g., a surgeon) may use the trajectory marker 362 to mark the intersection of the planned trajectory 199 and the patient's body B. The user may use a marking device (e.g., a marking pen) to mark the intersection of the planned trajectory 199 and the patient's body B, creating a mark on the patient's body B to coincide with the trajectory marker 362 offset from the marker plane 430 by a predetermined distance 440. Alternatively, a user may use the scalpel 190 to make a stab incision in the patient's body B by inserting the scalpel 190 into the guide slot 360 and aligning the point of the blade 194 of the scalpel 190 with the trajectory marker 362.

[0077] The user may also use the scalpel 190 to make an incision that intersects the planned trajectory 199 to access the surgical site ST and expose the patient's anatomical structures, such as bone surfaces. For example, the user may align the marker surface 430 with the patient's anatomical structures and use the scalpel 190 to make a single-plane incision along the trajectory surface 370, which may be longer than the inner diameter of the tool support 141.

[0078] To aid in insertion of scalpel guide 350 into opening 142, scalpel guide 350 may include an angled portion 408 that provides a transition between elongated portion 404 and tensioning portion 402. For example, angled portion 408 may extend upward from marker surface 430 at a predetermined angle and back through tensioning portion 402. The predetermined angle may be between twenty-five degrees (25°) and sixty degrees (60°). In an exemplary embodiment, the predetermined angle may be forty-five degrees (45°).

[0079] In some embodiments, the scalpel guide 350 may be used as a tissue retractor once an incision is made in the subject's body B. In an exemplary use of the scalpel guide 350, the scalpel guide 350 may be inserted into the opening 142 of the tool support 141 aligned with the planned trajectory 199. A user (e.g., a surgeon) may use the trajectory marker 362 to mark the intersection of the planned trajectory 199 and the patient's body B. The user may use a marking device (e.g., a marking pen) to mark the intersection of the planned trajectory 199 and the patient's body B and create a mark on the patient's body B to coincide with the trajectory marker 362 offset from the marker plane 430 by a predetermined distance 440. The user may then at least partially withdraw the scalpel guide 350 within the opening 142 and make an incision in the patient's body B through the mark. The scalpel guide 350 can then be inserted and / or advanced into the opening 142, and the elongated portion 404 can be inserted into the incision and used to retract the patient's tissue to expose the target anatomical structure, such as the spine.

[0080] From the foregoing description, it is apparent that the inventive concepts disclosed herein are well adapted to carry out the objects and attain the advantages mentioned herein as well as those inherent in the inventive concepts disclosed herein. It will be understood that the embodiments of the inventive concepts disclosed herein have been described for purposes of this disclosure, and that many modifications, readily suggested to those skilled in the art, may be made which are within the scope and spirit of the inventive concepts disclosed herein.

[0081] [Embodiment] (1) A scalpel guide, a body having a first surface and a second surface, the body sized and shaped to be at least partially inserted into an opening in a tool guide of a surgical system, the body having a shoulder extending outward from a portion of the body, the shoulder having a lower surface, the body having a first central axis extending through a center of the body, the body having an outer periphery extending from the upper surface to the lower surface; the body having spaced first and second sides forming a first guide slot extending through the body from the first surface to the second surface, the first guide slot having a second central axis substantially coaxially aligned with the first central axis of the body, the first guide slot being sized and shaped to receive a scalpel body and guide a scalpel blade along the second central axis; a second guide slot having upper and lower portions, the upper portion of the second guide slot being formed in the body and the shoulder and extending through the body and the shoulder from the first surface of the body to the lower surface of the shoulder and not intersecting the outer circumferential surface of the body; the lower portion having a channel extending through the body from the lower surface of the shoulder to the second surface of the body, the sides of the channel being defined by opposing sides, the channel defining a track surface extending laterally through a center of the channel and intersecting the third central axis; and the second guide slot being positioned such that the body of the knife inserted into the second guide slot is guided vertically by the sides of the second guide slot and is able to move horizontally across the channel along the track surface. (2) A scalpel guide as described in embodiment 1, wherein the second guide slot intersects with the first guide slot and is oriented perpendicular to the first guide slot. (3) The scalpel guide according to embodiment 1, wherein the second guide slot intersects with the outer circumferential surface of the body. (4) The scalpel guide of embodiment 1, wherein the outer peripheral surface of the body is configured to mate with the inner surface of the tool guide, and the inner surface of the tool guide defines the opening. (5) A scalpel guide, a body having a first surface and a second surface, the body sized and shaped to be at least partially inserted into an opening in a tool guide of a surgical system, the body having a shoulder extending outwardly from the body, the body having a first central axis extending through a center of the body; a body having an interior portion defining a guide slot, the guide slot being aligned with the first central axis of the female guide; a handle having first and second guide prongs extending therefrom, the first and second guide prongs constructed from a spring-biased material, the first and second guide prongs slidably inserted into first and second openings in the body, the first guide prong having a first guide portion and the second guide prong having a second guide portion, the first and second guide portions being spaced apart and extending across at least a portion of the guide slot; A knife guide, wherein when the handle is in a first position, the first guide portion and the second guide portion are positioned adjacent to the guide slot to restrict horizontal movement of a knife positioned in the guide slot, and when the handle is in a second position, the first guide portion and the second guide portion are positioned away from the guide slot to allow horizontal movement of a knife positioned in the guide slot.

[0082] (6) The scalpel guide according to embodiment 5, wherein the shoulder portion extends from the first surface of the body to a lower surface of the shoulder portion. (7) The scalpel guide of embodiment 5, wherein the guide slot has an upper portion and a lower portion, the upper portion is formed in the body and the shoulder and extends through the body and the shoulder from the first surface of the body to the lower surface of the shoulder, the upper portion is sized and shaped to receive a scalpel body, the lower portion has a channel extending through the body in a region between the lower surface of the shoulder and the second surface of the body, sides of the channel are defined by a first side and a second side opposite the first side, and the channel defines a track surface extending laterally substantially through a center of the channel. (8) The scalpel guide of embodiment 5, wherein the first guide prong has a first bend adjacent to the first guide portion, the second guide prong has a second bend adjacent to the second guide portion, and the first bend in the first guide prong and the second bend in the second guide prong are substantially right-angle bends. (9) The scalpel guide according to embodiment 5, wherein the first opening and the second opening extend through the top surface of the body. (10) The scalpel guide of embodiment 5, wherein the body has an outer circumferential surface and the channel intersects the outer circumferential surface.

[0083] (11) The scalpel guide according to embodiment 5, wherein the one or more interior portions defining the guide slots extend through the body from the first surface to the second surface. (12) A robotic surgical system, comprising: A robotic arm, a tool guide supported by the robot arm, the tool guide having a tool support having a first end, a second end, an opening extending through the tool support from the first end to the second end, and a longitudinal axis extending through a center of the opening from the first end to the second end; a controller in communication with the robotic arm, the controller having a non-transitory computer readable memory and a processor, the non-transitory computer readable memory storing at least one planned trajectory associated with a surgical procedure and processor executable instructions that, when executed, cause the processor to pass a first signal to the robotic arm to position the tool support at a distance from a patient with the longitudinal axis of the tool support substantially coaxially aligned with the at least one planned trajectory; A female guide, a female guide comprising a body having a first end, a second end opposite the first end, a guide slot extending between the first end and the second end, and a central axis extending through a center of the body; the body includes a shoulder at the first end of the body, the shoulder extending outwardly from a portion of the body and extending from the first end to a lower surface of the shoulder; the guide slot is formed in the body and extends through the body from the first end to the second end, the guide slot being defined by a first surface, a second surface opposite the first surface, a third surface, and a fourth surface opposite the third surface, the guide slot having a second central axis substantially coaxially aligned with the central axis of the female guide, the guide slot defining a track surface extending through a center of the guide slot parallel to the first surface and the second surface and intersecting the second central axis; The body comprises: a seat extending from the underside of the shoulder to an insertion marker formed on the body, the seat being sized and shaped to be at least partially inserted into the opening of the tool guide of the robotic surgical system; and and an elongated portion extending from the second end toward the seat, the elongated portion having a marker surface that is an extension of the first surface of the guide slot, the marker surface having a trajectory marker formed therein, the trajectory marker aligned with the central axis of the scalpel guide and offset from the trajectory surface by a predetermined distance. (13) The robotic surgical system of claim 12, wherein the scalpel guide further comprises a tension section between the seat and the elongated portion, the tension section having a tension element configured to maintain tension between the body and the tool guide when the tension section is positioned within the opening of the tool guide. (14) The robotic surgical system of claim 13, wherein the tensioning section further comprises an angled portion extending upward through the tensioning section at a predetermined angle from the marker surface of the elongated portion. (15) The robotic surgical system of claim 12, wherein the predetermined distance by which the trajectory marker is offset from the trajectory plane is half the width of the scalpel body.

[0084] (16) The robotic surgical system of embodiment 15, wherein the width of the body of the scalpel is 4 millimeters.

Claims

1. A female guide, a body having a first surface and a second surface, the body sized and shaped to be at least partially inserted into an opening in a tool guide of a surgical system, the body having a shoulder extending outward from a portion of the body, the shoulder having a lower surface, the body having a first central axis extending through a center of the body, the body having an outer periphery extending from the upper surface to the lower surface; the body having spaced first and second sides forming a first guide slot extending through the body from the first surface to the second surface, the first guide slot having a second central axis substantially coaxially aligned with the first central axis of the body, the first guide slot being sized and shaped to receive a scalpel body and guide a scalpel blade along the second central axis; a second guide slot having upper and lower portions, the upper portion of the second guide slot being formed in the body and the shoulder and extending through the body and the shoulder from the first surface of the body to the lower surface of the shoulder and not intersecting the outer circumferential surface of the body; the lower portion having a channel extending through the body from the lower surface of the shoulder to the second surface of the body, the sides of the channel being defined by opposing sides, the channel defining a track surface extending laterally through a center of the channel and intersecting the third central axis; and the second guide slot being positioned such that the body of the knife inserted into the second guide slot is guided vertically by the sides of the second guide slot and is able to move horizontally across the channel along the track surface.

2. The scalpel guide of claim 1 , wherein the second guide slot intersects the first guide slot and is oriented perpendicular to the first guide slot.

3. The scalpel guide of claim 1 , wherein the second guide slot intersects the outer periphery of the body.

4. The scalpel guide of claim 1 , wherein the outer circumferential surface of the body is configured to mate with an inner surface of the tool guide, the inner surface of the tool guide defining the opening.

5. A female guide, a body having a first surface and a second surface, the body sized and shaped to be at least partially inserted into an opening in a tool guide of a surgical system, the body having a shoulder extending outwardly from the body, the body having a first central axis extending through a center of the body; a body having an interior portion defining a guide slot, the guide slot being aligned with the first central axis of the female guide; a handle having first and second guide prongs extending therefrom, the first and second guide prongs constructed from a spring-biased material, the first and second guide prongs slidably inserted into first and second openings in the body, the first guide prong having a first guide portion and the second guide prong having a second guide portion, the first and second guide portions being spaced apart and extending across at least a portion of the guide slot; A knife guide, wherein when the handle is in a first position, the first guide portion and the second guide portion are positioned adjacent to the guide slot to restrict horizontal movement of a knife positioned in the guide slot, and when the handle is in a second position, the first guide portion and the second guide portion are positioned away from the guide slot to allow horizontal movement of a knife positioned in the guide slot.

6. The scalpel guide of claim 5 , wherein the shoulder extends from the first surface of the body to a lower surface of the shoulder.

7. 6. The scalpel guide of claim 5, wherein the guide slot has upper and lower portions, the upper portion formed in the body and the shoulder and extending through the body and the shoulder from the first surface of the body to the lower surface of the shoulder, the upper portion sized and shaped to receive a body of a scalpel, the lower portion having a channel extending through the body in a region between the lower surface of the shoulder and the second surface of the body, sides of the channel defined by a first side and a second side opposite the first side, and the channel defining a track surface extending laterally substantially through a center of the channel.

8. 6. The scalpel guide of claim 5, wherein the first guide prong has a first bend adjacent the first guide portion and the second guide prong has a second bend adjacent the second guide portion, the first bend in the first guide prong and the second bend in the second guide prong being substantially right-angle bends.

9. The scalpel guide of claim 5 , wherein the first opening and the second opening extend through the top surface of the body.

10. The scalpel guide of claim 5 , wherein the body has an outer periphery, and the channel intersects the outer periphery.

11. The scalpel guide of claim 5 , wherein the one or more interior portions defining the guide slot extend through the body from the first surface to the second surface.

12. 1. A robotic surgical system, comprising: A robotic arm, a tool guide supported by the robot arm, the tool guide having a tool support having a first end, a second end, an opening extending through the tool support from the first end to the second end, and a longitudinal axis extending through a center of the opening from the first end to the second end; a controller in communication with the robotic arm, the controller having a non-transitory computer readable memory and a processor, the non-transitory computer readable memory storing at least one planned trajectory associated with a surgical procedure and processor executable instructions that, when executed, cause the processor to pass a first signal to the robotic arm to cause the robotic arm to position the tool support at a distance from a patient with the longitudinal axis of the tool support substantially coaxially aligned with the at least one planned trajectory; A female guide, a scalpel guide comprising a body having a first end, a second end opposite the first end, a guide slot extending between the first end and the second end, and a central axis extending through a center of the body; the body includes a shoulder at the first end of the body, the shoulder extending outwardly from a portion of the body and from the first end to a lower surface of the shoulder; the guide slot is formed in the body and extends through the body from the first end to the second end, the guide slot being defined by a first surface, a second surface opposite the first surface, a third surface, and a fourth surface opposite the third surface, the guide slot having a second central axis substantially coaxially aligned with the central axis of the female guide, the guide slot defining a track surface extending through a center of the guide slot parallel to the first surface and the second surface and intersecting the second central axis; The body comprises: a seat extending from the underside of the shoulder to an insertion marker formed on the body, the seat being sized and shaped to be at least partially inserted into the opening of the tool guide of the robotic surgical system; and and an elongated portion extending from the second end toward the seat, the elongated portion having a marker surface that is an extension of the first surface of the guide slot, the marker surface having a trajectory marker formed therein, the trajectory marker aligned with the central axis of the scalpel guide and offset from the trajectory surface by a predetermined distance.

13. 13. The robotic surgical system of claim 12, wherein the scalpel guide further comprises a tension section between the seat and the elongated portion, the tension section having a tension element configured to maintain tension between the body and the tool guide when the tension section is positioned within the opening of the tool guide.

14. The robotic surgical system of claim 13 , wherein the tensioning section further comprises an angled portion extending upward through the tensioning section at an angle from the marker surface of the elongated portion.

15. The robotic surgical system of claim 12 , wherein the predetermined distance the trajectory marker is offset from the trajectory plane is half the width of a scalpel body.

16. The robotic surgical system of claim 15, wherein the width of the body of the scalpel is 4 millimeters.

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