Robotic spinal surgery system and method with haptic interface

Abstract

The present invention provides a technology that includes a robotic manipulator, which includes a surgical tool for connecting to a screw and rotating the screw around a rotation axis. [Solution] The tactile device 51 includes an actuator 55 and a rotary interface 53 coupled to the actuator 55, the rotary interface 53 being manually operable by the operator's hand. The controller controls the robotic manipulator to maintain the rotation axis of the surgical tool 30 along a planned trajectory, autonomously controls the surgical tool 30 to rotate the screw PS at a rotational speed around the rotation axis, advances the screw PS linearly at a forward speed according to the thread shape of the screw PS, obtains measurements indicating the interaction between the screw and the target site, and controls the actuator 55 of the tactile device 51 to enable the rotary interface 53 to emulate the interaction between the screw PS and the target site.

Description

[Technical Field]

[0001] (Cross-reference of related applications) This application is a prior art of U.S. Provisional Patent Application No. 63 / 001,019, filed on March 27, 2020. Prior to and all other rights are asserted, and by all reference thereto, any part of this Specified may be used. It shall be done. [Background technology]

[0002] Robotic surgical systems that perform surgical procedures on a patient's spine are well known. For example, The robotic surgical system inserts pedicle screws into the patient's spine. It is currently being used to position [something].

[0003] If the patient requires surgery involving the placement of pedicle screws, preoperative imaging and / or Intraoperative imaging (pre-operative imaging and / or intra-operative imaging) is used when treatment is necessary. It is often used to visualize the anatomical form of a patient (in this case, the patient's spine). And the surgeon, with regard to the images and / or the 3D models created from the images, Plan the positions where the pedicle screws should be placed. This can be done, for example, by using an image. By identifying the desired pose within the 3D model, the pedicle screws can be positioned The position and orientation of each pedicle screw relative to the specific vertebra in which it is placed (i.e., posture) This includes deciding on a plan. Once such a plan is set, the robot will use this plan to execute it. It is then transferred to the surgical system.

[0004] Typically, a robotic surgical system includes a robotic manipulator, and this robot The manipulator positions the tool guide above the patient and along a desired trajectory for the desired orientation and alignment of the pedicle screw to be placed. Also included is a navigation system that determines the position of the tool guide relative to the patient's anatomical form such that the robotic manipulator can place the tool guide along the desired trajectory according to the surgeon's plan. In some cases, the navigation system includes tracking devices attached to the manipulator and the patient, and the robotic surgical system can monitor the movement of the patient during surgery and respond to this movement by moving the tool guide as necessary to maintain the desired trajectory. Once the tool guide is positioned to take alignment along the desired trajectory, the robotic manipulator is controlled to maintain the alignment. Then, the surgeon positions a cannula adjacent to the vertebra through the tool guide. The surgeon inserts a conventional drilling tool into the cannula to drill a pilot hole for the pedicle screw. Then, the surgeon removes the drilling tool and inserts the pedicle screw into place within the pilot hole using a pedicle screw driver. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw. The robotic surgical stem includes a navigation system that can determine the position of the tool guide relative to the patient's anatomical form so that the robotic manipulator can place the tool guide along the desired trajectory according to the surgeon's plan. The navigation system determines the position of the tool guide relative to the patient's anatomical form so that the robotic manipulator can place the tool guide along the desired trajectory according to the surgeon's plan. In some cases, the navigation system includes tracking devices attached to the manipulator and the patient, and the robotic surgical system can monitor the movement of the patient during surgery and respond to this movement by moving the tool guide as necessary to maintain the desired trajectory. The robotic surgical system includes a navigation system that can determine the position of the tool guide relative to the patient's anatomical form so that the robotic manipulator can place the tool guide along the desired trajectory according to the surgeon's plan. The robotic surgical system can monitor the movement of the patient during surgery and respond to this movement by moving the tool guide as necessary to maintain the desired trajectory. Once the tool guide is positioned to take alignment along the desired trajectory, the robotic manipulator is controlled to maintain the alignment. Then, the surgeon positions a cannula adjacent to the vertebra through the tool guide. The surgeon inserts a conventional drilling tool into the cannula to drill a pilot hole for the pedicle screw. Then, the surgeon removes the drilling tool and inserts the pedicle screw into place within the pilot hole using a pedicle screw driver. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw.

[0005] Once the tool guide is positioned to take alignment along the desired trajectory, the robotic manipulator is controlled to maintain the alignment. Then, the surgeon positions a cannula adjacent to the vertebra through the tool guide. The surgeon inserts a conventional drilling tool into the cannula to drill a pilot hole for the pedicle screw. Then, the surgeon removes the drilling tool and inserts the pedicle screw into place within the pilot hole using a pedicle screw driver. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw. The surgeon positions a cannula adjacent to the vertebra through the tool guide. The surgeon inserts a conventional drilling tool into the cannula to drill a pilot hole for the pedicle screw. Then, the surgeon removes the drilling tool and inserts the pedicle screw into place within the pilot hole using a pedicle screw driver. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw. In this method, the robotic manipulator is little or not at all utilized since it plays little or no role during the drilling of the pilot hole or the insertion of the pedicle screw.

[0006] On the other hand, "Robotic Spine Surgery System and Me" U.S. 16 / 184, filed on November 8, 2018, titled "thods" Disclosure No. 376 describes a robotic system that uses a rotational speed around a rotation axis to control the screen. The nozzle rotates to move the screw linearly forward at a forward speed along the planned trajectory. Therefore, we are disclosing a technology that allows for the autonomous control of surgical tools. And even when using robotic manipulators, surgeons still have difficulty interacting with tissue. Direct contact with or control of the forces, energy, materials, and information flows involved within It is not possible. Next, this involves the surgeon monitoring and evaluating the tissue interaction process during surgical procedures. This can lead to the loss of tactile and sensory information that we are accustomed to. Therefore, the inability of surgeons to evaluate the process, in particular, leads to a loss of confidence in the surgeon, and Emotional stress, insufficient procedural effectiveness, and otherwise recognizable to the surgeon However, some robotic solutions cannot handle unexpected situations that are not captured. This could lead to problems. [Overview of the project] [Problems that the invention aims to solve]

[0007] A first aspect of this disclosure is a robot manipulator and a robot manipulator coupled to the robot manipulator. The surgical procedure is designed to connect to a screw and rotate the screw around a rotation axis. Includes a tool, an actuator, and a rotary interface coupled to the actuator. Furthermore, the rotary interface is configured to be manually operated by the operator. It includes a haptic device and a navigation system configured to track the location of a target area. The stem is coupled with a robotic manipulator, a haptic device, and a navigation system. A robotic surgical system comprising one or more controllers, The controller plans a trajectory to the target site based on the tracked position of the target site. The movement of the robotic manipulator is controlled to maintain the rotation axis of the surgical tool along the axis. This involves rotating the screw at a rotational speed around the axis of rotation, and following the planned trajectory. The surgical tool is autonomously controlled to advance the screw in a straight line at a specified forward speed. Therefore, the rotational speed and forward speed are predefined, and the screw's known speed The control is proportional to the ridge shape, and the current interaction between the screw and the target site. Obtaining measurement values ​​to indicate usage and controlling the haptic device based on the obtained measurement values. The rotation interface then emulates the current interaction between the screw and the target site. A robotic surgical system is configured to perform and enable the following: Includes mu.

[0008] In some embodiments, the rotary interface is a knob, wheel, rotary switch This includes, but is not limited to, one or more of the following: a dial or a swivel.

[0009] In some embodiments, the haptic device uses a linear push interface instead of a rotary interface. This includes, but is not limited to, buttons, linear switches, linear triggers, or linear sliders. Includes a non-linear interface.

[0010] In some embodiments, one or more controllers control the actuators of the haptic device. By being configured to control the current interaction between the screw and the target site, Emulates the function.

[0011] In some embodiments, one or more controllers provide resistance to the actuator. Then the operator adjusts the force required to rotate the rotary interface. By being configured in this way, the current interaction between the screw and the target site is further enhanced. It is simulated, and the force required to rotate the rotation interface is relative to the target area. This reflects the current force required to rotate the screw.

[0012] In some embodiments, one or more controllers are other than the actuator, or By using the means applied to the actuator, the mechanical movement of the interface is resisted. It is configured. For example, in response to the influence of interface movement, the haptic device is biased. This includes, but is not limited to, mechanisms, stoppers, ratchets and / or gear systems. These include mechanical components that are not inductive, capacitive, and / or resistive elements. Electrical components, magnetic components, electromagnetic components, etc., not limited to these, Electromechanical components, hydraulic components and / or pneumatic components It can be used.

[0013] In some embodiments, one or more controllers control the range of motion of the interface. By being configured to restrict the current interaction between the screw and the target site, Further emulate this.

[0014] In some embodiments, one or more controllers initiate autonomous check mode. Further configured, the rotation interface rotates the screw relative to the target site. To provide the operator with haptic feedback that reflects the current force required to do so, Without the ability to control the surgical tool to rotate the clew, the adjustment It can be operated manually according to the force applied.

[0015] In some embodiments, depending on a condition or command, one or more controllers, Further configuration to autonomously control surgical tools and simultaneously initiate an autonomous check mode. It will be accomplished.

[0016] In some embodiments, depending on a condition or command, one or more controllers, Stop or pause the autonomous control of the surgical tool to stop the rotation of the screw. After that, it is further configured to start autonomous check mode.

[0017] In some embodiments, depending on a condition or command, one or more controllers, After the autonomous control of the surgical tool stops or pauses and the rotation of the screw stops, The system was further configured to resume autonomous control of the surgical tool and rotate the screw. It will be done.

[0018] In some embodiments, one or more controllers initiate manual control mode. Further configured, the rotary interface allows the operator to manually control the rotary interface. Based on the operation, one of the screw's rotational speed or screw's forward speed is It can be manually operated using the ability to control, and one or more controllers are rotary interfaces The face is manually operated to control one of the following: the rotational speed of the screw or the forward speed of the screw. In accordance with controlling the rotational speed around the axis of rotation, the surgical tool is controlled to control the rotational speed around the axis of rotation. The leu rotates, and the screw moves linearly forward at a forward speed along the planned trajectory. It is configured in such a way that the rotary interface can be manually operated according to the adjusted force. Yes, there is a tactile feedback that reflects the current force required to rotate the screw relative to the target area. Provide feedback to the operator.

[0019] In some embodiments, depending on a condition or command, one or more controllers, Stop or pause the autonomous control of the surgical tool to stop the rotation of the screw. Afterward, it is further configured to enter manual control mode.

[0020] In some embodiments, depending on a condition or command, one or more controllers, From manual control mode, resume autonomous control of the surgical tool to rotate the screw. It is further configured to switch to doing so.

[0021] In some embodiments, the haptic device is configured to trigger a condition or command. It will be accomplished.

[0022] In some embodiments, the robotic surgical system has a current between the screw and the target site. It further includes sensors configured to obtain measurements indicating the interaction, one or more The controller shown above is connected to the sensor.

[0023] In some embodiments, one or more controllers are available during screw control if conditions exist It is determined that it exists, and in accordance with the determination that the condition exists, the action of the haptic device By preventing the ability to control the tuner and rotate the rotary interface, the operator It is configured to provide haptic feedback to the rator regarding those conditions.

[0024] In some embodiments, the navigation system is registered with the target site. This involves determining the position of screws relative to an anatomical model of a body part, and navigation The system uses screws and screws at multiple positions relative to an anatomical model. To determine, including predetermined data showing the expected interaction with the anatomical model, The determined position of the screw relative to the anatomical model and the predetermined date Based on the data, the measurement shows the current interaction between the screw and the target site. It is further configured to obtain a fixed value.

[0025] In some embodiments, the rotational speed and forward speed are related.

number

number

number

[0026] In some embodiments, the tactile device is further defined as a handheld pendant. ru.

[0027] In some embodiments, the tactile device is a knob, rotary switch, or dial. This is a rotation interface that includes, but is not limited to, the following:

[0028] In some embodiments, instead of screws, rods, anchors, spacers, etc. are used. Any implant can be used, such as spinal implants like plates or plates. can.

[0029] In some embodiments, the screw is more specifically a self-tapping screw. It is a self-tapping screw.

[0030] In some embodiments, tactile devices are used in robotic manipulators and surgical tools. It is located far away from the main unit.

[0031] In some embodiments, the tactile device is used in robotic manipulators or surgical tools. It is directly attached to the .

[0032] In some embodiments, one or more controllers receive input from the operator. The resistance force provided to the actuator and the surgical tool control the rotation of the screw. The ability of the rotating interface can be further adjusted to selectively adjust one or more of the sensitivity. It is composed of the following.

[0033] In some embodiments, the robotic surgical system further includes a display, one or more The controller above can be further configured to initiate a simulated autonomous check mode. One or more controllers rotate the screw at a rotational speed around the axis of rotation. By advancing the screw in a straight line at a forward speed along the planned trajectory, the surgery can be performed. It simulates the autonomous control of surgical tools, and simulates the operation of surgical tools. Autonomous control is displayed on the screen, and the simulated current between the screw and the target site is shown. The haptic device acquires the current interaction and simulates the current interaction based on it. The actuator is controlled, and the rotary interface provides resistance to the actuator. The force required to rotate the rotary interface is adjusted by the operator. By configuring it this way, the simulated current interaction between the screw and the target site It is configured to allow emulation of use and to rotate the rotation interface. The force required to do so is the simulated force needed to rotate the screw relative to the target area. The current force is reflected, and the rotation interface reflects the simulated current force. According to the adjusted force, it provides the operator with projected haptic feedback for surgical use. Without the ability to control the tool and rotate the screw, the simulation of surgical tools It can be operated manually without using the ability to control the rated autonomous control.

[0034] In some embodiments, one or more controllers autonomously control the surgical tools. Before that, it is further configured to start a simulated autonomous check mode.

[0035] In some embodiments, the robotic surgical system further includes one display. The above controllers can be further configured to initiate a simulated manual control mode. The rotary interface then utilizes the ability to control surgical tools and rotate screws. Without being present, the surgery is based on the operator manually operating the rotation interface. During simulated manual control of the tool, the rotation speed of the screw or the screw's forward rotation speed can be controlled. It is manually operable using the ability to control one of the speeds of movement, and one or more controls The roller's rotating interface is manually operated to control the rotation speed of the screw or the screw - Control one of the forward speeds, and the rotational speed around the axis of rotation is controlled by the screw The screw is rotated and propelled forward in a straight line at a forward speed along the planned trajectory. This simulates manually controlling surgical tools and the simulation of surgical tools. The rated manual control is displayed on the screen, and the simulation between the screw and the target area Get the current interaction that has been set, and based on the simulated current interaction, touch The rotary interface controls the actuator of the sensory device, resisting the actuator. Provides the force needed to rotate the rotary interface by the operator's hand. By configuring it to adjust, the simulated relationship between the screw and the target site It is configured to allow the current interaction to be emulated, and the rotation interface The force required to rotate the screw is the force required to rotate the screw relative to the target area. The rotation interface reflects the simulated current forces. To provide the operator with haptic feedback that reflects the current force, the adjusted force Therefore, it can be operated manually.

[0036] In some embodiments, depending on a condition or command, one or more controllers, Stop or pause the autonomous control of the surgical tool to stop the rotation of the screw. Afterward, it is further configured to initiate a simulated manual control mode.

[0037] A second aspect of this disclosure is, in accordance with the first aspect of this disclosure, and optionally, this sector This includes a method for operating a robotic surgical system according to any embodiment within this publication. The first and second embodiments of the demonstration are provided according to either of the embodiments in this section. It will be implemented selectively.

[0038] A third aspect of this disclosure relates to a robotic manipulator and a robotic manipulator coupled to the robotic manipulator. The surgical procedure is designed to connect to a screw and rotate the screw around a rotation axis. Includes a tool, an actuator, and a rotary interface coupled to the actuator. The rotary interface is configured to be manually operated by the operator. It includes a haptic device and a navigation system configured to track the location of a target area. The system is coupled with a robotic manipulator, haptic devices, and a navigation system. A robotic surgical system comprising one or more controllers, one or more The controller plans a trajectory towards the target site based on the tracked position of the target site. Control the movement of the robotic manipulator to maintain the axis of rotation of the surgical tool along the path. The rotation interface is to receive control input from a haptic device. The rotational speed of the screw is determined based on the operator manually operating the rotary interface. It is manually operable using the ability to control one of the degrees or the forward speed of the screw. The device receives and, in response to control input from the haptic device, controls the rotational speed around the axis of rotation. The propeller rotates at a certain speed, and the propeller moves linearly forward along the planned trajectory at a forward speed. Controlling the surgical tool to advance, the rotational speed and forward speed are... It is predefined and proportional to the known thread shape of the screw, and it is controlled and To obtain measurements that show the current interaction between the clew and the target site, and the obtained Based on the measurements, the actuators of the tactile device are controlled so that the rotation interface is This allows us to emulate the current interaction between the clue and the target site. This includes robotic surgical systems configured to perform the following:

[0039] A fourth aspect of this disclosure is, in accordance with the third aspect of this disclosure, and optionally, this sector This includes a method for operating a robotic surgical system according to any embodiment within this publication. The third and fourth embodiments of the demonstration are provided according to any of the embodiments in this section. It will be implemented selectively.

[0040] A fifth aspect of this disclosure relates to a robotic manipulator and a robotic manipulator coupled to the robotic manipulator. A surgical tool configured to rotate around a rotation axis, and an actuator and an actuator Includes an interface coupled to the inverter, and the interface is operated by the operator. A haptic device configured to be manually operable and track the location of a target area. A navigation system configured to include a robotic manipulator and haptic sensors. The system includes one or more controllers coupled to the vice and the navigation system. A robotic surgical system in which one or more controllers track the position of the target site. Based on this, the rotation axis of the surgical tool is maintained along the planned trajectory relative to the target site. The movement of the robotic manipulator is controlled, and the surgical tool is autonomously controlled, and the rotation axis The surgical tool is rotated at a rotational speed centered on the hand, and then moved forward at a speed along the planned trajectory. The surgical tool is advanced linearly, demonstrating the current interaction between the surgical tool and the target site. The system acquires measurements and controls the actuators of the haptic device based on those measurements. The rotation interface then emulates the current interaction between the surgical tool and the target site. This includes a robotic surgical system configured to enable the following:

[0041] A sixth aspect of this disclosure is, in accordance with the fifth aspect of this disclosure, and optionally, this sector This includes a method for operating a robotic surgical system according to any embodiment within this publication. The fifth and sixth embodiments of the demonstration are provided according to any of the embodiments in this section. It will be implemented selectively.

[0042] A seventh aspect of this disclosure relates to an actuator and a rotary interface coupled to the actuator. The face and the rotating interface can be manually operated by the operator. It is configured as follows: a haptic device, a display device, and a haptic device and a display. It will be coupled with the play device and provide the simulation on the display device. Includes a simulation system comprising one or more controllers configured in such a way. The simulation is linked to a simulated screw and simulated target Simulated around the axis of rotation along the simulated trajectory relative to the target part We provide a simulated surgical tool configured to rotate a screw. The steps involve rotating a simulated screw at a rotational speed around the axis of rotation. The simulated screw moves linearly along the simulated trajectory at a forward speed. To allow for forward movement, it provides simulated control of the simulated surgical tool. The step involves the rotational speed and forward speed being predefined and simulated. The provided steps are proportional to the known thread shape of the screw, and simulate Simulated current interaction between the screw and the simulated target site The steps involve acquiring the action and, based on the simulated current interaction, the haptic device The rotation interface controls the screw and simulates the screw. It is possible to emulate the simulated current interaction between the target site and the system. Perform the following steps.

[0043] The eighth aspect of this disclosure is, in accordance with the seventh aspect of this disclosure, and optionally, this sector This includes a method for operating the simulation system according to any embodiment within the description. The seventh and eighth aspects of this disclosure are based on any of the embodiments described in this section. It is implemented on an optional basis. [Brief explanation of the drawing]

[0044] [Figure 1] This is a perspective view of a robotic surgical system according to one embodiment. [Figure 2] This is a perspective view of one embodiment of a surgical robotic arm used with the robotic surgical system shown in Figure 1. [Figure 3] This is a perspective view of one embodiment of a robotic surgical system used in combination with an imaging device for performing spinal surgery. [Figure 4]This is a partial perspective view of one embodiment of a surgical tool that is coupled to a robotic arm, comprising a surgical tool including a housing coupled to a drill. [Figure 5] This is a partial perspective view of a robotic arm coupled to a surgical tool that is coupled to a driver and screw. [Figure 6] This is an elevation view of an alternative surgical tool. [Figure 7] This diagram shows a pilot hole being drilled within the pedicle of a vertebra, according to one embodiment. [Figure 8] This is a diagram of a pedicle screw inserted into a vertebra, according to one embodiment. [Figure 9] This is a diagram of pedicle screws positioned along the line of tactile sensation. [Figure 10] Figure 1 is a perspective view of an example of a robotic surgical system, which includes a tactile device. [Figure 11A] This table shows various operating modes, including autonomous check mode, manual control mode, simulated autonomous check mode, and simulated manual control mode, along with the parameters of the haptic device. [Figure 11B] This table shows various techniques for controlling the insertion of pedicle screws based on input from a tactile device in manual control mode. [Figure 11C] This is a diagram of the rotation interface of a haptic device being manually operated from the home position to a non-home position. [Figure 12A] This is a diagram of a haptic device that provides tactile feedback to the operator while a pedicle screw is inserted during autonomous check mode. [Figure 12B] This is a diagram of a tactile device that provides tactile feedback to the operator while a pedicle screw is being inserted in manual control mode. [Figure 13] Figures A and B show current output versus depth and can be used to verify that drilling and pedicle screw insertion are proceeding according to the operator's plan. [Figure 14A]This is a perspective view of a robotic surgical system, according to one embodiment, which includes a tactile device and displays a simulation of an inserted pedicle screw. [Figure 14B] This is a diagram of a haptic device that provides tactile feedback to the operator while a pedicle screw is being inserted during a simulated autonomous check mode. [Figure 14C] This is a diagram of a tactile device that provides tactile feedback to the operator while a pedicle screw is being inserted during a simulated manual control mode. [Figure 15A] This is a flowchart showing how to operate a robotic surgical system using haptic devices. [Figure 15B] This is a flowchart of sample steps for executing autonomous check mode. [Figure 15C] This is a flowchart of sample steps for executing manual control mode. [Figure 15D] This is a flowchart of sample steps for executing a simulated autonomous check mode. [Figure 15E] This is a flowchart of sample steps for executing a simulated manual control mode. [Figure 15F] This is a flowchart of sample steps performed during surgery to autonomously control the insertion of pedicle screws (PS). [Modes for carrying out the invention]

[0045] I. System Overview Referring to Figures 1 and 2, spinal surgery, for example, involves pedicle screws, and other screws. This includes spinal surgery in which a new or other type of implant is placed inside the spine. A surgical robotic surgical system 10 that can be used in a variety of surgical procedures, not limited to those described above, is shown. The robotic surgical system 10 includes a localizer 14 and a tracking device 16. Includes a navigation system 12, one or more displays 18, and a robotic manipulator. A robot arm (for example, a robot arm 20 attached to a base 22, a table, etc.) Includes. The robot arm 20 includes a base link 24 that is rotatably connected to the base 22, It includes a plurality of arm links 26 extending from the base link 24 to the distal end 28. The Mulink 26 pivots / rotates around multiple joints within the robotic arm 20. Spinal surgery The surgical tools used when performing this procedure are, for example, generally shown as 30. Surgical tools 30 can be pivotally connected to the distal end 28 of the robot arm 20. The arm link 26 is in series It can be attached to. Alternatively, the robot arm 20 can use a parallel arm linkage. It may include. Furthermore, any number of robot arms 20 can be used.

[0046] The robot controller 32 controls the robot arm 20 during the operation of the surgical tool 30. Provide guidance to the doctor or surgeon (referred to as “operator” in this specification). It is configured as follows. In one example, the robot controller 32 is controlled via the robot arm 20 The robot arm 20 is controlled to provide tactile feedback to the operator. For example, it is configured to control the joint motor. Doback allows the operator to cross a predetermined virtual boundary related to the surgical procedure using a surgical tool 30 This helps to restrict or suppress manual movement of such tactile feedback. The tactile system and the associated haptic objects that define the virtual boundary are, for example, from 2006. The application was filed on February 21st of the year, titled "Haptic Guidance System And U.S. Patent No. 8,010,180 by Quaid et al., titled “Method”, and / Alternatively, it was filed on December 21, 2012, and is titled "Systems and Methods" For Haptic Control Of A Surgical Tool” The patent application, published by Otto et al., is titled as follows: Each of these shall, by reference to the whole, constitute part of this specification. For example, the robotic surgical system 10 was used in Fort Lauderdale, Florida, USA. RIO® Robot manufactured by MAKO Surgical Corp. It is an ic Arm Interactive Orthopedic System.

[0047] In some examples, the robotic arm 20 uses a predetermined tool to perform surgical procedures. It operates autonomously based on paths and / or other predetermined movements. Such movements are It can be defined during and / or before the surgical procedure. The example utilizes a combination of manual and autonomous control. For example, the operator performs surgery Manual mode involves applying force to tool 30 to cause movement of robot arm 20, and operator mode The user holds the pendant and controls the robot arm 20 to autonomously follow the toolpath. A robotic surgical system that uses both a controlled semi-autonomous mode and a fully autonomous mode was released on June 4, 2015. Requested, "Robotic Surgical System and Method" For Transitioning Between Operating Mode It is described in U.S. Patent No. 9,566,122 by Bowling et al., titled "s" This entire text shall, by reference, constitute part of this specification.

[0048] The navigation system 12 tracks various objects in the operating room with respect to the target coordinate system. It is set up to track movement. Such objects are, for example, hands. Surgical tool 30, the anatomical form of the target patient (such as one or more vertebrae), and / or This includes other objects. Navigation system 12 shows their phases in the target coordinate system. For the purpose of displaying the relative position and orientation to the operator, and, in some cases, the patient's response In relation to anatomical form (for example, coordinate systems well known in surgical navigation) Movement of surgical tool 30 relative to a virtual boundary defined with respect to the target coordinate system (via transformation) These objects are tracked for the purpose of controlling or restricting them.

[0049] The surgical navigation system 12 houses the navigation controller 36. Includes computer cart assembly 34. Navigation controller 36 and robot The controller 32, together with the robotic surgical system 10, forms the control system for the robotic surgical system 10. The navigation interface communicates with the navigation controller 36 in an operable manner. The navigation interface is adjusted to the computer cart assembly 34. Includes a display 18 that can be mounted. Input devices such as a keyboard and mouse. Use the chair to enter information into the navigation controller 36, or otherwise By law, to select / control a specific mode of the navigation controller 36 This is possible. It can be done using a touchscreen (not shown) or other input devices including voice activation. S is planned.

[0050] The localizer 14 communicates with the navigation controller 36. In the example shown, Localizer 14 is an optical localizer and a camera unit (an example of a sensing device). The camera unit includes an outer housing that houses one or more optical position sensors. In some examples, at least two light sensors are used, and sometimes three or more. The sensor may be a separate charge-coupled element (CCD). The camera unit is adjustable. The tracking device 16, described below, is mounted on an arm and ideally free from obstacles. The light sensor is positioned relative to the field of view. In some examples, the camera unit is rotatable. By rotating around the joint, it can be adjusted with at least one degree of freedom. In this example, the camera unit can be adjusted with approximately 2 or more degrees of freedom.

[0051] Localizer 14 communicates with the light sensor to receive signals from the light sensor. Includes an Iza controller (not shown). The localizer controller is wired or wireless. It communicates with the navigation controller 36 via one of the connections (not shown). One such connection could be an IEEE 1394 interface, and this IEEE The 1394 interface is for high-speed communication and isochronous real-time data transfer. This is a serial bus interface standard for isochronous real-time data transfer. Furthermore, the connection can use the company's own proprietary protocol. Another example is optical sensors. The system communicates directly with the navigation controller 36.

[0052] Position and orientation signals and / or data are used for navigation purposes to track objects. The data is transmitted to the computer cart assembly 34 and the display controller 36. Play 18 and Localizer 14 refer to parts of this specification by quoting them in their entirety. It is intended to be published on May 25, 2010, in "Surgery System" Titled as described in U.S. Patent No. 7,725,162 by Malackowski et al. It can be similar to an object.

[0053] The robot controller 32 and the navigation controller 36 are, respectively, also This includes one or more personal computers or laptop computers, and Local memory, external memory, cloud-based memory, random access memory (RAM) Non-volatile RAM (NVRAM), flash memory, or any other suitable format Includes memory suitable for storing data and computer-readable instructions, such as memory. It can be seen. The robot controller 32 and the navigation controller 36 are, respectively , or together including one or more processors such as microprocessors, these The processor processes instructions or algorithms stored in memory, and this specification These processors can perform the functions described in the document. It can be a processor, microprocessor, or multiprocessor system. Alternatively, the robot controller 32 and the navigation controller 36 are: Each or in combination, one or more microcontrollers, field-programmable Gate arrays, systems on chips, discrete circuits, and / or specified herein Other suitable hardware, software, or May include firmware. Robot controller 32 and navigation controller Ra36 is transported by a robotic manipulator and a computer cart assembly 34. It can be and / or mounted in any other suitable location. The robot controller 32 and / or navigation controller 36 are equipped with the following: Load the software as described below. The software is Localizer 14 or The received signal is converted into data representing the position and orientation of the tracked object.

[0054] The surgical robot system 10 includes a robot controller 32, as well as a surgical robot System 10 may include any number of controllers for controlling its components. For example, the surgical robot system 10 is configured to control the surgical tool 30. It may include a robot controller. As another example, the surgical robot system 10 is a surgical robot Haptic device controller configured to control the haptic devices of bot system 10 It may include (explained in more detail below). Control of surgical robot system 10 The device can be configured to perform surgical functions individually or in combination. For example, a robot controller 32, a navigation controller 36, and a local color The Iza controller, tool controller, and haptic device controller are used in combination. It operates in a manner that allows the operator to receive tactile feedback via the tactile device of the surgical robot system 10. Feedback can be provided. As another example, the robot controller 32 is They can operate independently to control the bot arm 20. Therefore, these In order to incorporate various configurations, the following explanation, as shown in Figure 1, is "one The above may refer to "controller 33". "One or more controllers 33" means Any individual controller or any controller suitable for performing the referenced function Please understand that this includes combinations of R. A collective set of one or more controllers also constitutes a control system. It can be considered a Tem.

[0055] Furthermore, it is performed by one or more controllers 33 described herein. None of the steps in this specification are necessary to solve the tasks described herein. The control algorithm described herein may be carried out in accordance with a limited set of steps. It is operational.

[0056] Referring to Figure 3, the navigation system 12 is also referred to herein as a tracker. This includes multiple tracking devices 16. In the illustrated example, the tracker 16 tracks different patients. It is joined to individual vertebrae. In some cases, Tracker 16 is a bone screw, bone It is fixed to the bone section via pins or similar means. In other cases, the spinous process Alternatively, the Tracker 16 can be attached using clamps on other parts of the spine. In further examples, tracker 16 can identify other tissue types or parts of anatomical morphology. It can be attached. The Tracker 16 can be attached to the anatomical form. The position of tracker 16 is determined by registration technology such as point-based registration. These registration technologies enable the use of a digital probe 73 (for example, a marker itself) Use the provided navigation pointer to turn off contact on the bone marker on this bone. or make contact at several points on the bone for surface-based registration. Using the previous registration technology, the posture of tracker 16 is recorded in relation to the patient's anatomical form, for example, when being treated. It can be correlated with vertebra V.

[0057] Furthermore, the shape of the spinous process to which the clamp is attached, which is attached to the spinous process of vertebra V, was determined. Use tracker 16 equipped with a mechanical clamp including a tactile sensor (not shown). However, registration of other types is also possible. And, the shape of the spinous process is 3 of the spinous process for registration. It can be matched to the D model. It uses a tactile sensor and three or more tracking devices 16. The known relationships between the upper markers are preloaded into the navigation controller 36. Based on this known relationship, the position of the marker relative to the patient's anatomical form is determined. It is possible.

[0058] The base tracker 16 is attached to the base 22 to track the posture of the surgical tool 30. It is possible. In other examples, even if a separate tracker 16 is fixed to the surgical tool 30 Often, for example, it may be integrated into the surgical tool 30 during manufacturing, or it may be used in surgical procedures. Alternatively, it may be attached separately to the surgical tool 30. In either case, the surgical tool The working end of the 30 is tracked by the base tracker 16 or other tracker. The working end can be the distal end of the accessory of the surgical tool 30. Accessories such as drills, burrs, saws, and electrical ablation devices are available. (device), screwdriver, tap, surgical knife, Jamshidi needle, etc. It may include.

[0059] In the illustrated example, tracker 16 is a passive tracker. In this example, each tracker Car 16 reflects light from localizer 14 back to the light sensor, at least 3 It includes one passive tracking element or marker M. In other examples, tracker 16 is an active tracking element. It is a light sensor and includes a light-emitting diode or LED that transmits light such as infrared light to the light sensor. Obtained. Based on the received optical signal, the navigation controller 36 performs conventional triangulation. The technology is used to determine the relative position and orientation of the tracker 16 with respect to the localizer 14. Generate the data shown. Depending on the case, use more or fewer markers. This is possible. For example, if the tracked object is rotatable around a line, then two By using the markers, we can measure the position of the markers at various points around this line. This allows us to determine the orientation of this line. Localizer 14 and tracker 16 As mentioned above, optical tracking technology is used, but alternatively or in addition, electromagnetic tracking is also used. Other tracking modalities such as traces, ultrasound, radiofrequency tracking, inertial tracking, and combinations thereof can be utilized. Please understand that you can use this to track objects.

[0060] Furthermore, if the surgical tool 30 inadvertently touches the patient's skin outside any desired incision boundary... To ensure that there is no contact or penetration, the patient's skin surface is traced. This may be desirable. For this purpose, an active or passive mat with an adhesive backing is available. Skin-adhering markers such as markers M are applied to the patient's skin, and the environment related to the patient's skin is examined. The boundary can be defined. An array of such markers M is an outer ring 74 (circle The surgical procedure can continue inside ring 74 without substantially hindering its shape (rectangle, etc.). The outer ring 74 can be provided (i.e., the ring is the target incision and (Placed on the patient's skin around the vertebrae). One suitable skin marker array is S tryker Leibinger GmbH&Co KG(Botzinger St Manufactured by raBe41, D-79111 Freiburg, Germany It is a SpineMask (registered trademark) tracker. Also, May 13, 2015 The application was filed for "Navigation System For And Method". Of Tracking The Position Of A Work Targe U.S. Patent Application Publication No. 2015 / 0327948, titled "t", by Schoepp et al. See reference. This shall constitute part of this specification by all means. Other suitable skin trackers are also being considered. Digital probes are also being used to track the skin surface. Surfaces and / or incisions can also be mapped. However, mapping can lead to further... Unless digitized, it will not detect any movement of the skin, but the attached tracker array This allows for the detection of skin movement in the patient.

[0061] Before the start of the surgical procedure, additional data is loaded into the navigation controller 36. Based on the position and orientation of tracker 16, as well as previously loaded data, The navigation controller 36 is a surgical tool that directs the working end towards the tissue to which it is applied. Determine the position of the working end 30 and the orientation of the surgical tool 30. Additional data is used for surgery. The position of the tracker 16 or its marker M relative to the working end of the tool 30 and / or may include calibration data such as geometric shape data relating to orientation. The data is obtained by calibrating probes or divots on tracker 16 of known geometric shapes. The position of the working end of the surgical tool 30 is tracked, for example, by its own tracker or This is determined preoperatively or intraoperatively by, for example, by determining the base tracker 16. It is possible to obtain additional data from tracker 16 of the patient's anatomical form or its 3D model. This may include registration data such as conversion data associated with Dell. In some examples, Navigation The control controller 36 transfers this data to the robot controller 32. Then, the robot controller 32 uses this data to obtain the U.S. Patent No. 8,010,1 Control the robotic arm 20 as described in No. 80 or No. 9,566,122. Both of these may be used to refer to parts of this specification by quoting them in their entirety. It shall be done that way.

[0062] Furthermore, the navigation controller 36 directs the surgical tool 30 to the target tissue. It generates image signals that show the relative position of the working end. These image signals are displayed on display 1. These signals are applied to 8. Based on these signals, the display 18 shows the operator and staff The tool generates an image that allows the user to see the relative position of the surgical tool 30 to the surgical site. The display 18 considered above allows for the input of commands. This may include a screen or other input / output devices.

[0063] In the example shown, the orientation of the surgical tool 30 is determined using the navigation system 12. The position of the base 22 is tracked via the base tracker 16, and the joints of the robot arm 20 are tracked. Joint encoder data from and known between the surgical tool 30 and the robot arm 20 Determined by calculating the position of the surgical tool 30 based on the relationships of its geometric shapes. It can be done. Finally, the localizer 14 and tracking device 16 are used for surgical procedures. The navigation system allows for the determination of the patient's posture and anatomical form. Tem 12 recognizes the relative relationship between the surgical tool 30 and the patient's anatomical form. One such navigation system was filed on September 24, 2013, and is referred to as "Na vigation System Including Optical And No Titled "n-Optical Sensors", Wu's U.S. 9,008,75 As shown in Section 7, which in whole constitutes part of this Specification by reference.

[0064] During surgery, for a specific surgical task, the operator uses the robotic arm 20. To operate in motion (for example, to move a robotic arm or to induce motion of a robotic arm) (i) Using the surgical tool 30, perform perforation, cutting, sawing, reaming, and implantation. Surgical procedures such as insertion are performed on the patient. The operator manipulates the surgical tool 30. Then, the navigation system 12 will guide the surgical tool 30 and / or robotic arm. Track 20 positions and provide haptic feedback (e.g., force feedback) to the operator. Provided to and registered (or mapped) to the patient's anatomical morphology Move the surgical tool 30 across one or more predetermined virtual boundaries (or move the surgical tool) (By limiting the operator's ability to cause movement) extremely accurate and reproducible drilling, Cutting, sawing, reaming, and / or implant placement are performed.

[0065] In one example, the robot arm 20 operates in a passive manner, and the operator crosses a virtual boundary. Provides haptic feedback when attempting to move the surgical tool 30. Haptic feed Back is one or more actuators (e.g., joint motors) within the robot arm 20 It is generated by and flexible transmissions such as cable-driven transmissions. It is transmitted to the operator via the robot arm 20, which provides tactile feedback. When not in use, the operator can move the robot arm 20 freely. In other examples, all This specification is made possible by reference to U.S. Patent No. 9,566,12 Similar to the one shown in No. 2, the robot arm 20 is operated by the operator in a similar manner. Although operated, the robotic arm 20 operates in an active manner. For example, when the operator performs surgery... When force is applied to tool 30, this force / torque sensor measures the force, and this force / torque sensor The robot arm 20 emulates the operator's desired motion based on the measurements from ( (emulate). For other surgical tasks, the robotic arm 20 operates autonomously.

[0066] Referring to Figures 4 and 5, surgical equipment is connected to the distal end 28 of the robot arm 20. An example of tool 30 is shown. More specifically, the coupling 40 is connected to the surgical tool 30. It is provided between the distal end 28 of the robot arm 20, and the distal end centered on axis A This allows the surgical tool 30 to rotate relative to part 28. In Figure 4, the surgical tool 30 is Pilot holes for pedicle screws, other screws, or other types of implants. Includes a drill 42 for drilling holes. The drill 42 is positioned to rotate around a rotation axis R. In Figure 5, the surgical tool 30 is a pedicle screw PS or other implant. To insert, a dry is positioned along the rotation axis R so as to rotate around the rotation axis R. Includes bur 44 (e.g., screwdriver). Surgical tool 30 is housed in housing 45 This includes the drive system (e.g., motor), the drill 42, the driver 44, or another accessory. It is located within the housing 45 to drive it. The drive system may be variable speed.

[0067] Furthermore, the housing 45 drives the drill 42, screwdriver 44, or other accessories. Includes collet 47 or other type of coupler for release attachment. In this case, the reduction gear 48 (see Figure 5) is releasably attached to the collet 47, and in a certain way It may be used as an accessory. The reduction gear 48 is compared to when it is directly connected to the drive system. This includes a transmission or gear arrangement that reduces the rotational speed of the accessories. This is useful when a slower rotation speed is desired.

[0068] In another example shown in Figure 6, one end of the coupling 40 rotates around axis A. The surgical tool 30 is supported against it. The other end of the coupling 40 is housing Supports the coupling 45. The housing 45 may be fixed to the coupling 40, or It may be supported within the coupling ring 40 against rotation about the axis of rotation R. In other words, The housing 45 can rotate passively within the coupling 40. However, simultaneously The coupling 40 can precisely control the positioning of the housing 45. This restricts the axial movement of the housing 45 along the rotation axis R relative to the coupling 40. The tracker (not shown) is attached to the housing 45, and the position of the housing 45 is... By tracking the rotation axis R and / or orientation, the rotation axis R is attached to the housing 45. The distal end of the attached accessory can be tracked. The rotating shaft 60 is located inside the housing 45. It is rotatably supported. The rotating shaft 60 is supported by accessories (for example, dry as shown). The distal interface / collet 62 connects to the bar 44, and a torque source such as a motor, and the hand A proximal interface that connects to a power source such as a rotatable handle for motion rotation. Includes a 64. For example, the driver 44 is a distal interface 62 / rotating shaft. It is shown combined with 60.

[0069] The robotic surgical system 10 controls the drill 42 and / or driver 44. It may include various components. For example, in Figures 4 and 5, surgical tools 30 includes a handle 46 hanging from the housing 45. The handle 46 is a grip. This may include, during surgery, the operator grasps this grip and the surgical tool 3 0 and / or the robot arm 20 is operated. Trigger 49 is also present, and this trigger This controls the speed of the drill 42 and / or the driver 44, or the robotic arm. This involves initiating 20 movements, or aligning the desired trajectory with the axis of rotation R. The trigger 49 provides signals to control the robot arm 20 and / or surgical tool 30. It can communicate with the robot controller 32 and / or the tool controller.

[0070] In the example shown in Figure 6, the surgical tool 30 controls the surgical tool 30 and the drill 42. Includes a handpiece 66 equipped with an internal motor. As shown, the operator hand The piece 66 is gripped, triggering the motor to operate, and the motor drives through the rotating shaft 60. Torque can be transmitted to the Ibar 44, and ultimately to the pedicle screw PS. To that end, the handpiece 66 is connected to the proximal interface 64.

[0071] Preoperative and / or intraoperative imaging is used to analyze the patient's spine and other areas requiring treatment. The scientific form can be visualized. The operator can, with respect to the image, and / or this Regarding the 3D model created from these images, the position where the pedicle screw PS should be placed. This plan can be made, for example, of desired images and / or 3D models. By identifying the posture of each pedicle screw PS, the posture of each screw is determined by their positioning. This involves determining the specific vertebra V. This is done using a 3D model of the patient's anatomical form. Regarding the pedicle screw PS, create a separate 3D model or position it. It may also include the following. And once the plan is set, this plan is used for robotic surgery. It will be transferred to System 10.

[0072] The robotic surgical system 10 is connected to an imaging device 50 (for example, the C-arm shown in Figure 3). It can be used in conjunction with any preoperative images, such as X-rays and CT scans taken before surgery. In addition to or instead of MRI images, intraoperative images of the patient's anatomical morphology are also used. It can be obtained. The intraoperative image from the imaging device 50 is placed on the patient's spine. Actual position of drill 42 or driver 44 relative to the desired orientation of pedicle screw PS This can help determine the location. Using separate tracking devices 16 for each vertebra V, When placing pedicle screws (PS) or other implants within the vertebral v, each vertebral v and a separate The corresponding positions of the drill 42 and / or driver 44 for each individual vertebra V are separately It can be tracked.

[0073] The robotic surgical stem 10 evaluates the desired position of the pedicle screw PS, and the pedicle screw A virtual boundary (e.g., a tactile object) corresponding to the desired pose of the PS, a predetermined t Create autopaths and / or other autonomous motion commands to control the movement of the robot arm 20. The drill 42 and screwdriver 44 of the surgical tools 30 are ultimately used by the operator's plan The placement of pedicle screws (PS) is controlled according to the procedure. This is, for example, during surgery. The trajectory of the surgical tool 30 allows the pedicle screw PS to take the desired position and alignment. For example, to achieve the desired orientation and rotation axis R alignment of the pedicle screw PS. This may include ensuring certainty.

[0074] In other cases, the operator plans the desired trajectory and / or screw placement during surgery. This is possible. For example, the operator can examine the target anatomical form, such as vertebra V. The drill 42 is then positioned at the desired insertion point, and the trajectory of the rotation axis R is within the desired orientation. The drill 42 can be oriented until the display 18 indicates this trajectory. Once satisfied with the path, the operator sets this trajectory as the desired trajectory to be maintained during the surgery. The system provides input (e.g., touchscreen, buttons, foot pedals, etc.) to the control system. It can be used to maintain the rotation axis R and stay along the desired trajectory. The tactile object, created to constrain 30 movements, is as shown in Figure 4. A line tactile object LH can be further... Starting point SP as described below, and the desired depth with drill 42, pedicle screw PS, etc. It may include a target point TP that defines the shape and a point EP that protrudes. The shape of other tactile objects, Sizes and other specifications will also be considered.

[0075] Referring to Figures 7 and 8, one of the vertebrae V is shown during surgical procedures such as spinal fusion. The operator then moves through the pedicle region into the vertebral body 100 of vertebra V. One or more pedicle screws (PS) can be inserted. Before doing so, the operator uses the drill 42 to make a pilot hole 102 in the vertebral body 100. It can be opened. Alternative examples include self-drilling, self-tapping bone screws. In cases where it is used, the pilot hole can be excluded. For example, in 2009 It was published on February 29th and is titled "Self-drilling bone screw" See the instruction in U.S. Patent No. 7,637,929 by Stefan Auth. This shall, by reference in its entirety, constitute part of this specification.

[0076] In one example, before perforation begins, the robotic surgical system 10 rotates the surgical tool 30. The axis R is autonomously aligned to a desired orbit that matches the desired orientation of the pilot hole 102. By taking a position, the surgical tool 30 is positioned to place the axis of rotation R along the desired trajectory. Controlling movement. In this case, the robot arm 20 follows a desired trajectory, but the vertebral body 1 The drill 42 is autonomously positioned above 00 (as shown in Figure 4). This is possible, and the drill 42 has not yet made contact with the vertebral body 100. Such autonomous positioning The operator pulls the trigger of the surgical tool 30, or by other means. It can be initiated by providing an input to the control system to start the movement. In some cases, the tool center point (TCP) of the surgical tool 30 provides the desired trajectory. Within a predetermined distance from the starting point SP of the line tactile object LH (such as a predetermined starting sphere) It is brought first (inside). TCP (e.g., the center of gravity of the bar, the center of the drill tip, etc.) When within a predetermined distance from the starting point SP, pull the trigger (or press the foot pedal instead). By moving (or another input), the robotic arm 20 autonomously moves along the desired trajectory. The surgical tool 30 is aligned and positioned accordingly. For example, a patent application filed on December 21, 2012, entitled "Systems and Methods" s For Haptic Control Of A Surgical Tool” See the description in Otto et al.'s U.S. Patent Application Publication No. 2014 / 0180290, titled [translate]. Please do so. This shall constitute part of this specification by quotation in its entirety. The bot arm 20 moves the surgical tool 30 to a certain distance from the patient based on the preoperative plan. It can be programmed to do so, or to move TCP to the nearest point on its orbit. This is possible. When the surgical tool 30 is in the desired position, the robotic surgical system 10 , in order to maintain the axis of rotation R on the desired trajectory, i.e., to take the line haptic object LH and the ara ment, the movement of the patient is tracked and the robotic arm 20 is autonomously adjusted as necessary to effectively hold the axis of rotation R of the surgical tool 30 on the desired trajectory .

[0077] While the robotic surgery system 10 holds the surgical tool 30 on the desired trajectory, the operator manually operates the surgical tool 30 to move (or cause the movement of) the drill 42 along the line haptic object LH towards the vertebral body 100 and can drill the pilot hole 102. When using the passive robotic arm 20, in some cases, even if the operator tries to move the surgical tool 30 in a way that deviates from the line haptic object LH and the desired trajectory, the robotic surgery system 1 delivers tactile feedback to the operator to constrain the operator's movement of the surgical tool 30 and keep it along the desired trajectory. Due to the unconstrained movement of the surgical tool 30, if the operator wants to return the robotic arm 20 to free mode, the operator can pull the surgical tool 30 back along the line haptic object LH away from the patient until reaching the puncture point EP. constrain the operator's movement of the surgical tool 30 and keep staying along the desired trajectory. For the unconstrained movement of the surgical tool 30, if the operator wants to return the robotic arm 20 to free mode, the operator can pull the surgical tool 30 back along the line haptic object LH away from the patient until reaching the puncture point constrain the operator's movement of the surgical tool 30 and keep staying along the desired trajectory. For the unconstrained movement of the surgical tool 30, if the operator wants to return the robotic arm 20 to free mode, the operator can pull the surgical tool 30 back along the line haptic object LH away from the patient until reaching the puncture point EP. EP. Then, the operator drills the pilot hole 102 to the desired depth. The drilling speed can be controlled by the operator via the trigger 49 or can be automatically controlled based on the position of the drill 42 relative to the patient's anatomical form. For example, the rotational speed of the drill 42 can be set high during the first drilling into the vertebral body V, but can be pulled back along the line haptic object LH away from the patient.

[0078] And the operator drills the pilot hole 102 to the desired depth. The drilling speed can be controlled by the operator via the trigger 49 or can be automatically controlled based on the position of the drill 42 relative to the patient's anatomical form. For example, the rotational speed of the drill 42 can be set high during the first drilling into the vertebral body V, but can be automatically controlled based on the position of the drill 42 relative to the patient's anatomical form. For example, the rotational speed of the drill 42 can be set high during the first drilling into the vertebral body V, but can be set high during the first drilling into the vertebral body V, but Further drilling into vertebral body V can be slowed down, and the final drilling to the final depth It can be set to an even slower speed. Also, the control system is a robot controller. 32 communicates with one or more sensors S (for example, one or more force sensors, force / torque sensors, During line tactile guidance via torque sensors, pressure sensors, light sensors, etc., contact / contact force It can monitor the situation. If no significant contact / contact force is detected, this is a surgical tool. Since this means that L30 is passing through soft tissue, the control system Motor for surgical tool 30, or other power source (e.g., RF energy, ultrasonic motor) To prevent activation of functions such as when contact with bone is detected (e.g., optically, sensitive). If the known force exceeds a predetermined threshold, for example, the control system will deactivate the motor or other power source It can be activated. Also, the operator passively feels the contact / contact force and the switch You can activate the power source by triggering it.

[0079] When the operator reaches the desired depth of the pilot hole 102, for example, the target point T When point P is reached, a hypothetical is used to constrain the motion of the operator along the desired trajectory. Even conceptual boundaries (for example, haptic objects) can be represented through haptic feedback. In addition, a separate virtual boundary can be used to set the desired depth. The robotic surgical system 10 autonomously drills a pilot hole 102 to a desired depth. It can be made to puncture. In further cases, the robotic surgical system 10 initially operates autonomously. It can be punctured, but then the final puncture can be done manually, or The reverse can be done. Once the pilot hole 102 is created, use the driver 44. Then the pedicle screw PS can be placed. In some cases, a pilot hole Lu102 may be unnecessary, and the pedicle screw PS is used in robotic surgery system 1 On a guide wire positioned by 0, or without any guidance, This is possible. For example, when using self-drilling or self-tapping bone screws, Pilot holes may be unnecessary. For example, by quoting the entirety of them in this specification. It is intended to be part of the "Self-drill" document, issued on December 29, 2009. Titled "ing bone screw", Stefan Auth's U.S. 7, Please refer to instruction number 637,929.

[0080] Using the navigation system 12, each vertebra V is tracked separately and sequentially, and drill 42 One advantage of tracking movement is that the pedicle screw PS is inserted close to the spinal cord 103. It is possible to insert them, and therefore, pedicle screws PS and their corresponding... The placement of the pilot hole 102 is to avoid interaction with or damage to the spinal cord 103. It must be precisely aligned to the operator's pilot hole 102. If the drilling is at an inappropriate angle and / or too deep, pedicle screw PS, The drill 42 used to drill the pilot hole 102 damaged the spinal cord 103. It is possible that the navigation system 12 will be used to determine the patient's anatomy. Morphology, specifically anatomical shapes that are outlined in preoperative and / or intraoperative images. By tracking the posture of the drill 42 and / or driver 44 relative to the spine, The spinal cord 103 can be avoided.

[0081] When the drilling is completed, the drill 42 is removed from the vertebral body 100 and disengaged from the drive system via the collet 47. Then, the driver 44 is coupled to the drive system (regardless of the presence or absence of the reducer 48).

[0082] The pedicle screw PS can be inserted with the assistance of the robotic surgical system 10. In one example, the robotic controller 32 autonomously controls the insertion of the pedicle screw PS such that the forward speed along the planned trajectory centered on the axis of rotation R is proportional to the thread shape of the pedicle screw at a rotational speed. The robotic controller 32 can autonomously control the insertion of the pedicle screw PS using various methods.

[0083] For example, the pedicle screw PS can be inserted at a constant rotational speed or a constant forward speed that can be pre - stored in the memory of the robotic surgical system 10 before the surgery. In such a case, the forward speed and / or the rotational speed can be stored in the memory of the robotic surgical system 10 before the surgery. The forward speed and / or the rotational speed can also be input and stored in the memory of the robotic surgical system during the surgery by the operator.

[0084] In another example, the robotic controller 32 can follow a predetermined profile for the rotational speed or the forward speed. The predetermined profile of the rotational speed or the forward speed can be based on any suitable variable such as time or the position of the pedicle screw PS. For example, referring to FIG. 9, the insertion of the pedicle screw PS is based on the ​​​​​​​​​​​​​It may be autonomously controlled based on the position of the driver 44 and / or pedicle screw PS. In such cases, the rotational speed of the driver 44 is set high during the initial insertion into the vertebral body V. It can be set, but can be delayed during further insertion into the vertebral body V, and It can be set even slower during the final embedding to the final depth.

[0085] Figure 9 shows the vertebrae while the robot controller 32 autonomously controls the surgical tool 30. This shows the home position of the pedicle screw PS. As shown in the figure, pedicle screw P S is adjacent to the target site and, in this case, is a plan designated by the linear tactile object LH. Along with the trajectory, it is shown as vertebra V. Pedicle screw PS and vertebral body 100 The threaded interface between them can cause problems if the pedicle screw is not inserted correctly, affecting the bone. There is a risk of damaging screw PS, driver 44, or surgical tool 30. Bone is arguably the weakest material, so if the screw is not inserted correctly, it can cause damage. This is the most likely outcome. Improper insertion, for example, is insufficient around the rotation axis R. This occurs when the pedicle screw PS advances linearly along the trajectory LH during rotation. This causes the bone material to be sheared adjacent to the screw threads and pushed into the bone. This could happen. In another example, for instance, a pedicle screw PS aligned with the LH orbit. Due to insufficient forward movement causing rotation around the axis of rotation R, the bone material becomes adjacent to the screw threads. It breaks and is pushed back along the threads, effectively over-drilling the hole. Improper insertion can occur. In all cases, the result of improper insertion is pedicle This involves a decrease in the strength and amount of bone material used to fix the Clue PS to the bone.

[0086] Figure 9 also shows the robot controller 32 autonomously controlling the surgical tool 30 while This shows the insertion of a pedicle screw (PS) using positional control. Positional control for insertion is crucial throughout the surgery, ensuring the correct depth, position, angle, and rotational position. Ensure that the position is maintained. As shown in the example above, pilot the vertebral body 100. A hole can be formed, or the surgery requires a pilot hole. Self-perforating and self-tapping screws can be used that do not cause this. The starting point Do of the pedicle screw PS is adjacent to vertebral body 100, that is, the screw One of the parts is before it penetrates vertebral body 100. In the alternative example, starting point Do is the entire surgery. To ensure proper positional control throughout the body, a certain distance from the vertebral body 100 is designated as a safety zone. It can be separated to this extent. Insertion depth D is the pedicle screw PS into the vertebral body 100. As the planned depth for completing the insertion, the orbit LH progresses to the final depth Df. nothing.

[0087] The robot controller 32 controls the rotational speed and forward speed along the trajectory LH. The insertion of the pedicle screw PS is autonomously controlled in proportion to the thread shape of the lyu PS. Each pedicle screw PS is configured to be a memory of the robotic surgical system 10. It has a known thread shape stored in memory. For example, in the case of each pedicle screw PS, the thread The shape of the screw is determined by the length of the pedicle screw PS, the diameter of the thread, the depth of the thread, and the head size. Either the thread size or the thread pitch P, which is defined as the number of threads per unit length. It may include one or more. In a particular example, the pedicle screw PS shown in Figure 11A is 1 inch It can have a thread pitch of 12 threads per inch (2.54 centimeters). To cut. Other example pedicle screws (PS) are 1 inch (2.54 cm) per It can have 8, 10, 14, 16 or other number of threads. (Robot arm) The defined relationship between 20 and the pedicle screw PS, and the robotic surgical system 10 By having a known shape of the pedicle screw PS stored in Mori, the robot The controller 32 is for inserting pedicle screws PS having a specific thread pitch. It is configured to ensure that the appropriate rotational speed and forward speed are maintained.

[0088] The thread shape of the pedicle screw PS is determined preoperatively or intraoperatively by the robotic surgical system 10. It can be stored in memory. For example, pedicle screws (PS) are part of the surgical plan. Selected as a fraction, the corresponding thread shape of the pedicle screw PS is the pedicle screw P It is associated with S and entered into the plan. When the plan is loaded for the surgery during the operation, The bot surgical system 10 stores known thread shapes in memory for immediate access. In another example, the operator can manually select different pedicle screws (PS). Can you use the GUI related to operating the robotic surgical system 10 to shape the screw threads? The shape can be entered manually. The entered thread shape is stored in memory. Can be obtained from the base, or selected by the operator. This can be derived from obtaining such information from the offline specifications related to the PS. Yes, it is possible. In any of these examples, the operator enters the screw using a GUI. The mountain shape can be stored in memory, and then the robotic surgical system 10 inputs it. The control techniques described herein can be implemented using a threaded profile. Then, using measurement tools that are connected directly or wirelessly to the robotic surgical system 10... Then, scan or measure any intended pedicle screw PS and determine the thread shape. The extracted and measured thread shape can be transmitted to the memory of the robotic surgical system 10. The thread shape of the pedicle screw PS is stored in the memory of the robotic surgery system 10. When this happens, the pedicle screw PS can be virtually presented within the navigation system 12. ru.

[0089] The pitch, angle, or rotational position of the threads of the pedicle screw, and the insertion depth or trajectory. The relationship between forward motion and along the path is determined by the equation θ = D * (pitch / 2π), where θ is The angular position is where D is the insertion depth per unit length, and the pitch is the single unit of the pedicle screw PS. This is the number of threads per unit length. The robot controller 32 uses this relationship to determine the number of threads per unit length. Control the insertion of the pedicle screw PS. For example, by time, rate of change in angular position, or rotation. When we take the first derivative with respect to velocity δθ / δt, we get the interpolation multiplied by the pitch divided by 2π. The rate of change at entry depth, or the forward velocity δD / δt, is equal to this, as follows: δθ / δ t can be expressed as t = δD / δt * pitch / 2π (Equation 1).

[0090] The robotic surgical system 10 prepares the anatomical form of the pedicle screw PS for It may include various accessories. For example, one of the accessories of the surgical tool 30 is a scalpel, an electrosurgical unit. This may include skin incision tools such as other tools with sharp tips. , may be mounted in the same manner as the drill 42 and / or the driver 44, or separately It is part of the end effector and is connected to the mounting frame that attaches to coupling 40. Often, skin incisions are performed using tactile guidance in the same manner as described above, i.e., temporary This can be done using a thought boundary (e.g., a tactile object) when creating an incision. By using a virtual boundary, the operator's movement is restricted with respect to the desired incision within the patient's skin. This can be done. For example, the digital probe can contact the desired incision location and the associated border / It can be used to create tactile objects. In another example, digitizing By doing so, and / or by preoperative methods, based on the posture of the skin tracker The 3D skin model can be determined, and the control system can determine the desired placement of the pedicle screws. Using this plan, the location of the incision can be determined based on this skin model.

[0091] Laser pointers, end effectors, and other components that can be attached to skin incision tools. Or, like other components that project visible light onto the patient's skin to indicate the incision site, Other types of pointers, similar to digital probes, are also used to identify the desired incision location. It is possible to use such a laser pointer to control the desired trajectory and rotation of the skin incision tool. First, align the rotation axis R, then activate the laser pointer to determine the desired trajectory. Light can be projected along the line. An alternative form of skin incision tool is a robotic arm. It is positioned through tool guides that hold it in the appropriate place. Achieved via skin trackers. For tracking the patient's skin, the navigation system 12 also (for example, the surface Based on a skin model (such as a model or point cloud) and the intersection of a desired trajectory with that skin model. This allows the operator to roughly determine the desired location of the incision, thereby enabling them to use tactile feedback. The feedback allows the patient to make the desired incision at the desired location within the skin.

[0092] Tactile objects are used to establish various tactile feedbacks that guide the incision method. It can be defined by the method. The tactile object is the width of the skin incision tool, the skin incision It can be defined based on the desired length and / or the desired depth of the incision. The desired incision depth can be controlled by the operator within the maximum incision depth. This maximum incision depth is programmed as part of the tactile object, or the skin incision tool. The tool guide TG of the end effector crosses a predetermined point and passes the guide opening (not shown) within it. A mechanical stop that can be used to prevent sliding by either It can be decided.

[0093] One of the accessories for the 30 surgical tools is a Jamshidi needle, another with a stylet. This may include wire insertion tools such as access cannulas. Wire insertion tools are used for skin incisions. It can be mounted in the same way as the saddle, or as part of a separate end effector. The wire can be fixed and connected to a frame attached to the coupling 40. If relative movement between the insertion tool and the mount is not permitted, that is, if they are fixed to each other, If so, the wire insertion tool is guided by the line tactile object and skin The skin incision allows access to the bone, such as the target point on the vertebrae. The support structure has an opening. Relative axial sliding motion between the wire insertion tool and the mount, such as when a tool guide is included. If movement is permitted, the tool guide can be positioned in the desired orientation, and wire insertion The tool can be inserted along the opening in the tool guide. Relative to the target point Depending on the distance, the length of the wire insertion tool, and the position of the tool guide, the wire insertion tool will , in the same manner as described above for the drill 42 and / or driver 44, It can be guided through tactile objects.

[0094] Because this skin and the desired location for the incision are being tracked, the robotic surgical system Tem 10 controls the movement of the skin cutting tool with respect to the tactile object created for incision. It can be controlled. The tactile object can make an incision at a desired location within the patient's skin. It is defined in the target coordinate system. In one example, the robotic surgical system 10 is a skin incision tool. By controlling the manual operation, the movement of the skin cutting tool relative to the tactile object is controlled. It can be controlled. This is while the operator is manually moving it, or the operator While you manually initiate the movement of the skin incision tool, the tool will make an incision at the desired location. To that end, the movement of the skin cutting tool is constrained to the virtual boundary defined by the tactile object. This can be done by using a robotic surgical system 10, which is a skin incision tool. The desired depth of the incision has been reached, or the desired limit of the incision has been reached by other means. By generating haptic feedback to the operator indicating that the target has been reached, The movement of the skin cutting tool relative to the object can be restricted. The incision can be made in the desired position. When performed, the skin incision tool is withdrawn from its anatomical form, and all incisions are made. The surgery will proceed until the skin incision is complete. The skin incision technique is called "Robotic Spine Surger". A patent application titled "y System and Methods" was filed on November 8, 2018. This may be similar to what is described in U.S. Patent Application No. 16 / 184,376.

[0095] II. Haptic Feedback Technology As described above, the robotic system 10 is used to control the surgical tool 30 and plan The screw can be rotated along the defined trajectory. What is described herein is The bot system 10 is involved in the interaction of the surgical tool 30 with the tissue, for the surgeon. The direct tactile sensation "feel," the contact or control of force, energy, material, and the flow of information. This technology is used in combination with the robot system 10 to provide the following: The techniques described herein enable surgeons to monitor and evaluate tissue interaction processes during surgical procedures. To do this, a technical solution is needed to (manually) emulate familiar tactile and sensory information. The solution is provided. The tactile technology described herein is a robot-controlled hand To restore the surgeon's ability to evaluate the process during surgery. This solution is, for example, Using one degree of freedom (e.g., rotation) and one associated phenomenon (e.g., resistance), It provides a sophisticated mechanism for providing haptic feedback. The screw is operated by the robotic arm 20 and / or surgical tool 30. An interface (e.g., a knob) that controls or emulates the interaction of accessories. This may include: In some cases, the interface resistance is adjusted or amplified, and the screw - It can change dynamically depending on the interaction between the screw and the surrounding tissue in which it is inserted. In some examples, when a user interacts with the interface, the robot rotates its screw. Turn and move forward. The robotic system uses appropriate sensors to guide the screw insertion process. The parameters are captured. Then the sensor information is converted and sent to the interface. Used to adjust the feedback, which allows the surgeon to insert the screw. The consistency of the tissue and the quality of the foam grip that fits between the screw and the tissue. It gives surgeons enhanced sensory acuity, which helps them understand... Tactile technology enhances surgeons' confidence, reduces emotional stress, and improves procedural effectiveness. The ability to recognize and respond to unexpected situations that cannot be captured by robotic solutions is a surgical skill. Provide to medical professionals.

[0096] The tactile technologies described herein can be used in a variety of medical applications. For example, tactile While the technology is related to the screw insertion process, tactile technology also has various other medical applications. It can be used in the interface of a tactile device during surgery involving a scalpel or syringe. The face is when the scalpel or syringe moves through different tissues. Haptic technology can provide haptic feedback to emulate the force being applied. It can be used in soft tissue surgery to prevent damage to soft tissue. For example, stretching During surgery in which a distractor separates soft tissue, the interface of the tactile device is The stretcher is used at the wound site, surgical opening, between bones in the joint cavity, or between bones during bone growth surgery (e.g.) For example, when separating the soft tissue of mandibular extension, the force applied to the soft tissue by the stretcher ( Tactile feedback to emulate the tension applied by soft tissue on the stretcher. It may provide a back. Another example is the interface of a tactile device during surgery, including the use of a tourniquet. The face emulates the pressure applied to soft tissue by a tourniquet. It can provide tactile feedback. Another example is a jaggie to open up joint space. During surgery involving a jack, the interface of the tactile device is applied to the ligament by the jack. The force applied (or tension from the ligaments on the jack) is emulated to balance the ligaments. It can provide haptic feedback to assist in the process.

[0097] A. Haptic devices For example, as shown in Figure 10, the robotic surgical system 10 is a surgical tool. Includes a tactile device 51 for controlling the controller 30. The tactile device 51 is for the operator It may include an interface 53 that can be operated manually by hand. In this example, the haptic device 51 may be a handheld pendant. Alternatively, the haptic device 51 is useful in units that can be placed on a surface, tactile gloves, or manual surgical procedures. This may include a physical design that mimics the tool used (e.g., a screwdriver). The sensory device 51 is configured to provide the surgeon with any other functions described herein. It could be a device.

[0098] In the context of haptic devices, the term "device" refers to the specific embodiments described herein. (Multiple) Not limited to. In fact, haptic devices allow haptic responses to be transmitted to areas away from the haptic device. The system is configured to emulate the conditions that occur at the boundary and to provide the operator with tactile (sensory) feedback. This may include any device that has been modified to provide proper tactile sensation. Mechanical components, electrical components, electromechanical components, software, One or more controllers, pneumatic components, or hydraulic components. It can be composed of the above components.

[0099] In Figure 10, the tactile device 51 is connected to the robot manipulator via the base 22. Alternatively, it can be directly attached to the surgical tool 30. In another example, the tactile device 51 is a composite Robotic surgical systems such as the tuner cart assembly 34 or navigation system 12 It can be attached to any other suitable component of stem 10. In yet another example, The tactile device 51 does not need to be held by the operator. It can be directly coupled to a robotic arm 20 or a surgical tool 30. (Tactile device 51) Furthermore, as shown in Figure 10, the robotic manipulator and surgical tool 30 They can be placed remotely, at a distance and with a gap between them. In such cases, the haptic device 51 is robotic It can be wirelessly coupled to the surgical system 10. Alternatively, the tactile device 51 is shown in Figure 10. As such, power can be supplied by a cord connected to system 10. The tactile device 51 is not necessarily attached to the robotic surgical system 10. It can be used as a standalone device, not limited to a specific purpose. For example, haptic device 5 1 is a hand that does not include a robotic manipulator and / or navigation system 12. It can be used in conjunction with the surgical system.

[0100] The interface 53 of the haptic device 51 moves with a certain degree of freedom relative to the haptic device 51. For example, interface 53 can rotate the haptic device 51. It is a rotation interface that can be moved with degrees of freedom. In some examples, rotation input The tapface 53 may be a rotary knob, as shown in Figure 10. Rotary interface 53 may also be a rotatable dial, ball, or wheel. Interface 53 is a configuration other than those specifically shown in the drawings or described herein. It may have.

[0101] The rotation interface 53 allows the operator to control the rotational degrees of freedom of the rotation interface 53. It is possible to associate a clew or tool with a rotational degree of freedom that rotates around it. It may be desirable to do so. However, using a configuration other than the rotating interface 53 By using this, it is possible to realize the interface 53 of the haptic device 51. For example, The tactile device 51 may be manually operated by the operator's hand via a linear interface -53 may be included. In some examples, the linear interface 53 is a pivot lever, push Buttons, palm or finger triggers, spring switches, plungers, elastic pads, or It can be a Rider. Furthermore, one or more controllers 33 activate the haptic device 51 The inverter 55 controls the linear interface 53, which is currently connected to the screw and the target site. It becomes possible to emulate the interaction of a linear interface. If -53 is a push button, one or more controllers 33 respond to the current interaction Therefore, the operator applies greater or less force to press the push button. The actuator 55 can be controlled. In another example, the linear interface 53 If it is a switch or plunger, one or more controllers 33 allow the operator to Applying a larger or smaller force to activate the switch or plunger. This allows control of the actuator 55 of the tactile device 51. In yet another example, The linear interface 53 includes a mechanism configured to slide along a path. It is a Rider. One or more controllers 33 allow the operator to control the larger or smaller Apply force to operate the slider and / or control the actuator 55 The actuator 55 of the tactile device 51 is controlled to limit the linear displacement of the slider. It is possible.

[0102] The robotic surgical system 10 provides tactile feedback to the operator via a tactile device 51. The device provides a tactile interface. As shown in Figure 10, the tactile device 51 has one or more controllers 3 It may include an actuator 55 that can be controlled by 3. The actuator 55 is an interface The face 53 is connected and configured to apply force to the interface 53. The ETA 55 is a drive output coupled between the actuator 55 and the interface 53. It may include a drive shaft 68. One or more controllers 33 control the actuator 55. Interface 53 then emulates the current interaction between the screw and the target site. It can be made possible to do so by using interface 53. Then, to rotate the screw, use the surgical tool 30 and / or screwdriver 44 directly Direct control is performed via the haptic device 51, and this is combined with haptic feedback. This allows us to emulate the current interaction between the screw and the target site. In these examples, the operator perceives the degrees of freedom of interface 53 through the script. This can be associated with the degrees of freedom in which the element moves around it.

[0103] Actuator 55 is a brushed or brushless motor, a direct drive motor, or an actuator DC actuators, DC motors, electric linear motors, linear current-controlled motors, steppers - Motor, electric rotary motor, torquer (a motor with a limited angular range) ), spring-based actuators, magnetic actuators, hydraulic actuators, pneumatic actuators Actuators, manual mechanical actuators, and passive actuators including magnetic particle brakes A treadmill, friction brake, damping resistance mechanism, or friction generating mechanism, or a combination thereof, It can be implemented as a motor, for example.

[0104] In some examples, the tactile device 51 is connected to the robotic system 10 or the tactile device 5 It may include safety features to prevent unintended use of 1. For example, the haptic device 51 may include A user interface that may need to be pressed in order for interface 53 to be operable. 57 (dead man's switch) may be included. Similarly, haptic device 51 may be used in robotic surgical systems. To send a command to Tem 10, it may be necessary to press user interface 57. In another example, interface 53 is pressed and held in the pressed position before being operated. It may need to be done. In yet another example, the haptic device 51 has one or more controllers Ra33 can determine whether the operator's hand is in contact with the tactile device 51. To enable this, force sensors, temperature sensors, proximity sensors, light sensors, and / or pressure sensors are used. It may include one or more sensors, such as a sensor.

[0105] The haptic device 51 can be used in various operating modes, some of which are shown in Figure 1. It is listed in Table 1A (the operating mode is called "Haptic Device Operating Mode"). As described, these operating modes are "autonomous check mode" and "manual control mode". " and "Simulated Autonomous Check Mode" and "Simulated Manual Control Mode" This includes, but is not limited to, the following. The names of these modes are intended to make them easy to understand and explain. Since it is provided for this purpose, it may be named according to other appropriate rules. The functionality is fully understood based on the following explanation.

[0106] Referring to column B of the table in Figure 11A, in each operating mode of the haptic device, 1 The controllers 33 provide haptic feedback to the haptic device 51. In check mode and manual control mode, the tactile device 51 controls the pedicle screw PS. It emulates the current interaction between the target site and the simulated autonomous check. In the simulated manual control mode, the haptic device 51 is simulated The current interaction between the inserted pedicle screw and the simulated target site is expressed by EMI. These modes are automatically started by the robot system 10. It can be started by the operator, manually by the operator, or according to any other command. It will begin.

[0107] Furthermore, the screw position and depth are determined for any control mode described herein. It can be displayed on a display device.

[0108] B. Interaction detection For any of the operating modes described herein, the robotic surgical system 10 is one The system includes one or more sensors coupled to the controller 33, and the movable elements (i The current phase between the plant, screw, and / or the tool itself and the target site Measurements showing the interaction can be obtained. For example, the robotic surgical system 10 targets the target area A position sensor configured to sense the position of the pedicle screw PS relative to the position, and / or rotation of surgical tool 30 screwdriver 44 or rotation of pedicle screw PS The system may include a rotary encoder configured to sense [something]. Robotic surgical system 1 The 0 is configured to sense the force applied to the pedicle screw PS by the target site. It may include force sensors. The robotic surgical system 10 uses a pedicle screw depending on the target site. - A torque sensor configured to sense the torque applied to the PS, and / or hand The surgical tool 30 is configured to sense the electrical parameters generated by its actuator. It may include an electrical parameter sensor, which controls the electrical parameters of the screw and the target part. The torque applied to the surgical tool 30 by the current interaction between the positions is proportional to the torque applied. For example, in such a case, the increase in torque is due to the pedicle screw PS making contact with the cortical wall, Alternatively, it may indicate contact, and a rapid decrease in torque indicates that the pedicle screw PS It can be shown that the cortical wall has been breached and the bottom has been hit. The robotic surgical system 10 also, A proximity sensor configured to detect the proximity of the pedicle screw PS to the characteristics of the target site. A depth sensor configured to sense the depth of the pedicle screw PS within the target site. It is configured to sense the displacement of the pedicle screw PS relative to the characteristics of the target site. It may include a displacement sensor.

[0109] In one embodiment, the navigation system 12 additionally or alternatively provides pedicle Determine the current interaction between the Clue PS and the target site. As mentioned above, preoperative imaging Using and / or intraoperative imaging, the patient's anatomical morphology can be visualized. For example, Using preoperative images, such as X-ray, CT scan, or MRI images, the patient's anatomy is determined. It is possible to create a target morphology, specifically an anatomical (virtual) model of the target area. Anatomical models of a position can be registered to the target site using any appropriate registration method. The navigation system 12 controls the robot, tools, screws, and / or patient. Track the individual and determine the position of the pedicle screw PS relative to the anatomical model of the target site. The navigation system 12 can perform the following actions on the pedicle screw relative to the anatomical model. - Expected interaction between pedicle screws at multiple locations of PS and anatomical models It may include predetermined data that demonstrates the action. In one example, the data may include one or more controllers 33 For access by navigation, it can be stored in a lookup table in memory. The selection system 12 determines the screw position for an anatomical model and given data. Based on the state, position, orientation, and / or posture, the pedicle screw PS and target site Measurements showing the current interaction between can be obtained. The given data is vertebra V The navigation system 12 may include bone density data and vertebral V Using the screw configuration relative to the anatomical model, pedicle screws PS and vertebral V Obtain a measurement showing the current interaction between, for example, at depth A as shown in Figure 12A. Obtain. The given data relates to the shape of the screw, tool, or the definition of the interaction. This may also include known data about any other functions.

[0110] By combining any combination of the above sensors, including the navigation system 12, It is possible to perform sensing between the movable element and the target area.

[0111] C. Haptic Interaction Feedback The controller 32 is configured to provide physical feedback to the haptic device 51. This emulates the current interaction between the pedicle screw PS and the target site. It can be rated. As explained below, physical feedback can take various forms. It is possible.

[0112] The control modes described herein are "autonomous check mode" and "manual control mode". "Simulated autonomous check mode" and "Simulated manual control mode" None of these fully utilize any of the haptic interaction feedback technologies described herein. It is possible.

[0113] To enable these technologies, the tactile device 51 touches as shown in Figure 10. The sensory device 51 may be equipped with one or more sensors 65 for sensing the characteristics of the device. For example, one The above sensors include actuator 55, interface 53, and any combination thereof. , or any measurement related to any other function can be detected. The Sensor 65 includes position or displacement sensors, incremental / absolute encoders, angle sensors, potentiometers, and more. Inertial sensors such as tactile effect sensors, induction sensors, capacitive sensors, accelerometers, and speed / velocity sensors. Inclinometer, gyroscope, force sensor, torque sensor, strain gauge sensor, or They can be implemented as any combination or equivalent of these.

[0114] In some embodiments, one or more controllers 33 control actuators other than the actuator 55. By means of, or in addition to, modifying or controlling the mechanical movement of interface 53. It is configured to limit the effects of the movement of interface 54. The 51 chair features a bias mechanism, a stopper, a ratchet, and / or a gear system, etc. Mechanical components, including but not limited to these, inductive, capacitive, and / or resistors. Resistance elements, but not limited to these, include electrical components, magnetic components, etc. Electromagnetic components, electromechanical components, hydraulic components and / or air Pressure components can be used.

[0115] In some embodiments, one or more controllers 33 manually control the interface 53. It is configured to interfere with the ability to operate it. For example, one or more controllers 33 are configured to interfere with the ability to operate it. It is possible to determine if certain conditions exist during the control of the pedicel screw PS, and accordingly The actuator 55 of the tactile device 51 is controlled to rotate the rotary interface 53. By hindering the operator's ability to react, the system provides haptic feedback regarding the conditions. It can be provided. For example, this condition provides the ability to rotate the rotating interface 53. This may include error conditions that could hinder the procedure. These stopping conditions may involve the pedicle screw PS being located To reach the desired depth, the pedicle screw PS is rotated a predetermined number of times, (20 Moctezuma de la Barrera et filed on June 28, 2016 al's “Robotic surgical systems And Method” s For Controlling A Tool Removing Materi U.S. Patent Application Publication No. 2017 / 0, titled "al From A Workpiece" This is described in Article 000572 and, by reference, constitutes part of this specification. ) Prediction of the contact point between the pedicle screw PS and the bone, and / or stopping the operator Subjective knowledge (for example, setting the amount of time the operator spends rotating each pedicle screw PS) This includes the ability to determine the following conditions: This may include error conditions such as malfunctions. In some examples, the rotation of the rotation interface 53 Instead of interfering, the robotic surgical system 10 operates via vibration and / or pulses. It is possible to provide haptic feedback to the controller. For example, one or more controllers 33 vibrates the tactile device 51 when the pedicle screw PS reaches the desired depth. It is possible.

[0116] Any of the above haptic technologies, including any mode or example described herein, or those They can be used individually or in combination for their equivalents. Furthermore, one or more The controller 33 reads from the sensor 65 of the interaction sensor, the tactile device 51. Depending on any conditions such as a change in value, change or start of control mode, or input by the operator Based on force, any of the tactile technologies can be modified or corrected. Furthermore, this specification Any of the technologies described in this document is a rotational interface or linear interface of the haptic device 51 It can be fitted to the face.

[0117] 1. Tactile feedback - resistance or torque In one example, the physical feedback is the resistive force applied to interface 53. The actuator 55 is necessary for the operator to operate the interface 53. The required force or torque can be adjusted. To operate the rotary interface 53 The required force is the current force needed to rotate the screw relative to the target site. It can reflect force. Since interface 53 is coupled to actuator 55, The tutor 55 provides resistance to movement in the degrees of freedom of the interface 53. It can be generated.

[0118] For example, referring to Figure 12A, the current required to rotate the pedicle screw PS Force is F PS As shown, the resistive force provided to actuator 55 is F A It is shown as, and The force required to rotate the rotating interface 53 is F RI It is shown as F RI Opera When the user manually operates the rotary interface 53, F RI Because this occurs, it is shown by the dotted line. is present. At various depths along the orbit LH, the magnitude of the current force F PS changes, and accordingly the resistance force F A and the force F RI change.

[0119] The controller 32 can control the actuator 55 to adjust, modify, amplify, or dynamically change the resistance force. To do so, the controller 32 can change the operating voltage, frequency, or current of the actuator 55. The resistance force can be modeled or implemented as a spring force, damper force, impact force, etc. Further, the resistance force can be based on position, velocity, and / or acceleration parameters.

[0120] In some examples, the robotic surgery system 10 can be configured to receive an input from an operator to selectively adjust the resistance force F provided to the actuator 55. Additionally, the robotic surgery system 10 can receive an input from an operator and selectively adjust the sensitivity of the interface 53 to control the surgical tool 30 to rotate the pedicle screw PS. In some examples, the resistance force F A and the sensitivity of the interface 53 are related. For example, the greater the resistance force F , the higher the sensitivity of the interface 53, and the smaller the resistance force F , the lower the sensitivity of the interface 53. Parameters that can be adjustable to change the sensitivity of the interface 53 can include spring parameters, damping parameters, force parameters, scaling coefficients between the rotation ratio of the actuator 55 and the interface 53, actuator parameters, magnitude of the force, direction of the force, any A interface 53, and the sensitivity are related. For example, the greater the resistance force F A , the higher the sensitivity of the interface 53, and the smaller the resistance force F , the lower the sensitivity of the interface 53. The interface 53 can be adjustable sensitive parameters, spring parameters, damping parameters, force parameters, the actuator 55 and the interface 53 rotation A ratio between the scaling factor, actuator parameters, force magnitude, force direction, any parameters that can be adjustable to change the sensitivity of the interface 53 can include spring parameters, damping parameters, force parameters, scaling coefficients between the rotation [[ID=4,8]]ratio of the actuator 55 and the interface 53, actuator parameters, magnitude of the force, direction of the force, any and the force direction, any Displacement limits or ranges, resistance curves or slopes of interface 53 with respect to a given resistance force This includes, but is not limited to, the following: Interface 53 includes a spring, If the parameter is adjusted, such a spring parameter may also be a spring constant. Therefore, a larger spring constant requires a greater force to actuate interface 53. In such cases, the spring can be modified by changing the material properties of the elastic element, The spring constant can be changed by altering the geometric properties of the elastic element. It can be formed from elements.

[0121] In one example, resistance is on interface 53 or interface 53 and actuate Deviation of interface 53 from the home position (zero return stop) defined between it and Ta 55 The restoring force may have a magnitude proportional to the size of the tactile motor. The home position is, for example, a tactile motor. The position of interface 53 defined by the controller at the moment the game starts. For example, the home position is defined as a static position relative to the haptic device 51. In this example, one or more controllers 33 control interaction sensors and tactile device sensors 51. Any existing readings from 65, such as changes or starts in control mode, or completion of tasks. Dynamically adjust the home location based on conditions or operator input. It can be adjusted. Alternatively, the home position can be, for example, a physical return stop (physical d It can be mechanically predefined using methods such as etent.

[0122] In some embodiments, the resistance may succumb to the movement of interface 53. In other words, the resistance attempts to restore the position of interface 53 to an arbitrary home position. It will not be like that. The resistance is initially small in size, and interface 53 is from the home position Its size can increase as it travels further away.

[0123] In some cases, resistance indicates that the screw PS has reached its limit against the target site. It increases to the size necessary to communicate with the user. For example, this is when the screw is in the vertebral body It may be appropriate in situations where it may be adjacent to the endocortical wall, thereby the cortical wall Restrictions are provided to avoid failure. For example, resistance is greater when the stiffness is large. It can be modeled as a barrier force effect. Alternatively, in such cases, control The actuator 55 controls the interface 53 to apply mechanical limitations to its movement. It is possible.

[0124] In many examples, resistance forces are applied to resist rotational motion. However, linear motion Resistance can also be applied to resist motion. For example, linear motion is an interface. It can resist 53 linear motions. Such linear motions include linear motions such as sliders and push buttons. The mechanism of interface 53 may be moving. Alternatively or additionally, linear motion may be rotation. This could be an example where interface 53 can be pushed down. Resistance in such an example. The force can resist the downward pressure on the rotary interface 53.

[0125] The resistance force is different, related to the current interaction between the pedicle screw PS and the target site. It may be provided depending on the conditions. Any of these conditions may be any of the above interaction sensors. It can be detected by [method].

[0126] In one example, depending on the rotational position of the pedicle screw PS, the resistance force on interface 53 is applied. It is added. The position of screw PS relative to the reference point is determined. Interface 53 The applied resistance force gradually increases or decreases until the screw reaches the designated position. It can be reduced. In this example, the home position of interface 53 can be used. Yes, it is possible. Interface 53 is used to command the drive of the screw, moving away from the home position. It can be rotated so that it can be moved. While in the non-home position, resistance is applied to interface 5 It is added to 3. However, once it reaches a certain position, it is possible to reduce the resistance to zero. Interface 53 can bounce back to the home position. Alternatively, the screw can slowly The process of gradually reducing resistance (to zero) as one approaches a specific location. It is possible.

[0127] In another example, depending on the insertion depth of the pedicle screw PS, the resistance force of interface 53 It can be added to this. In this example, the home position of interface 53 can be used. Interface 53 commands the screw to move away from the home position in order to drive the screw. It can be rotated. While in the non-home position, resistance is applied to interface 53. However, once the insertion depth is reached, the resistance can be reduced to zero, and the interface Face 53 can bounce back to its home position. Alternatively, the screw can gradually increase the insertion depth. As you get closer to reaching your goal, you can gradually reduce your resistance (to zero).

[0128] In another example, the resistance force on interface 53 depends on the rotational speed of the pedicle screw PS. It can be added to this. In this example, the home position of interface 53 can be used. Interface 53 commands the screw to move away from the home position in order to drive the screw. It can be rotated. While in the non-home position, the resistance force is proportional to the rotation speed of the screw. It can be gradually increased or decreased.

[0129] In another example, resistance is applied to the torque on the pedicle screw PS by the target site. In response to, or in accordance with the torque applied by the tool, the interface 53 is It can be done.

[0130] In another example, one or more controllers 33 also transmit vibrations and / or pulses via It can provide haptic feedback to the operator. For example, one or more controllers -Ra33 is based on the current force required to rotate the screw relative to the target site. The frequency and / or amplitude of the vibration of the haptic device 51 can be adjusted. More specifically In a typical example, as the force required to rotate the screw relative to the target site increases... The amplitude of the vibration of the tactile device 51 may increase, and the frequency of the vibration of the tactile device 51 is It may decrease. Similarly, the force required to rotate the screw relative to the target site may decrease. As this occurs, the amplitude of the vibration of the tactile device 51 may decrease, and the vibration of the tactile device 51 The dynamic frequency may increase.

[0131] Resistance is achieved by using any combination of the embodiments described herein, or their equivalents. It can be implemented.

[0132] 2. Haptic feedback - position Interface 53 may employ feedback techniques other than resistive force. For example... The position of interface 53 depends on the current interaction between the screw PS and the target site. It is then actively controlled (moved) by the actuator 55 and provides feedback to the operator. The system provides a solution. Any of these conditions can be detected by any of the above interaction sensors. can.

[0133] In one example, the position of interface 53 is controlled according to the rotational position of the pedicle screw PS. The position of interface 53 is controlled based on the real-time position of the screw. It can be actively rotated by the cutter 55. When the screw rotates, Interface 53 also rotates. In another example, the position of interface 53 is fixed to a specific position. To place or move in between, any screw-related position or insertion depth The operator can be notified about location information. Interface 53 is an interface Includes a graphic scale or markings to correlate face position to screw position. It is visible.

[0134] In another example, the location of interface 53 is determined by the target site to the pedicle screw PS. Controlled according to the applied torque, or according to the torque applied by the tool. The position of interface 53 is actively moved by actuator 55, The interface can show the operator the various torque levels the clew is subjected to. 53 is a graphics cable for correlating the interface position with screw torque. It may include a letter or mark.

[0135] In yet another example, the position of interface 53 is related to the rotational speed of the pedicle screw PS. It is controlled accordingly. The position of interface 53 is actively controlled by actuator 55. It can be moved to show the operator the various speed levels the screw is subjected to. The interface 53 correlates the interface position with the tool or screw speed. It may include a graphic scale or markings.

[0136] 3. Haptic Feedback - Range of Motion In another example, the location of interface 53 is the current position between screw PS and the target site. It is controlled to be limited according to the interaction and provides feedback to the operator. Any of these conditions can be detected by one of the interaction sensors mentioned above.

[0137] In one example, interface 53 rotates by an amount related to the amount the screw rotates. It is restricted so that it is permitted. In another example, interface 53 is a screw It is restricted to rotating by an amount related to the depth to which it is inserted. In the example, interface 53 is where the Screw reaches a physical or virtual boundary. It is restricted to rotating only by the amount necessary for identification.

[0138] In another embodiment, when interface 53 is rotating, its range of motion is continuous The rotation can be controlled, for example, to allow for any number of full 360-degree rotations. As described below, the rotary interface 53 controls the speed or force input. / By controlling the torque reached, the user can manually control screw insertion. In certain control modes, such as when a haptic device 51 is used to enable this, It could be appropriate.

[0139] D. Autonomous check mode One mode of the haptic device 51 is autonomous check mode. Inside, the robotic surgical system 10 autonomously controls the screw PS by the robotic system 10. As insertion progresses, the current interaction between the pedicle screw PS and the target site is emulated. To do this, provide haptic feedback to the operator. During autonomous check mode, The rotation interface 53 is force F RI It can be operated manually according to the pedicle relative to vertebra V The current force F required to rotate screw PS PS Tactile feedback that reflects this Provided to the operator. In other words, the autonomous check mode allows the operator to control the autonomous system. "Feeling" the screw interaction at any point before, during, or after screw insertion "It is possible to do this."

[0140] As shown in columns B and D of the table in Figure 11A, haptic feedback is checked The tactile device 51 is provided for the robot, but the tactile device 51 is a screw Since it is inserted autonomously by the system 10, the pedicle during autonomous check mode Do not control the surgical tool 30 or driver 44 to insert the clew PS (Figure) (See column D in 11A).

[0141] Figure 12A shows the pedicle scrub interacting with the target site, vertebra V, during autonomous check mode. An example of the Ryu PS is provided. In Figure 12A, one or more controllers 33 are planned The insertion of the pedicle screw PS along the trajectory LH is autonomously controlled. - is self-tapping. Meanwhile, one or more controllers 33 control the haptic device 51 This controls and emulates the current interaction between the pedicle screw PS and vertebra V. For example, when a pedicle screw PS is inserted to a depth A along the planned trajectory LH One or more controllers 33 control the tactile device 51 to control the pedicle scrub at depth A. Emulate the current interaction between vertebral parenchyma (PS) and vertebral v. Therefore, the system 10 is a tactile experience of screw PS insertion being performed by a robotic system. To provide knowledge to operators.

[0142] For example, as outlined in column F of the table in Figure 11A, the autonomous check mode is a robot Simultaneously with / during active and autonomous screw insertion by the 10 screw system. It is possible. In such cases, by starting the autonomous check mode, the rotation The interface 53 allows the operator to rotate the screw when it is being inserted autonomously. The interface 53 receives haptic feedback from the robotic surgical system 10. It is controlled to be manually operable so that it can be done. In this example, tactile check Therefore, autonomous screw insertion does not stop. Screw PS continues to be inserted autonomously. As the insertion depth changes continuously, the current interaction between the pedicle screw PS and the vertebra is The action changes. Therefore, in this example, the resistive feed to the rotating interface 53 By changing the back, the current interaction between the pedicle screw PS and the vertebra is now in near real-time. The effect can be reflected. The resistance force is updated every N seconds, or every N degrees of rotation of the screw. The settings can be configured according to any appropriate time step, such as updating the screw displacement every Nmm. Cut.

[0143] Alternatively, as outlined in column F of the table in Figure 11A, there is one autonomous check mode. The controller 33 autonomously controls the surgical tool 30 to insert the pedicle screw PS. The rotation can be stopped or paused and then started. In one example, the robot system 10 In response to the operator triggering the autonomous check mode, the autonomous control will be stopped or stopped. It stops at a time. Alternatively, the robot system 10 can stop autonomous movement initiated by the user, etc. In response to any other system command, autonomous control may be stopped or suspended. In addition, system 10 controls the haptic device 51 to stop or pause system 10. This emulates the interaction between the pedicle screw (PS) and the vertebra when the screw is fixed in place. After the autonomous check mode is executed, the operator can control the autonomous control of the robot system 10. The procedure can be resumed, and the screw insertion can be continued.

[0144] In another example, as outlined in column F of the table in Figure 11A, the robotic surgical system 10 One or more controllers 33 autonomously control the surgical tool 30 to perform pedicle screw - Before inserting the PS, you can start the autonomous check mode. For example, the operator The procedure involves one or more controllers 33 autonomously controlling the surgical tool 30 to perform pedicle scrubbing. Before inserting the pedicle screw PS, it may be worthwhile to consider tactile feedback from the pedicle screw PS. It is possible. In such cases, the screw PS is partially inserted by manual insertion by the surgeon. It can be implanted and later autonomously inserted. Partially implanted screw P Existing interactions between the S and the target site are checked by the surgeon before initiating autonomous insertion. Therefore, this can be reflected in the haptic device 51.

[0145] In some cases, the start of the autonomous check mode is initiated by one or more controllers 33. Autonomous control of the surgical tool 30 is automatically initiated. Similarly, the autonomous check mode is inactive. When activated, one or more controllers 33 cease autonomous control of the surgical tool 30. It is possible. Alternatives to the autonomous check mode, along with their functions and usage, are being considered. Yes, they are.

[0146] E. Manual control mode In manual control mode, the operator uses the tactile device 51 to limit the operation. However, it controls the surgical tool 30 for purposes such as the insertion of pedicle screws (PS). During manual control mode, one or more controllers 33 (as shown in column D of Figure 11A) (Uni) Does not autonomously control the insertion of pedicle screws PS. Instead, tactile device 51 Interface 53 controls the insertion of pedicle screws PS by having one or more controllers It is operated to provide input to the trolling device 33. In response to control input from the haptic device 51 Then, one or more controllers 33 rotate the screw at a rotational speed around the rotation axis R. Rotate the surgical screw and advance it linearly at a forward speed along the planned trajectory LH. The tools are controlled.

[0147] The manual control mode precedes any of the other haptic device modes described herein. Alternatively, it can be used later. In one example, the robot can use a desired or predetermined torque pitch. The screw can be inserted autonomously, up to the stroke, insertion depth, or screw rotation speed. Yes, it's possible. And you can use manual control mode to complete the rest of the task.

[0148] 1. Manual control input Referring to column G of the table in Figure 11A for manual control mode, one or more controllers 3 3 is an input control technique that defines how the haptic device 51 can be used as input. It can be configured to determine or receive.

[0149] Referring to the table in Figure 11B, examples of these input control techniques include force or torque input, rotation This includes using the tactile device 51 as a rotation position input or rotation speed input, It is not limited to these. Input control technology may be set according to the surgeon's preference or by the system. It can be specified as such, or any combination thereof. The operator is Using the user interface 57 (shown in Figure 10) of the haptic device 51, and The input control technology is selected by other means, such as input to the display device 18. It is possible.

[0150] In manual control mode, the screw is inserted in response to input from the tactile device 51. The tool is controlled by various outputs for controlling the screw, as described below. The technology is also available, and this may be the same as or different from the technology used for input control.

[0151] a. Force or torque input from a tactile device Referring to Figure 11B, an example input provided by the haptic device 51 is: This is the force or torque input applied to interface 53 by the terminal. (See Figure 12B) Thus, the operator applies force F in In addition, interface 53 can be operated manually. Cut. This power F in This can also be the applied torque. One or more controllers 33, The force applied to interface 53 is measured and used to insert the pedicle screw PS. Determine the desired force and control the insertion of the pedicle screw PS based on the desired force. It is possible. The force or torque applied is the force between the screw PS and the target site. The '-' can represent the desired force or torque.

[0152] For example, one or more controllers 33 have a rotary interface as shown in Figure 11C. Force F is used to manually move 53 from the home position P0 to the non-home position P1. in to Based on this, the desired force for inserting the pedicle screw PS can be determined. In each of these examples, position P1 is such that interface 53 is positioned relative to the home position. This is shown as only one possible example of many possible positions. In one example, one or more... The controller 33 allows the operator to apply force F in When adding, the rotation interface 53 is added. By measuring or calculating the torque, the force F in Configured to obtain the measured value In another example, one or more controllers 33 allow the operator to exert force F in When adding wo By determining the acceleration of the rotation interface 53, the force F in Obtain the measurement value It can be configured in this way.

[0153] In one example, the robotic surgical system 10 has a hand with a trigger 49 as shown in Figures 4 to 6. If a surgical tool 30 is included, the operator controls the rotation interface 53 of the tactile device 51. Instead, manually operating trigger 49 controls the insertion of the pedicle screw PS. It can be controlled. In such cases, the operator controls force F. in Press down trigger 49. The trigger 49 can then signal an operator input to one or more controllers 33. It can be transmitted to.

[0154] Interface 53 is released by the operator after force has been applied. A zero stopper (home position P0) may be included to allow face 53 to return to the home position. Thus, the operator can apply a series of forces F without unnecessarily moving their hands. in Rotate interface It can be added to S53. In another example, interface 53 achieves the desired force. The interface 53 allows for sufficient rotation without being hindered, providing a degree of freedom. And so it can continue to rotate. In this way, the rotation interface 53 can rotate a full 360 degrees. To provide a range of motion and simulate an operator manually rotating the screw. This makes it possible.

[0155] b. Position input from haptic devices In another example, one or more controllers 33 provide control inputs to the interface -53 can be used to obtain measurements of the position (or change in position). For example, operator When the user manually operates the rotation interface 53 from home position P0 to position P1, one The controller 33 described above controls the vertebral arch based on the location of position P1 relative to the location of home position P0. The desired rotational position of the root screw PS can be determined. In some examples, one or more The controller 33 above controls the rotation interface 53 at position P1 relative to home position P0. The rotation angle can be measured. The position is obtained from interface 53 and / or A An incremental or absolute encoder, etc., coupled to the cutter 55. This can be determined using any suitable sensor. Interface relative to home position P0 The displacement of face 53 can also be used to provide input. Alternatively, interface 53 The position of interface 53 relative to the full range of motion (e.g., 360 degrees) is the home position. It can be used as input regardless of the position. Position is also an interface to the full range of motion. The cumulative number of rotations of the face 53 (e.g., 1.5 rotations or 540 degrees) can be taken into consideration.

[0156] In one example, interface 53 may include a zero return stop (home position P0). As a result, when interface 53 is released by the operator at the desired position, Return to the base position. In another example, interface 53 is sufficient to achieve the desired position. It allows the interface 53 to rotate freely without any hindrance. It can be continued.

[0157] c. Speed ​​input from haptic devices In yet another example, the input provided by the tactile device 51 is used in the operator's operation. This is the speed experienced by interface 53 accordingly. One or more controllers 33 control inertia Using any suitable sensing device such as a sensor, encoder, or Hall effect sensor, The speed of the interface 53 can be measured. For example, as shown in Figure 11B. Interface 53 is at home position P0 at time T0, and the operator is at position P0 at time T1. Assume that you manually manipulate the interface to move to P1. One or more controllers -La 33 determines the distance or displacement between P1 and P0 with respect to the change in time T1-T0, The velocity of interface 53 can be determined. This distance or displacement is linear or Angle can be used. One or more controllers 33 are integrators, differentiators, lookups. Any appropriate method for calculating speed based on sensed readings such as a phototable Software or logic can be used.

[0158] In one example, interface 53 may include a zero return stop (home position P0). As a result, interface 53 returns to its home position when released by the operator. In another example, interface 53 is sufficient to achieve the desired speed input. To allow Face 53 to rotate freely without being hindered It is possible.

[0159] Input control from the haptic device 51 is any combination of force, position, and / or velocity. It is possible.

[0160] 2. Manual control output Control from a haptic device 51 that utilizes one of the above input technologies (force, position, velocity) Depending on the input, system 10 is configured to control the insertion of the screw. Figure 11 Referring to B, the tool controls the screw to drive according to various output control techniques. These output control technologies control force, rotational position, insertion depth, and speed. This includes. These output control technologies are described in detail below, and the output control technologies are... It can be used according to the input technology (force, position, velocity).

[0161] One or more controllers 33 indicate how the tool should be operated in manual control mode. The output control techniques that define this (i.e., force, rotational position, insertion depth, and velocity) are determined. It can be configured to receive. Output control technology can be set according to the surgeon's preference. , can be specified by the system, or any combination thereof. The operator uses the user interface 57 (shown in Figure 10) of the haptic device 51. Output control by using or by other means such as input to display device 18. You can choose the technology.

[0162] In all examples of manual control mode output, the screw rotation and forward speed are as follows: The screws are joined by the screw pitch according to the technique described. Furthermore, the tool controls The sensitivity of the interface 53 for causing the event is as follows: It can also be changed. The sensitivity of interface 53 is adjusted to take bone density into consideration. It can be updated manually or automatically.

[0163] a. Tool force output control Depending on the input technology (force, position, velocity), one or more controllers 33 control the force. Based on this, the tool can be operated to drive the screw PS.

[0164] In one example, the input position of interface 53 corresponds to the force output to the screw by tool 30. Determine the force output, which can be converted to torque. In one example, the input of interface 53 The position determines the specific force or torque level that the tool should apply to the screw. The tool 30 is controlled to apply a specified force or torque. In another example... The position of interface 53 is where the maximum force or torque that the tool should apply to the screw should be. The level can be determined, and the robot and tool 30 can reach the maximum force or torque. Continue inserting the screw until it is done. In these examples, interface 53 is zero It may also include a return stop (home position P0), and as a result, interface 53 is operator It returns to its home position when released by the data.

[0165] In one example, the input speed of interface 53 is the force output to the screw by tool 30. This determines the speed of interface 53. For example, increasing / decreasing the speed of interface 53 is determined by the tool. This can cause an increase or decrease in the torque applied to the screw. In this example, the complete screw To achieve insertion, the user may need to rotate interface 53 more and more quickly. .

[0166] In yet another example, the force or torque of the input applied to interface 53 can cause The screw drives the screw by applying force or torque output. In one example, the interface 53 The input force or torque is the specific force or torque that the tool should apply to the screw. The level can be determined, and tool 30 applies a specified force or torque. It is controlled. Alternatively, the force or torque of the input to interface 53 controls the tool. It is possible to determine the maximum force or torque level to be applied to the robot and the engine. The 30 continues to insert the screw until the maximum force or torque is achieved.

[0167] b. Tool rotation position output control Depending on the input technology (force, position, velocity), one or more controllers 33 control the rotational position Based on the position control, the tool can be operated to drive the screw PS. The rotation position can be defined as the angle of rotation of the screw relative to the reference angle.

[0168] In one example, depending on the input position of interface 53, the tool moves the screw PS to a certain position. Rotate it to that point. Alternatively, due to the displacement of interface 53, the tool moves according to the displacement. Rotate the screw PS.

[0169] In another example, the speed input of interface 53 causes the tool to move the screw PS to a certain extent. Rotate it to the position. Increasing / decreasing the input speed of interface 53 also controls the output position. This can cause changes. In this example, in order to achieve complete screw insertion, the user It may be necessary to increase the speed of interface 53.

[0170] In another example, a force or torque input to interface 53 causes the tool to screw P Rotate S to a certain position. In one example, the force or torque input to interface 53 is The tool can determine the specific position where it should be driven to the screw. Alternatively, The input force or torque of the Toughface 53 is the maximum position the tool should drive the screw to. The robot and tool 30 can determine the position of the screw until it reaches its maximum position. Continue inserting.

[0171] c. Tool insertion depth output control Depending on the input technology (force, position, velocity), one or more controllers 33 will control the tool. It can operate in a way that drives the screw PS to a specific insertion depth within the target site. ru.

[0172] In one example, depending on the input position of interface 53, the tool inserts the screw PS into a specific location. Rotate until the insertion depth is reached. Alternatively, the tool will move to the insertion depth due to the displacement of interface 53. The screw PS is rotated accordingly.

[0173] In another example, the speed input of interface 53 causes the tool to screw PS to a specific Rotate to the insertion depth. Increasing / decreasing the input speed of interface 53 also affects the insertion depth. This can cause changes. In this example, to achieve the full insertion depth, the user You may need to rotate the Toughface 53 very quickly.

[0174] In another example, a force or torque input to interface 53 causes the tool to screw P Rotate S to a specific insertion depth. In one example, the input force or to of interface 53 Luk can determine the specific insertion depth to which the tool should be driven into the screw. In other words, the force or torque of the input to interface 53 should be such that the tool drives the screw. The maximum specific insertion depth can be determined, and the robot and tool 30 can perform the specific insertion. Continue inserting the screw until it reaches the required depth.

[0175] d. Tool speed output control Depending on the input technology (force, position, velocity), one or more controllers 33 control the speed. Based on the instructions, the tool can be operated to drive the screw PS. The speed is , screw rotation angle, screw linear insertion speed, tool rotation speed, or their respective It can be defined by the change over time in the combination of meanings.

[0176] For example, depending on the input speed of interface 53, the tool will scroll according to the relevant speed. Rotate the loop PS. Alternatively, due to the displacement of interface 53, the tool is related The screw PS is rotated according to the speed.

[0177] In another example, the speed input on interface 53 causes the tool to move according to the associated speed. Rotate the Clue PS. Increasing / decreasing the input speed of interface 53 also affects the output speed. This can cause a change in the degree of control. In this example, in order to achieve a specific speed, the user You may need to rotate the center face 53 very quickly.

[0178] In another example, a force or torque input to interface 53 causes the tool to move at the associated speed. The screw PS is rotated according to the force of the input to interface 53 or Torque can determine the specific speed at which the tool should drive the screw. The force or torque of the input to interface 53 determines the optimal setting for the tool to drive the screw. The robot and tool 30 can determine the maximum speed and will continue to operate until they reach the maximum speed. Continue inserting the lubricant.

[0179] e. Relationship between input and output What was explained above is the various input control technologies provided by the haptic device 51, and This involves various output control technologies for driving the motor. It also involves input from the haptic device 51 to the tool. The relationship with the output can be defined according to the various configurations described below. Tactile The relationship between the input of device 51 and the output to the tool depends on the various configurations described below. It can be defined according to the combination of meanings.

[0180] One or more controllers 33 receive input from the haptic device 51 and output it to a predetermined output to the tool. It can be mapped, which can correspond to the tool's default settings. For example, the memory of one or more controllers 33 receives input from a haptic device 51 to the tool. It may include a lookup table corresponding to a given default output. One such example: Then, one or more controllers 33 measure when the interface 53 is rotated 30 degrees. The value can be obtained. Then, one or more controllers 33 look up the value. Based on Bull's findings, the pedicle screw PS should be rotated at a rotational speed of 1.5 revolutions / second. It can be determined that it exists.

[0181] One or more controllers 33 process the input from the haptic device 51 based on various variables. It can be mapped to a predetermined output to a tool. For example, a predetermined output to a tool. The output can be detected by either the interaction sensor or sensor 65 mentioned above. The conditions of the tactile device 51 can be determined. For example, a predetermined output is based on the pedicle screen. The insertion depth of the lyu PS, and the current force F required to rotate the pedicle screw PS. PS ,oh This can be based on bone density data of vertebra V. As another example, the location of the tool The constant output is sensed by the sensor 65 of the user interface 57 of the haptic device 51. It can be based on the readings obtained. For example, the user interface 57 is "perceived" A push button that can be pressed for control, or that can be activated to indicate the desired sensitivity of the control. It may include a slider. The predetermined output is sensed by the sensor 65, and the desired sensitivity of the control It can be based on this.

[0182] One or more controllers 33 can be monotonic, linear (e.g., proportional), exponential, logarithmic, polynomial, Based on any suitable mathematical function such as roots, powers, and rational functions, the relationship between input and output Relationships can be mapped. For example, one or more controllers 33 can rotate The amount of angle of rotation of the interface 53 is proportional to the desired insertion depth, based on a linear function. Therefore, the measurement position can be mapped to the desired insertion depth. For example, a rotational interface For each degree the face 53 is rotated, one or more controllers 33 adjust the desired insertion depth. Increase by only 1 / 90th of a millimeter. In another example, one or more controllers 33, Based on a piecewise constant function (i.e., a floor function), the measured position This can be mapped to rotation speed. In such cases, one or more controllers 3 3 is when the rotation interface 53 rotates between 1 degree and 180 degrees (including both ends). Then, one or more controllers 33 determine the desired rotation speed to be 1 revolution / second, and the rotation When the interface 53 rotates between 181 degrees and 360 degrees (including both ends), one The controller 33 determines the desired rotation speed to be 2 revolutions / second, and the measurement position The position can be mapped to a desired rotational speed.

[0183] One or more controllers map the input of the haptic device 51 to the output of the tool. Based on the relationship, any input technology (force, position, velocity) is used to control the output (force, rotation) of the tool. It can be mapped to position, insertion depth, and velocity.

[0184] As shown in column D of Figure 11B, the force input is rotational position output, insertion depth output, force output, Alternatively, it can be mapped to velocity output. For example, force input can be linearly mapped to rotational position output. It can pinch, and as a result, the measured force input (F in The measured value of the screen is proportional to the scale It can be mapped to the rotation angle. Similarly, the force input can be mapped to the insertion depth output, and the force output can be mapped to the insertion depth output. , and can be linearly mapped to velocity output, and as a result, force input is proportional to speed The screw insertion depth, the proportional torque applied to the pedicle screw PS, and the screw It can be mapped to a proportional speed of insertion.

[0185] As shown in column D of Figure 11B, the position input is the rotational position output, insertion depth output, and force output. , or it can be mapped to a velocity output. For example, a position input can be linearly mapped to a rotational position output. It is possible to ping, and as a result, the measurement of the position input (measurement of position P1 or position P1 and The displacement measurement between P0 and the screw rotation angle can be mapped to a proportional screw rotation angle. Similarly, position inputs are linearly mapped to insertion depth outputs, force outputs, and velocity outputs. This allows the measured value of position P1 relative to home position P0 to be proportional to the screen. The insertion depth and the proportional maximum torque level that must be applied to the pedicle screw PS This can be mapped to a proportional speed of screw insertion.

[0186] As shown in column D of Figure 11B, the speed input is used for rotational position output, insertion depth output, and force output. , or it can be mapped to a velocity output. For example, the velocity input can be linearly mapped to the rotational position output. It can be pinned, and as a result, the measured value of the speed input (P for change over time T1-T0) The displacement measurement between 1 and P0 can be mapped to a proportional screw rotation angle. Yes, it is possible. Similarly, the speed input can be linearly mapped to the insertion depth output, the force output, and the speed output. This allows for a speed input that is proportional to the screw insertion depth and the pedicle screw. The proportional torque applied to the LU PS is mapped to the proportional speed of screw insertion. It is possible to do so.

[0187] F. Simulated Mode The technology related to the above-mentioned tactile device 51 is for physical robot control and / or This relates to intraoperative techniques that utilize drive to the motor. However, when performing actual surgical procedures... Before using the robotic system, provide operators with training or greater confidence in its use. To that end, the simulation is intended to be performed using the haptic device 51. Referring to the table in Figure 11A and Figures 14A to 14C, the haptic device 51 is used There are various simulated modes that allow for this. These modes are simulations This includes an automated autonomous check mode and a simulated manual control mode, and these modes The code will be explained in detail below.

[0188] The simulation modes include patient, robot system, robot manipulator, and patient. This includes, but is not limited to, tables, navigation systems, tools, and screws. It can simulate all possible operating room conditions that may exist during surgery. In other words, the simulation involves the screw and the target area, and the tool and the screw and the target area. Can the position be simulated, or can a robotic manipulator and tool be used? It is possible to simulate the screw and the target area. Furthermore, a reference simulator The system can provide a surgical plan that includes the target trajectory and insertion depth.

[0189] The simulation is displayed on the robot system 10's display 18, or outside the operating room. This includes, but is not limited to, one or more of the displays, any suitable display. It can run on a graphical display device. One or more controllers 3 3 can perform the simulation. Alternatively, the tactile device 51 can detect stains The regulation system is separate from the robot system 10, which has its own control system. It can be connected to a simulation system.

[0190] The simulated modes described herein may be performed preoperatively or intraoperatively. For example, a surgeon might simulate robotic control in the operating room just before giving instructions for the physical execution of the robot. You can perform a simulation. Alternatively, you can run a simulation before the surgery. In the case of misalignment, the surgeon can also observe any behavior of system 10 experienced during the simulation. The lamina can be set, checked, or modified. For example, a surgeon can set the pedicle scrub. Surgical planning including the size of the ligament, insertion depth, and position of the pedicle entry point, as well as the operation of tactile devices. Furthermore, sensitivity, preferred control input technologies for tactile devices (force / torque, position, speed), and tool operation. Power, feed rate, linear forward speed, rotational speed, or sensitivity; control output technology suitable for the tool (force) Set and check robot parameters such as torque, position, speed, pose, and orientation. Alternatively, it can be modified.

[0191] As mentioned above, preoperative and / or intraoperative imaging is used to visualize the patient's anatomical form. It can be converted. For example, preoperative images, such as X-rays, CT scans, or MRI images. Using the images, we can create an anatomical model of the patient's anatomical form, specifically of the target area. This is possible. This virtual anatomical model can be used in simulations. In addition, the vertebral arch When the thread shape of the root screw PS is stored in the memory of the robotic surgical system 10, The selected pedicle screw PS can be virtually presented within the simulation.

[0192] During the execution of the simulated mode, one or more controllers 33 control the haptic device 51 provides haptic feedback. One or more controllers 33 provide haptic device 5 Actuator 55 controls the rotary interface 53 to the pedicle screw PS This enables the emulation of simulated current interactions between the target site and the system. It is configured as follows. Referring to Figures 14B and 14C, one or more controllers 3 3 is the force F required by the operator to rotate the rotary interface 53. RI of To adjust, apply resistance F to actuator 55. A By being configured to provide This allows us to emulate the simulated current interaction and rotation interface The force required to rotate -53 is shown in Figure 14C as F SPS Vertebral V is shown as Simulation required to rotate the pedicle screw PS relative to the target site. It reflects the current force. Of course, the haptic device 51 also reflects the above force, position, and This uses any technology other than resistive feedback, such as range of motion feedback technology, It can be controlled to provide haptic feedback.

[0193] During the execution of the simulated mode, one or more controllers 33 operate in various ways Using (simulated) pedicle screw PS and (simulated) target It can be configured to obtain simulated current interactions between sites. For example, One or more controllers 33 are simulated in the coordinate system of the simulation. It is possible to obtain virtual measurements corresponding to the current interaction. Tem tracks simulated robots, tools, screws, and / or patients. And the simulated position of the pedicle screw PS relative to the anatomical model of the target site. It is possible to determine this. The simulation system simulates the anatomical model. Simulated pedicle screws at multiple positions of a rated pedicle screw PS - May include predetermined data showing the expected interaction between PS and the anatomical model. In the example, the data is stored in memory for access by one or more controllers 33. It can be stored in a backup table. The simulation system uses anatomical models and and the determined state, position, orientation, and / or orientation of the screw relative to the given data. Based on this, simulated current interaction between pedicle screw PS and target site The parameters indicating the function can be calculated. The given data is bone density data of vertebra V. It may include. The simulation system compares bone density data with an anatomical model of vertebra V. Using the screw configuration, between the pedicle screw PS and vertebra V at various depths. Parameters representing the simulated current interaction can be calculated or obtained. The data relates to the shape of the screw, the tool, or other functions related to the definition of the interaction. This may include known data related to this.

[0194] 1. Simulated autonomous check mode In a sense, the simulated autonomous check mode is a stain on the autonomous check mode. This is a modified version. Therefore, the above explanation of the autonomous check mode is here. It can be integrated into the system to understand the simulated autonomous check mode. During the rated autonomous check mode, one or more controllers 33 control the surgical tool 3 It (graphically) simulates autonomous control of 0, and the operator uses haptic feedback. The Vice 51 can be used to tactilely sense the simulated autonomous insertion. One or more controllers 33 rotate the pedicle screw PS at a rotational speed around the rotation axis R. By simulating the rotation of and along the planned orbit LH To simulate the linear advancement of the pedicle screw PS at a certain forward speed... Therefore, we simulate the autonomous control of the surgical tool 30. However, The robotic system does not physically control the movement of the tool. Instead, it uses one or more controls. The controller 33 autonomously controls the surgical tool 30 (as shown in column E of Figure 11A). The system will simulate the autonomous insertion of a pedicle screw (PS). During the simulated autonomous check mode, the rotation interface 53 controls the adjusted force. F RIIt can be operated manually according to the instructions, but the simulated surgical tool 30 controls the vertebra Without using the ability to rotate the pedicle screw PS, the simulation of the surgical tool 30 It does not use the ability to control the autonomous control that has been set. Just like the autonomous check mode, it simulates The rated autonomous check mode stops the simulation of autonomous screw insertion. This can be executed before, during, or after the pause / suspension.

[0195] 2. Simulated manual control mode In a sense, the simulated manual control mode is a simulation of the manual control mode. This is the updated version. Therefore, the above explanation of manual control mode is incorporated here. This allows for understanding the simulated manual control mode. In contrast to manual control mode. Specifically, during the simulated manual control mode, interface 53 is used for (physical) surgery. It can be operated manually without using the ability to control the tool 30. Instead, one or more The controller 33 above allows the operator to manually control the interface 53 of the haptic device 51. Depending on the operation, the manual control of the surgical tool 30 (as shown in column E of Figure 11A) Simulate the operation. During the simulated manual control mode, one or more controllers R33 allows manual control of the surgical tool 30 in response to input from the tactile device 51. Simulates the following: During the simulated manual control mode, one or more controllers 33 controls either the rotational speed or the advancement speed of the pedicle screw PS. Simulate. The operator manually operates the tactile device 51, and accordingly, 1 The controllers 33 (as shown in column G of Figure 11A) use pedicle screws P It is possible to simulate controlling either the rotational speed or the forward speed of S. For example, the operator can use any of the above input techniques to access interface 53. It can be operated by movement. Depending on the control input, one or more controllers 33 control the pedicle Any appropriate force, position, or velocity for simulated insertion of screw PS Based on output technology, the output of the simulated tool is controlled. In this example, Figure 1 As shown in 4C, the user inputs force F in In addition to interface 53, display Simulated manual control of screw insertion is performed on I18. The input force is active. The (resistive) force F output by the tuner 55 RI They are resisting.

[0196] III. Methods for controlling robotic surgical systems Referring to Figure 15A, the flowchart shows how to control the robotic surgical system 10. This shows one example of how to do it. As shown, the flowchart illustrates various touches during surgery. This shows the operation mode of the sensory device.

[0197] The flowchart simulates the insertion or insertion of a pedicle screw (PS). This shows how to control the robotic surgical system 10. This method is shown in step 200. Step 20: Beginning, preparing the anatomical morphology for receiving the pedicle screw PS. Proceed directly to step 2. During step 202, anatomically insert the pedicle screw PS. Various steps may be performed to prepare the morphology. These steps are performed on the patient. Step (1) to form an opening, step (2) to open the tissue with a tissue retractor, and Step (3) involves positioning the cannula in the tissue and creating a pilot hole 10 in the anatomical form. Step 2 involves drilling (4), and step 5 involves tapping the threads to match the anatomical form. It may include. Step 202 does not necessarily have to include steps (1) to (5) above. Please note that this is not the case. For example, in an alternative example, drilling of pilot hole 102 and Since tapping the threads into the anatomical form can be ruled out, steps (4) and (5) The following may be excluded. For example, such cases include self-perforation, self-tapping bone sculpting. Includes examples where "yu" is used.

[0198] The method involves the pedicle screw PS interacting with the surgical tool 30. Proceed to step 204. In some embodiments, before interacting with the anatomical form, The 30 is joined to the PS screw. Alternatively, the pedicle screw PS is manually or Using any technique, including robotic insertion, to partially modify the anatomical form of the target site. It can be seated, and then the tool 30 interacts with the partially seated screw PS. It works. More likely, the pedicle screw PS is in the pilot hole 102 To be positioned in one place, it is attached to the distal end of the driver 44. In tactile objects can be used to insert pedicle screws (PS). , or a new line tactile object including a new starting point, target point, and thorn point, Created when installing driver 44 and / or pedicle screw PS. This is possible. In this case, one or more robot controllers 33 are connected to the housing 45. To allow identification of the accessories, the drill 42 and / or screwdriver 44 are It may include RFID tags or other identification devices. The housing 45 is the corresponding RFID This RFID reader, including the reader itself, communicates with one or more controllers 33. It can read the tags and determine which accessories are attached. Based on this information, the controller creates a new line tactile object, and this You can access this or determine it by other means. Similarly, one or more Determine the size / type of the pedicle screw PS to which the controller 33 above will be attached. To enable this, RFID tags can also be attached to pedicle screws (PS). Driver 44 may include a similar leader. Therefore, the line tactile object is Since it can be based on driver 44 and / or pedicle screw PS, A specific pedicle screw (PS) is placed in the desired position, for example, the desired position relative to the patient's anatomical form. The robotic arm 20 is precisely controlled to be positioned in orientation and depth.

[0199] Furthermore, via either an RFID tag or other detection device such as a vision camera. By automatically detecting the accessories, the control system is utilized by the robotic surgical system 10. Proceed to the next screen related to driver 44 using any of the surgical software. This is possible, and here, driver 44 is connected, so different professionals for the operator It can be given commands and instructions. Voice recognition, gesture sensitivity... Using a ping or other input device to advance the software, and / or Or change to the next vertebra to be treated, and / or the vertebral body in which surgery is being performed. The 100 sides can be changed. This is also based on the position of the surgical tool 30. This is possible. For example, the operator can insert the TCP of the attached accessory into one side of vertebra V. If you manually position it closer to the other side, the software will position it on that side of vertebra V. It can automatically proceed to match the surface. The selected vertebra V and the surgical surface are This can be confirmed visually by display 18 or via audio input / output. It is possible.

[0200] In some surgeries, all pilot holes 102 are perforated first, and then... When all pedicle screws PS are inserted into their desired positions, pilot Between the drilling of hole 102 and the insertion of the pedicle screw PS, the rotation axis R follows the desired trajectory. They may be separated. In such cases, before placing each pedicle screw PS, the robotic hand The surgical system 10 sets the desired trajectory and surgical thread for each pedicle screw PS in the manner described above. By autonomously aligning the rotation axis R of the wheel 30, it rotates along the desired trajectory. The movement of the surgical tool 30 can be controlled initially to position axis R.

[0201] The method proceeds to step 208, and the operator completes the surgical procedure during step 206. If not, one or more controllers 33 determine which haptic device operating mode is selected. Determine (step 206 will be explained in more detail below). Operation mode of the haptic device. The method can be selected according to any condition or command. During step 210, the method is The selected haptic device operating mode is currently being executed by one or more controllers 33. Determine whether the selected haptic device operating mode is one or more controllers. If not performed by step 33, the method first proceeds to step 212, one or more Controller 33, when the haptic device operating mode is running, controls the haptic feedback being performed. Exit the device operating mode. Accordingly, the method is the selected haptic device operating mode. Based on the code, autonomous check mode, manual control mode, simulated autonomous check Proceed to either the haptic mode or the simulated manual control mode. Selected haptic mode If the device operating mode is already running, the method is the selected haptic device operating mode Continue executing the code. Therefore, between step 208 and step 210, one or more The controller 33 above determines whether the condition prompts the start of the haptic device operating mode, or The operator determines whether to command the haptic device to start operating mode.

[0202] Therefore, any haptic device operating mode depends on the conditions or commands, It can be started at the appropriate time. For example, depending on the conditions or commands, one or more The controller 33 stops or pauses autonomously controlling the surgical tool 30. Afterward, the manual control mode is activated and configured to stop the rotation of the pedicle screw PS. This is possible (also shown in column F of Figure 11A). As another example, depending on the condition or command Then, one or more controllers 33 manually control the surgical tool 30 before autonomously controlling it. It can be configured to initiate the mode (also shown in column F of Figure 11A). In this case, one or more controllers 33 switch from manual control mode to autonomous control of the surgical tool 30. After stopping or pausing, the autonomous control of the surgical tool will be resumed to rotate the screw. It can be switched to do so depending on a condition or command. One or more controllers 33 stop or pause autonomous control of the surgical tool before Alternatively, it can be configured to initiate a simulated autonomous check mode later (Figure 11). (Also shown in column F of A). In yet another example, depending on the condition or command, 1 One or more controllers 33 may stop or pause the autonomous control of the surgical tool before It can be configured to later initiate a simulated manual control mode (see column in Figure 11A). (Also shown in F)

[0203] The ability to initiate any haptic device operating mode at any appropriate time allows the operator You can customize the surgery based on your preferences. For example, one or more options After the Trola 33 stops or pauses autonomously controlling the surgical tool 30 In one configuration to initiate manual control mode, one or more controllers 33 first, The operator inserts the pedicle screw PS to the final depth of the implant while in manual control mode. The pedicle screw PS can be autonomously inserted to the initial depth before (and (The opposite is true). In such a configuration, the pedicle screw PS is ( Within a predetermined distance of the final depth (as determined by the navigation system 12) It can be positioned autonomously until it becomes available. At this point, the operator uses the surgical tool 30 The operator manually completes the implantation of the pedicle screw PS, and the pedicle screw - Allows you to feel the tightening of the PS more actively. The user manually uses a different tool (electric or manual) than the one used during autonomous control. You can also choose to complete the placement of the pedicle screw PS during control mode.

[0204] Other configurations also demonstrate the operator's ability to customize the surgery based on their preferences. For example, in another configuration, one or more controllers 33 autonomously control the surgical tool 30. Before taking control, start the simulated autonomous check mode. In such a configuration, One or more controllers 33 initiate autonomous control for inserting pedicle screws PS. Before proceeding, the operator can view a simulation of the autonomous control of the surgical tool 30 on the display 18. The process can be visualized. In another configuration, one or more controllers 33 can be manually controlled. Before starting the control mode to control the surgical tool 30, simulated manual control mode The process begins. In such a configuration, one or more controllers 33 control the pedicle screw. Before initiating manual control mode to manually control the insertion of the PS, the operator This visualizes the simulation of manual control of the surgical tool 30 on the display 18. It is possible.

[0205] Furthermore, the ability to initiate any haptic device operating mode in response to conditions or commands is This eliminates potential errors (e.g., collision with spinal cord 103) and allows the operator to perform the surgery. It provides on-the-fly control. For example, during manual control mode, the operator can Before implanting the pedicle screw PS to its final depth, one or more controllers In the above configuration, where 33 autonomously inserts the pedicle screw PS to the initial depth, One or more controllers 33 initiate manual control mode in response to a condition or command. This is possible. If the start of manual control mode and the stop of autonomous control are triggered by conditions, One or more controllers 33 control the pedicle screw PS to a predetermined final depth during autonomous control. It can detect when something is within a certain distance and send a condition to one or more controllers 33. Then, one or more controllers 33 start manual control mode and stop autonomous control. They were prompted to do so, and as a result, the operator manually completed the placement of the pedicle screw PS. This is possible. The predetermined distance to the final depth is such that the pedicle screw PS touches the spinal cord 103. It can be decided in advance not to touch it. Manual control mode can be started by command. If instructed, the operator will inform the navigation system 12 of the status of autonomous control. Therefore, it can be indicated. For example, display 18 indicates that the pedicle screw PS is at its maximum depth. It can show how many rotations remain until it reaches the target, and / or display 18 This indicates to the operator how far further insertion of pedicle screws (PS) is needed. To make it easy to visualize, the pedicle screw PS, anatomical form, and / Alternatively, the target point can be represented graphically. One or more controllers 33 also, Tactile feedback (e.g., vibration or pulse) is provided to the operator via the tactile device 51. ) provides a notification to the operator that the pedicle screw PS has reached a predetermined depth. This is possible. When the pedicle screw PS is within a predetermined distance of the final depth, the operator Upon making this determination, the operator initiates manual control mode on one or more controllers 33, and Stop the controlled motion to allow the operator to manually complete the placement of the pedicle screw PS. You can give commands.

[0206] Some exemplary conditions that can trigger the activation of a haptic device operating mode include the pedicle The screw PS reaches the desired depth, and the pedicle screw PS strikes the spinal cord 103. This includes the possibility of protrusion and the fact that the pedicle screw PS is rotated a predetermined number of times. It is possible. In such cases, one or more controllers 33 will be in autonomous check mode, manual control Manual control mode, simulated autonomous check mode, or simulated manual control It can be configured to automatically select one of the modes. In one such example, one The controller 33 autonomously controls the surgical tool 30 to insert the pedicle screw PS. After rotating to a predetermined number of revolutions, one or more controllers 33 automatically switch to manual control mode. Select this option to allow the operator to manually complete the insertion of the pedicle screw (PS). It can be configured in this way.

[0207] The robotic surgical system 10 has various commands for initiating the operation mode of the tactile device. It may include components. For example, the operator may use the haptic device 51 to feel The device can be commanded to start operating mode. As shown in Figure 10, the haptic device 51 may include user interface 57. The operator controls user interface 5 By activating 7 and sending commands to one or more controllers 33, the user The interface 57 can be used to select the operating mode of the haptic device. In some cases, the operator presses down the rotating interface 53 to control the tactile device. The operating mode can be selected. The robotic surgical system 10 performs the surgeries shown in Figures 4 to 6. If a surgical tool 30 is included, the operator may use the trigger 49 or user The interface 59 can be used to select the operating mode of the haptic device. Other examples Then the operator will use the computer cart assembly 34, such as the keyboard 61. The haptic device operating mode can be controlled via the user interface of the haptic device assembly 34. It can be selected. The operator can also do so via the user interface 63 of base 22. This allows you to select the haptic device operating mode. Individuals other than the operator can use the haptic device. The intention is to be able to command the start of chair operation mode. For example, a haptic device. The operation mode is initiated using the remote user interface at a remote location. It can be commanded by a remote user.

[0208] Figure 15B shows an exemplary step in autonomous check mode. As shown, The autonomous check mode indicates the current interaction between the pedicle screw PS and the target site. Step 304 to obtain measurement values, and based on the obtained measurement values, the actuation of the haptic device Eta controls the rotation interface 53 of the tactile device 51 to the pedicle screw PS Step 306 allows for the emulation of the current interaction between the system and the target site. Therefore, resistance F A The actuator 55 of the tactile device 51 is provided to the operator The force F required to rotate the rotating interface 53 by hand. RI Steps to adjust The force F required to rotate the rotating interface 53, including 308 RI is the pedicle sculpt The current force F required to rotate the PS relative to the target site PSSteps that reflect 306 and adjusted force F RI The rotary interface 53 is operated manually according to the instructions for surgery. Without using the ability to control tool 30, insert a pedicle screw PS into the target site. The current force F required to rotate it PS Provide the operator with haptic feedback that reflects this. This includes step 310.

[0209] Figure 15C shows exemplary steps in manual control mode. As shown, The control mode is based on the operator manually operating the rotary interface 53. The rotational speed of the pedicle screw PS or the advancement speed of the pedicle screw PS, one of the above Using the ability to control, step 300 involves manually operating the rotary interface 53, and hand The surgical tool 30 controls the rotation interface, which is manually operated to control the pedicle screw P Depending on the rotational speed of S or the advancement speed of the pedicle screw PS, The pedicle screw PS is rotated at a rotational speed around the axis of rotation, following the planned trajectory. Step 302 involves linearly advancing the pedicle screw PS at a forward speed, and the aforementioned... Steps 304, 306, and 308, and the adjusted force F RI Rotation interface according to Manually operate 53 to rotate the pedicle screw PS relative to the target site. Current force F PS Step 311 provides the operator with haptic feedback that reflects the include.

[0210] Figure 15D shows exemplary steps of a simulated autonomous check mode. To enable this, the simulated autonomous check mode controls the rotational speed around the rotation axis R. Then rotate the pedicle screw PS and advance the screw along the planned trajectory LH at a speed. By simulating the linear forward movement of the surgical tool 30, Step 312 simulates controlling the surgical tool 30. Step 314 displays the autonomously controlled state on the display 18, and the pedicle screw P Obtain measurements that show the simulated current interaction between S and the target site (S An example of step 304 (shown as step 304') and tactile based on the obtained measurements The device's actuator is controlled so that the rotation interface 53 of the tactile device 51 moves. The simulated current interaction between the pedicle screw PS and the target site is emulated. An example of step 306 that makes it possible to do so, with resistance force F A actuator 5 Provided to 5, necessary for the operator to rotate the rotary interface 53 by hand. force F RI An example of step 308 is to adjust (shown as step 308'), and The force F required to rotate the rotating interface 53 RI The pedicle screw PS is used as the target part The current force F required to rotate relative to the position SPS Reflecting this, (step 306') An example of step 306 (shown) and the adjusted force F RI Rotation interface 5 The ability to manually operate 3 to control the surgical tool 30 and rotate the pedicle screw PS The ability to control the simulated autonomous control of the surgical tool 30 without using force. The current force F is simulated without using actual force. SPS Haptic feedback that reflects The procedure includes step 316, which provides the operator with the following:

[0211] Figure 15E shows exemplary steps of a simulated autonomous check mode. To enable this, the simulated autonomous check mode controls the surgical tool 30 to perform the spine surgery. Without using the ability to rotate the pedicel screw PS, the operator can rotate the interface Based on the manual operation of the S53, the rotation speed of the pedicle screw PS or the pedicle screw Using the ability to control one of the forward speeds of the Ryu PS, the rotation interface 53 Step 318 is operated manually, and the rotation interface 53 is operated manually, pedicle To control either the rotational speed of the screw PS or the advancement speed of the pedicle screw PS Accordingly, the pedicle screw PS is rotated at a rotational speed around the rotation axis R, and the planned By linearly advancing the pedicle screw PS at a forward velocity along the trajectory LH, Step 320 simulates manually controlling the surgical tool 30, and the surgical tool Step 322 displays the simulated manual control of the 30 on the display 18. , the aforementioned step 304' and the aforementioned step 306' which includes the aforementioned step 308' , adjusted force F RI The rotating interface 53 is operated manually according to the instructions for the surgical tool 3. Without using the ability to control 0 and rotate the pedicle screw PS, the simulation Current force F SPS Step 32: Provide the operator with haptic feedback that reflects the situation. Includes 4.

[0212] Referring to Figure 15A, the dashed box shows the autonomous control of the surgical tool 30 to the vertebral arch. Step 214 shows inserting a root screw (PS). Preparing the anatomical structure. Step 204 involves placing the top 202 and the pedicle screw PS onto the surgical tool 30. Step 214 is the same as steps 206, 208, 210, and autonomous check mode. These can occur simultaneously. As mentioned above, manual control mode and simulated autonomous Between check mode and simulated manual control mode, one or more controls R33 does not autonomously control the surgical tool 30. Therefore, one or more controllers The RA33 has a manual control mode, a simulated autonomous check mode, and a simulated When one of the selected manual control modes is initiated, one or more controllers 33 , abort the execution of step 214 and stop the autonomous control of the surgical tool 30 (one or more (When the controller 33 autonomously controls the surgical tool 30). However, During any of steps 206, 208, or 210, or at any time during autonomous check mode Step 214 can be performed, and one or more controllers 33 are surgical tools. It can start 30 autonomous control systems simultaneously.

[0213] Step 214, which autonomously controls the surgical tool 30, is further shown in Figure 15F. As shown, this method involves step 400 of tracking the position of the target site and the rotation axis. Step 402 involves positioning R along the desired trajectory and controlling the movement of the robot manipulator. Based on the tracked position of the target site, the trajectory LH is followed along the trajectory planned for the target site. Step 404 maintains the rotation axis R of the surgical tool 30, and autonomously controls the surgical tool 30. By precisely controlling the rotation, the pedicle screw PS is rotated at a rotational speed around the rotation axis R, and the plan is to... Steps to advance the pedicle screw PS linearly at a forward velocity along the defined trajectory LH. 406, where rotational speed and forward speed are predetermined, pedicle screw PS The process includes step 406, which is proportional to the known thread shape.

[0214] During step 400, the position of the target site is tracked. (Ultrasonic transducer shown in the figure) The device is attached to the underside of the patient's skin to realistically represent the patient's anatomical form and the progress of the surgical procedure. Time-lapse images can be generated. Intraoperative images can be used to plan pedicle screw placement (PS). It can be determined that it is following the desired trajectory, or that drill 42 or Pedicle screws (PS) are located in either the nerve or the medial or lateral cortical boundary, which is a crucial structure. It is possible to determine whether or not it is approaching construction.

[0215] During step 402, the axis of rotation R is aligned with the planned trajectory LH. (Figure) As in 9, according to the surgical plan, the rotational axis R is still aligned with the planned trajectory LH. If not taken, or if the rotation axis R is off the desired trajectory for other reasons, Step 402 involves aligning the rotation axis R. Specifically, in step 402, The bot surgical system 10 positions the rotation axis R along the desired trajectory using a surgical tool This controls the movement of the R30. This allows the robotic surgical system 10 to move the rotation axis R along a desired trajectory. This may include causing autonomous movement of the surgical tool 30 to position itself along a certain line. The robotic surgical system 10 positions the rotation axis R along the planned trajectory LH. The operator then moves the surgical tool 30 by applying force / torque in manual mode. This may be made possible. The robotic surgical system 10 provides a feed indicating proper alignment. Back (visual, auditory, and / or tactile) can be generated for the operator. In a few examples, the tool's position is planned along the trajectory LH by the threshold distance defined by the attractive touch. Since it is close, use the attractive tactile sensation to pull tool 30 towards the planned trajectory LH. It is possible.

[0216] During step 406, the robotic surgical system 10 performs autonomous movement of the surgical tool 30. At the same time as triggering it, control the autonomous forward movement of the tool in a straight line along the planned trajectory LH. Furthermore, it also controls the autonomous rotation of surgical tools around the rotation axis R. The control of the screw threads is related to the thread pitch defined by (Equation 1) above. Autonomous control, determined by the pitch of the vertebral column, ensures proper insertion of the pedicle screw. To avoid causing damage to the surrounding bone tissue.

[0217] Step 214 can be commanded by the operator with multiple options. In the first example, The robotic surgical system 10 can be configured to operate with complete autonomy. In other words, the operator performs autonomous control of the surgical tool 30 on the robotic surgical system 10. When instructed to do so, the robotic surgical system 10 will not perform any further operations until the operation is complete. Autonomous control is performed without using operator input. In an alternative example, the operator operates To initiate autonomous execution, press and hold the button, then press and hold the foot switch. By doing so, or by providing continuous input through other continuous input control methods, etc. If input stops, for example, if a button or foot switch is released, the robot The surgical system 10 pauses the execution of the operation. In cooperation with autonomous control, the operator The speed at which the operation is performed can be adjusted. In addition to buttons or foot switches, Stepwise functionality for multiple discrete velocities allows for increasing or decreasing the robot's speed. Additional control can be provided so that the operator can issue commands. Speed ​​control may include a set of buttons, selectors, dials, or other appropriate controls. ru.

[0218] Referring to Figure 15A, in step 206, the robotic surgical system 10 operates Determine whether the operation has finished. An operation can be determined to have finished using various methods. For example, the operator inserts all pedicle screws (PS) to the desired depth. If the operator determines that the operation is in progress, they can order the operation to be terminated. If the operator subjectively determines that the operation is complete, the operator will order the operation to end. It is possible. In yet another example, one or more controllers 33 control all pedicles If it is determined that the Clue PS has been inserted to the desired depth, one or more controllers 33 can trigger the end of the operation. However, in some cases, the pedicle The procedure is not complete after the screw PS has been implanted to the desired depth. In that case, this method repeats the steps of the method in Figure 15A for another pedicle screw PS. This can be continued until all pedicle screws (PS) have been implanted. .

[0219] If the robotic surgical system 10 determines that the operation is complete during step 206, The method involves step 21, which determines whether the surgical tool 30 has been inserted into the target site. Proceed to step 6. During step 216, one or more controllers 33 control the surgical tool 30. The position and whether the surgical tool 30 has been inserted into the target site can be determined. The robotic surgical system 10 determines that the surgical tool 30 has not been inserted. The method then proceeds to step 218, which is the end of the operation. The robotic surgical system 10 is for surgery If it is determined that tool 30 has been inserted, the method proceeds before ending step 218. Then proceed to step 220, which is to remove the tool.

[0220] During step 220, the surgical tool 30 is withdrawn from the implant. As with advancing the clue PS into the bone, the operator moves away from vertebra V. By applying force to the surgical tool 30, it is possible to command the withdrawal of the surgical tool 30. Alternatively, once the implant is in place, the robotic surgical system 10 will operate... The surgical tool 30 can be autonomously withdrawn without further input.

[0221] A partial facetectomy involves using a surgical tool 30 to remove the pedicle. This procedure is performed while providing a smooth bone surface for the final acceptance of the head of the Clue PS. This can be done. The amount to be removed is determined based on the operator's plan, i.e., the head in the 3D model. It can be defined by determining the position of the bar or corresponding to the head shape. The material can be removed using a pre-formed reamer 70. Therefore, drill 42 incorporates a reamer into it to avoid the need for a separate tool. This allows the drill 42 to create a smaller contour in order to produce a pilot hole. To include the drilling shaft and to fabricate the sheet 72 for the head of the pedicle screw PS By positioning the reamer 70 more proximal, the pilot hole 102 and At least a portion of sheet 72 can be formed simultaneously. In the example shown, Lu 42 comprises a drilling shaft having a proximal end and a distal end, and a drill located at the distal end. The reamer 70 includes a tip. The reamer 70 is positioned near the facet joint, with a gap proximally from the drill tip. Use the cutting function of either a suitable drill and / or reamer to form the hole. This can be done, for example, by creating a pilot hole in the spine of a patient receiving an implant. A sheet can be formed.

[0222] The systems and methods described herein include pedicle screws PS, other screws, and It is understood that fasteners, or other implants, may be used to place them in the patient. Therefore, assuming that pedicle screws (PS) are referenced throughout as an example, Furthermore, using the same systems and methods described herein, any of the patient's It is possible to treat anatomical morphology and / or implant either of the following in the patient. For example, it can be placed in the hip joint, knee, femur, tibia, face, shoulder, spine, etc. For example, the robotic arm 20 is also used to position the cage for the spinal implant. Positioning the head, driving the pin, implanting the threaded cup, Alternatively, other components can be positioned, and the robotic arm can be used for discectomy or other surgical procedures. It can be used for other surgeries, including different end effectors and robotic arms. It can be mounted on a 20. In some cases, the end effector also includes an articulated arm. Furthermore, this articulated arm facilitates the insertion of implants, that is, the implant can be placed in It can be positioned in the desired posture. The articulated arm of the end effector is positioned to accommodate the implant. It may also be simply a scaled-down version of the robotic arm 20 controlled in the same way, Alternatively, there may be another mechanism that controls the positioning of the implant.

[0223] Navigation system 12 is an optical navigation system with an optical-based tracker. This may include systems, but ultrasonic navigation systems that track objects via ultrasound, A radio frequency navigation system that tracks objects via RF energy, and / or or other modalities such as electromagnetic navigation systems that track objects via electromagnetic signals It can be used as an additional or alternative. Other types of navigation systems are also planned. As shown in the diagram, in some cases the models described herein use triangular meshes and voxels. This may include the use of volumetric models, or other types of 3D and / or 2D models. I hope you understand that too.

[0224] The above explanation has described several examples. However, the following will not be discussed in this specification. Examples are exhaustive, or do not limit this disclosure to any particular form. This is not the intention. The terminology used is descriptive rather than restrictive. This is intended to be the case. In light of the above instructions, many modified and transformed forms are possible. Yes, and this disclosure may be implemented in ways other than those specifically described.

Claims

1. Robot manipulator and The robot manipulator is connected to the screw and rotates around the axis of rotation. A surgical tool configured to rotate the clew, The actuator and a rotary interface coupled to the actuator, The interface is configured to be manually operated by the operator. , haptic devices and, A navigation system configured to track the location of a target site, The robot manipulator, the tactile device, and the navigation system are connected One or more combined controllers and A robotic surgical system comprising: The one or more controllers, based on the tracked position of the target area, Maintain the axis of rotation of the surgical tool along a planned trajectory relative to the target site. Controlling the movement of the robot manipulator and the rotational speed around the rotation axis. The screw is then rotated, and the screw moves forward at a speed along the planned trajectory. The autonomous control of the surgical tool so that it moves forward in a straight line, and the rotation The speed and the forward speed are predefined and depend on the known thread shape of the screw. It is proportional, controlling and the current relationship between the screw and the target site Obtaining measurements that show the interaction and, based on the obtained measurements, the tactile The actuator of the device is controlled so that the rotary interface and the screw To enable the emulation of the current interaction with the target site. A robotic surgical system configured to perform surgery.

2. The one or more controllers provide resistance to the actuator and operate The force required to rotate the rotating interface by the aforementioned hand is adjusted. By being configured, the current interaction between the screw and the target site Furthermore, it emulates the force required to rotate the rotation interface. , reflecting the current force required to rotate the screw relative to the target area. The robotic surgical system according to claim 1.

3. The one or more controllers are further configured to initiate an autonomous check mode. The rotation interface, according to the adjusted force, moves toward the target area. Tactile feedback that reflects the current force required to rotate the screw is provided in advance. The surgical tool is used to rotate the screw, providing the operator with the opportunity to do so. The robotic surgery according to claim 2, which can be operated manually without the use of control capabilities. system.

4. Depending on the conditions or commands, one or more controllers may control the surgical tool themselves. It is further configured to initiate the autonomous check mode at the same time as controlling it according to the rules. The robotic surgical system according to claim 3.

5. Depending on the conditions or commands, one or more controllers may control the surgical tool themselves. After stopping or temporarily suspending the rotation of the screw by strictly controlling it, The robot according to claim 3 or 4, further configured to initiate an autonomous check mode A surgical system.

6. Depending on the conditions or commands, one or more controllers may control the surgical tool itself. After the control is stopped or paused and the rotation of the screw is stopped, the surgical tool The screw is further configured to resume autonomous control of the screw and rotate the screw. a robotic surgical system according to any one of claims 3 to 5.

7. The one or more controllers are further configured to initiate a manual control mode, The rotation interface is operated manually by the operator. Based on the rotational speed of the screw or the forward speed of the screw, It can be operated manually using the ability to control one of them, The one or more controllers are operated manually when the rotation interface is operated. To control one of the rotational speed of the wheel or the forward speed of the screw Accordingly, the surgical tool is controlled to rotate at the rotational speed around the rotation axis. Rotate the wheel and move the screw linearly along the planned trajectory at the forward speed. It is configured to move forward, The rotation interface is manually operable according to the adjusted force, and the standard A tactile feedback that reflects the current force required to rotate the screw relative to the target area. This provides feedback to the operator. A robotic surgical system according to any one of claims 2 to 6.

8. Depending on the conditions or commands, one or more controllers may control the surgical tool themselves. After stopping or temporarily suspending the rotation of the screw by strictly controlling it, The robotic surgical system according to claim 7, further configured to initiate a manual control mode Tem.

9. Depending on the conditions or commands, one or more controllers may switch to manual control mode. Then, autonomously control the surgical tool to resume rotating the screw. The robotic surgical system according to claim 8, further configured to switch to

10. The haptic device is configured to trigger the condition or the command. or the robotic surgical system according to any one of claims 4 to 9.

11. Obtain the measured value indicating the current interaction between the screw and the target site. The system further includes a sensor configured to such an extent, wherein one or more controllers control the sensor A robotic surgical system according to any one of claims 1 to 10, which is coupled to a

12. The one or more controllers described above It is determined that a condition exists during the control of the screw, In accordance with the determination that the above conditions exist, the actuator of the tactile device By controlling and preventing the ability to rotate the rotation interface, the conditions Provides haptic feedback to the operator. A robotic surgical system according to any one of claims 7 to 11, configured as described above. 。

13. The aforementioned navigation system The screw for the anatomical model of the target site registered at the target site. The navigation system determines the position of the anatomical model. The distance between the screw and the anatomical model at multiple positions of the screw. This includes predetermined data showing the expected interaction, and to determine, The determined position of the screw relative to the anatomical model and the predetermined data Based on the above, the measurement that shows the current interaction between the screw and the target site Obtaining a fixed value and A robot according to any one of claims 1 to 12, further configured to perform Surgical system.

14. The rotational speed and the forward speed are related [Math 1] It is proportional to the known thread shape according to the formula, [Math 2] This is the rotational speed, [Math 3] is the forward speed, and the pitch is the number of threads per unit length of the screw. A robotic surgical system according to any one of claims 1 to 13.

15. The tactile device is further defined as a handheld pendant, and the rotating interface Robotic surgery according to any one of claims 1 to 14, wherein the s is further defined as a knob. system.

16. The tactile device is separated from the robotic manipulator and the surgical tool. A robotic surgical system according to any one of claims 1 to 15, which is located remotely. Hmm.

17. The tactile device is directly attached to the robotic manipulator or the surgical tool. A robotic surgical system according to any one of claims 1 to 16.

18. The one or more controllers receive input from the operator, The resistive force provided to the actuator, The rotation interface that controls the surgical tool to rotate the screw Force sensitivity and Claims 1 to 17 are further configured to selectively adjust one or more of the following A robotic surgical system as described in any one of the items.

19. The robotic surgical system further includes a display and one or more controllers It is further configured to initiate a simulated autonomous check mode, The one or more controllers described above are: The screw is rotated at the rotational speed around the rotation axis, and the planned trajectory is formed. By moving the screw forward in a straight line at the aforementioned forward speed along the path, the surgical It simulates the autonomous control of the tool, The simulated autonomous control of the surgical tool is displayed on the display. Obtain the simulated current interaction between the screw and the target site, Based on the simulated current interaction, the actuary of the haptic device The ETER controls the rotation interface between the screw and the target area. This allows for the emulation of the simulated current interaction. A robotic surgical system according to any one of claims 1 to 18, configured as described above. 。

20. Before the one or more controllers autonomously control the surgical tool, the stain Claim 19, further configured to initiate a controlled autonomous check mode. The robotic surgical system described above.

21. The robotic surgical system further includes a display and one or more controllers It is further configured to initiate a simulated manual control mode, The one or more controllers described above are: The rotation interface is operated manually to control the rotation speed of the screw or In order to control one of the forward speeds of the screw, a control input is received, In response to the control input, the screw rotates at the rotational speed around the rotation axis. This causes the screw to move linearly forward at the forward speed along the planned trajectory. This simulates manually controlling the surgical tool, The simulated manual control of the surgical tool is displayed on the display. Obtain the simulated current interaction between the screw and the target site, Based on the simulated current interaction, the actuary of the haptic device The ETER controls the rotation interface between the screw and the target area. This allows for the emulation of the simulated current interaction. A robotic surgical system according to any one of claims 1 to 20, configured as described above. 。

22. Depending on the conditions or commands, one or more controllers may control the surgical tool themselves. After stopping or temporarily suspending the rotation of the screw by strictly controlling it, The following is described in claim 21, which is further configured to initiate a simulated manual control mode. A robotic surgical system.

23. A robotic manipulator and a screw connected to the robotic manipulator. A surgical tool configured to rotate the screw around a rotation axis, The actuator includes an actuator and a rotary interface coupled to the actuator, and the operator A tactile device configured to be manually operated by the user's hand, and which tracks the position of the target area. A navigation system configured to track, the robot manipulator and the A haptic device and one or more controllers coupled to the navigation system A method for controlling a robotic surgical system, The one or more controllers, based on the tracked position of the target area, Maintain the axis of rotation of the surgical tool along a planned trajectory relative to the target site. The steps include controlling the movement of the robot manipulator, The one or more controllers control the screw at a rotational speed around the rotation axis. Rotate and advance the screw linearly at a forward speed along the planned trajectory. A step of autonomously controlling the surgical tool, wherein the rotation speed and the The forward speed is predefined and proportional to the known thread shape of the screw. The aforementioned control step, The one or more controllers currently interact with the screw and the target site. Steps to obtain a measurement value indicating the use, The one or more controllers, based on the acquired measurements, the haptic device The actuator controls the rotation interface between the screw and the target. A step that enables the emulation of the current interaction between the parts and A method for controlling a robotic surgical system comprising the above.

24. The actuator of the tactile device is controlled based on the acquired measurement values. , the rotation interface is the current interaction between the screw and the target site The step that enables the emulation of the one or more controllers Provides resistance to the actuator, and the operator's hand rotates the interface This includes adjusting the force required to rotate the face, and rotating the rotating interface. The force required to cause this is the same force required to rotate the screw relative to the target area. Controlling the robotic surgical system according to claim 23, which reflects the current capabilities method.

25. The step further includes initiating an autonomous check mode with one or more controllers, The rotation interface, according to the adjusted force, moves the S The operator provides haptic feedback that reflects the current force required to rotate the clew. Control the surgical tool to rotate the screw in order to provide it to the lector. The robotic surgical system according to claim 24, which can be operated manually without using the ability to operate manually A method for controlling the system.

26. The one or more controllers, in response to conditions or commands, control the surgical tool itself The further step includes starting the autonomous check mode at the same time as controlling it according to the rules. A method for controlling the robotic surgical system described in item 25.

27. The one or more controllers, in response to conditions or commands, control the surgical tool itself After stopping or temporarily suspending the rotation of the screw by strictly controlling it, The step of starting an autonomous check mode, as described in claim 25 or 26 A method for controlling a bot-assisted surgical system.

28. The one or more controllers, in response to conditions or commands, control the surgical tool itself. After the control is stopped or paused and the rotation of the screw is stopped, the surgical tool The further includes restarting autonomous control of the screw to rotate the screw. A method for controlling a robotic surgical system as described in any one of the requests 25 to 27.

29. The step of one or more controllers starting a manual control mode, the number The rotation interface is based on the operator manually operating the rotation interface. Therefore, one of the following: the rotational speed of the screw or the forward speed of the screw The starting step, which is manually operable using the ability to control one of the, The one or more controllers are operated manually when the rotation interface is operated. To control one of the rotational speed of the wheel or the forward speed of the screw Accordingly, the surgical tool is controlled to rotate at the rotational speed around the rotation axis. Rotate the wheel and move the screw linearly along the planned trajectory at the forward speed. Steps to move forward It further includes, The rotation interface is manually operable according to the adjusted force, and the standard A tactile feedback that reflects the current force required to rotate the screw relative to the target area. The robotic surgical system according to claim 24, wherein feedback is provided to the operator. How to control it.

30. The one or more controllers, in response to conditions or commands, control the surgical tool itself After stopping or temporarily suspending the rotation of the screw by strictly controlling it, The robotic surgical system according to claim 29, further comprising the step of initiating a manual control mode A method for controlling the system.

31. The one or more controllers, depending on a condition or command, switch between manual control mode and manual control mode. Then, autonomously control the surgical tool to resume rotating the screw. Controlling the robotic surgical system according to claim 30, further including the step of switching to How to do it.

32. The haptic device further includes the step of triggering the condition or the command. A method for controlling a robotic surgical system according to any one of claims 26 to 31.

33. The robotic surgical system includes a sensor, and using the sensor, the screw and the The step further includes obtaining the measurement value that indicates the current interaction with the target site. The one or more controllers are coupled to the sensor, any of claims 23 to 32 A method for controlling a robotic surgical system as described in any one of the items.

34. The one or more controllers determine that a condition exists during the control of the screw. Steps and When one or more controllers determine that the condition exists, the contact The ability to control the actuator of the sensory device to rotate the rotary interface. The steps include providing tactile feedback regarding the conditions by preventing the above from happening. Controlling the robotic surgical system according to any one of claims 29 to 33, further including How to do it.

35. The navigation system has registered information about the anatomy of the target site. A step of determining the position of the screw relative to the target model, wherein the navigation The system is configured to allow the screw to be positioned at multiple locations relative to the anatomical model. Includes predetermined data showing the expected interaction between the clue and the anatomical model, The decision-making steps, The navigation system determines the position of the screw relative to the anatomical model. Based on the determined position and the predetermined data, between the screw and the target area A step of obtaining the measured value that shows the current interaction of and Controlling the robotic surgical system according to any one of claims 23 to 34, further including How to do it.

36. The one or more controllers receive input from the operator, The resistive force provided to the actuator, The rotation interface that controls the surgical tool to rotate the screw Force sensitivity and Any of claims 23 to 35 further includes selectively adjusting one or more of the following. A method for controlling the robotic surgical system described in item 1.

37. The robotic surgical system further includes a display, and the method includes the one or more of the The step further includes the controller entering a simulated autonomous check mode. 、 The one or more controllers described above are: The screw is rotated at the rotational speed around the rotation axis, and the planned trajectory is formed. By moving the screw forward in a straight line at the aforementioned forward speed along the path, the surgical Steps to simulate autonomous control of the tool, The simulated autonomous control of the surgical tool is displayed on the display. Step and, Obtain the simulated current interaction between the screw and the target site. Steps and Based on the simulated current interaction, the actuary of the haptic device The ETER controls the rotation interface between the screw and the target area. The steps described enable the emulation of the simulated current interaction. A robotic surgical system according to any one of claims 23 to 26, which includes How to control it.

38. Before the one or more controllers autonomously control the surgical tool, the stain Claim 37 further includes the step of initiating a controlled autonomous check mode. How to control a robotic surgical system.

39. The robotic surgical system further includes a display, and the method includes the one or more of the The controller further includes the step of entering a simulated manual control mode, The one or more controllers described above are: The rotation interface is operated manually to control the rotation speed of the screw or A control input is received in accordance with controlling one of the forward speeds of the screw. Steps and In response to the control input, the screw rotates at the rotational speed around the rotation axis. This causes the screw to move linearly forward at the forward speed along the planned trajectory. This involves the step of simulating the manual control of the surgical tool, The simulated manual control of the surgical tool is displayed on the screen. Step and, Obtain the simulated current interaction between the screw and the target site. Steps and Based on the simulated current interaction, the actuary of the haptic device The ETER controls the rotation interface between the screw and the target area. The steps described enable the emulation of the simulated current interaction. A robotic surgical system according to any one of claims 23 to 27, which includes How to control it.

40. The one or more controllers, in response to conditions or commands, control the surgical tool itself After stopping or temporarily suspending the rotation of the screw by strictly controlling it, Claim 39 further includes the step of initiating a simulated manual control mode. How to control a robotic surgical system.

41. Robot manipulator and The robot manipulator is connected to the screw and rotates around the axis of rotation. A surgical tool configured to rotate the clew, The actuator and a rotary interface coupled to the actuator, The interface is configured to be manually operated by the operator. , haptic devices and, A navigation system configured to track the location of a target site, The robot manipulator, the tactile device, and the navigation system are connected One or more combined controllers and A robotic surgical system comprising: The one or more controllers, based on the tracked position of the target area, Maintain the axis of rotation of the surgical tool along a planned trajectory relative to the target site. Controlling the movement of the robot manipulator and receiving control input from the tactile device Receiving, the rotation interface is such that the operator can use the rotation interface Based on the manual operation of the face, the rotational speed of the screw or the screw - The receiving Furthermore, in response to the control input from the tactile device, the rotational speed around the rotation axis is The screw is rotated and the screw is moved forward at a speed along the planned trajectory. Controlling the surgical tool to advance linearly, the rotational speed and The forward speed is predefined and proportional to the known thread shape of the screw. This indicates the control and the current interaction between the screw and the target site. To obtain a measurement value, and to control the tactile device based on the obtained measurement value. The rotation interface then controls the current interaction between the screw and the target area. It is configured to enable the emulation of the action, Bot-based surgical system.

42. A method for operating the robotic surgical system described in claim 41.

43. Robot manipulator and A hand connected to the robotic manipulator and configured to rotate around a rotation axis. Surgical tools and, The actuator and a rotary interface coupled to the actuator, The interface is configured to be manually operated by the operator. , haptic devices and, A navigation system configured to track the location of a target site, The robot manipulator, the tactile device, and the navigation system are connected One or more combined controllers and A robotic surgical system comprising: The one or more controllers, based on the tracked position of the target area, Maintain the axis of rotation of the surgical tool along a planned trajectory relative to the target site. Controlling the movement of the robotic manipulator and autonomously controlling the surgical tool. Then, the surgical tool is rotated at a rotational speed around the rotation axis, and the planned The surgical tool is moved forward in a straight line at a forward speed along the trajectory, and the surgical tool To obtain measurements that show the current interaction between the lu and the target site, and the obtained Based on the measured values, the tactile device is controlled so that the rotation interface can operate during surgery. This enables the emulation of the current interaction between the tool and the target site. A robotic surgical system configured to perform the following actions.

44. A method for operating the surgical system described in claim 42.

45. The actuator and a rotary interface coupled to the actuator, The rotary interface is configured to be manually operated by the operator. , haptic devices, Display devices and, The haptic device and the display device are coupled together, and the display device One or more controllers configured to provide simulations on the system A simulation system comprising, The aforementioned simulation is To provide a simulated surgical tool, the simulated hand The surgical tool is connected to a simulated screw and inserted into the simulated target site. In contrast, the simulated screw around the axis of rotation along the simulated trajectory Rotating the lever, providing the above, The simulated screw is rotated at a rotational speed around the aforementioned rotation axis, The simulated screw is moved in a straight line at a forward speed along the simulated trajectory. Simulated control of the simulated surgical tool to advance it to the target The purpose is to provide a system in which the rotational speed and the forward speed are predefined, The provided information is proportional to the known thread shape of the simulated screw. and, Simulation between the simulated screw and the simulated target site To obtain the current rated interaction, Based on the simulated current interaction, the haptic device is controlled to The rotation interface is the simulated screw and the simulated mark This makes it possible to emulate the simulated current interaction with the target site. What to do and A simulation system configured to perform the following actions.

46. A method for operating the simulation system described in claim 45.

Images