Systems and methods for assessing and assisting surgical performance

Abstract

In one example, the system includes a processor capable of: (i) receiving instrument data from the surgical instrument related to the operation of the surgical instrument during the surgical procedure; (ii) receiving position data from the surgical navigation system indicating the position of the surgical instrument relative to the patient's anatomy during the surgical procedure; (iii) determining kinematic data based on the position data; (iv) using the instrument data and the kinematic data to determine a plurality of surgical performance metrics that characterize surgical performance; (v) performing an analysis of (a) the kinematic data and the instrument data against (b) the plurality of surgical performance metrics; and (vi) outputting information to a user interface based on the analysis that provides feedback to the surgeon and / or stakeholders (e.g., hospital administrators) regarding the performance of the surgical procedure.

Description

[Technical Field]

[0001] The present disclosure relates generally to systems and methods for acquiring and processing information related to surgical performance, and more particularly to systems and methods for using data acquired from surgical instruments and / or devices in an operating room pre-operatively, intra-operatively, and / or post-operatively to assess surgical performance, assist in surgical performance, and / or reduce cognitive load on the surgeon during a surgical procedure.

[0002] [CROSS-REFERENCE TO RELATED APPLICATIONS] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 443,588, filed February 6, 2023, the contents of which are incorporated herein by reference in their entirety. [Background technology]

[0003] Multiple factors can affect a patient's post-operative outcome following a surgical procedure. For example, several studies have found a relationship between patient outcomes and the technical skill of the surgeon performing the surgical procedure. As another example, during a surgical procedure, a surgeon may be inundated with information from a variety of sources. Conflicting information provided to the surgeon can increase the surgeon's cognitive load, which in some cases can negatively impact patient outcomes. Summary of the Invention

[0004] In one example, a non-transitory computer-readable medium has stored thereon instructions executable to cause a processor to perform functions including determining a plurality of treatment datasets for a plurality of surgical procedures and determining a plurality of surgical performance metrics characteristic of surgical performance based on the plurality of treatment datasets, wherein determining the plurality of treatment datasets can include, for each surgical procedure of the plurality of surgical procedures, determining a respective treatment dataset of the plurality of treatment datasets by: (i) receiving instrument data from a surgical instrument related to operation of the surgical instrument during the surgical procedure, the instrument data being based on one or more instrument parameters determined by the surgical instrument at a plurality of time points during the surgical procedure, (ii) receiving position data from a surgical navigation system indicative of a position of the surgical instrument relative to a patient's anatomy at the plurality of time points during the surgical procedure, (iii) determining kinematic data at the plurality of time points based on at least one of the position data or the instrument data, and (iv) correlating the instrument data, the position data, and the kinematic data for each of the plurality of time points to determine a respective treatment dataset for the surgical procedure.

[0005] In another example, a non-transitory computer-readable medium has stored executable instructions to cause a processor to perform functions including: (i) receiving instrument data from a surgical instrument related to operation of the surgical instrument at multiple time points during a surgical procedure; (ii) receiving position data from a surgical navigation system indicating a position of the surgical instrument relative to a patient's anatomy at the multiple time points during the surgical procedure; (iii) determining kinematic data at the multiple time points based on the position data; (iv) using the instrument data and the kinematic data to determine a plurality of surgical performance metrics characteristic of surgical performance; (v) performing an analysis of (a) the kinematic data and the instrument data against (b) the plurality of surgical performance metrics; and (vi) outputting information to a user interface based on the analysis that provides feedback to a surgeon regarding performance of the surgical procedure.

[0006] In another example, a non-transitory computer-readable medium has stored executable instructions to cause a processor to perform functions including: (i) receiving pre-operative information for a surgical procedure to be performed; (ii) using the pre-operative information to determine a plurality of surgical performance metrics; (iii) receiving instrument data from a surgical instrument related to operation of the surgical instrument at a plurality of time points during the surgical procedure; (iv) receiving position data from a surgical navigation system indicative of a position of the surgical instrument relative to a patient's anatomy at the plurality of time points during the surgical procedure; (v) determining kinematic data at the plurality of time points based on the position data; (vi) (a) performing an analysis of the kinematic data and the instrument data against (b) the plurality of surgical performance metrics; and (vii) outputting information to a user interface based on the analysis to provide feedback to a surgeon regarding the performance of the surgical procedure.

[0007] The above-described features, functions, and advantages may be achieved independently in various embodiments or may be combined in still other embodiments, further details of which can be seen in the following description and by reference to the drawings.

[0008] The novel features believed distinctive to the exemplary embodiments are set forth in the appended claims, however, the exemplary embodiments will best be understood by reference to the following detailed description of exemplary embodiments of the present disclosure, together with the preferred mode of use, further objects and description thereof, when read in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0009] [Figure 1] 1 is a simplified block diagram of a system for assessing and / or assisting surgical performance, according to one exemplary embodiment. [Figure 2] FIG. 1 is a simplified block diagram of a system for assessing and / or assisting surgical performance, according to another example. [Figure 3] FIG. 1 illustrates a first display screen of an application for assessing and / or assisting surgical performance, according to one example. [Figure 4] FIG. 10 illustrates a second display screen of an application for assessing and / or assisting surgical performance, according to one example. [Figure 5] FIG. 10 illustrates a third display screen of an application for assessing and / or assisting surgical performance, according to one example. [Figure 6] FIG. 10 illustrates a fourth display screen of an application for assessing and / or assisting surgical performance, according to one example. [Figure 7] FIG. 10 illustrates a third display screen of an application for assessing and / or assisting surgical performance, according to one example. [Figure 8] FIG. 10 illustrates a fourth display screen of an application for assessing and / or assisting surgical performance, according to one example. [Figure 9]1 is a flowchart of a method for assessing the surgical performance of a surgical procedure, according to an example. [Figure 10] 1 is a flowchart of a method for assessing the surgical performance of a surgical procedure, according to an example. [Figure 11] 1 is a flowchart of a method for assessing the surgical performance of a surgical procedure, according to an example. DETAILED DESCRIPTION OF THE INVENTION

[0010] The disclosed embodiments are described more fully below with reference to the accompanying drawings. The drawings illustrate some, but not all, of the disclosed embodiments. Indeed, several different embodiments may be described, and should not be construed as being limited to the embodiments set forth herein. Rather, these embodiments are described so that this disclosure will be thorough and complete, and will fully convey the scope of the disclosure to those skilled in the art.

[0011] As described above, factors such as a surgeon's surgical skill and / or cognitive load can affect a patient's post-operative outcome following a surgical procedure. The present disclosure provides systems and methods that can assist in assessing surgical performance, assisting in surgical performance, and / or reducing cognitive load for a surgeon during a surgical procedure.

[0012] Increased surgical case volume and years of practice have generally been associated with improved surgical performance in a procedure-specific manner. However, while surgical expertise is often defined in terms of the number of surgical procedures performed (surgery volume), i.e., the surgeon's experience, this number is not always related to complication rates, suggesting that it is not an adequate measure of surgical skill. Experience alone may not be sufficient to mitigate the risks associated with surgical care, and surgical performance cannot be maintained through the passive accumulation of experience. Rather, targeted performance improvement, such as through the use of monitoring tools and structured behavioral change programs, may be beneficial throughout a surgeon's career.

[0013] The current standard for evaluating surgeons is peer review via video footage either during or after surgery. Peer review is subject to bias due to subjectivity and individual differences in the grading process (e.g., surgeons sometimes disagree about what constitutes "good" surgical care). The present disclosure provides for quantifying surgical techniques in a more consistent and objective manner based at least in part on information measured directly from one or more surgical devices used during the surgical procedure(s). Determining and / or using surgical performance metrics in accordance with the systems and methods of the present disclosure can reduce subjectivity and bias and provide objective feedback, both of which are useful to individual surgeons, patients, and / or others (e.g., credentialing and licensing boards).

[0014] In additional or alternative aspects, the present disclosure further provides systems that can provide scalable evaluation of surgical technique and / or surgical performance using computer-based data analytics and / or machine learning computer algorithms. Additionally, in some examples, information determined by such computer algorithms can be used pre-, intra-, and / or post-operatively to, among other things, (i) enable a surgeon to obtain personalized feedback regarding their surgical technique, (ii) train a surgeon or surgical team members to perform a surgical procedure, (iii) provide information related to the performance of a surgical procedure to a patient, (iv) plan a surgical procedure to be performed, (v) provide predictive analysis and recommendations regarding the surgical technique of a surgical procedure to be performed (e.g., to reduce the incidence of complications), (vi) provide feedback regarding how surgical instruments performed during a surgical procedure, (vii) provide a knowledge-sharing tool, and / or (viii) provide a memory aid to remind a surgeon of clinical choices for a particular surgical procedure.

[0015] As described above, the present disclosure additionally or alternatively provides for a reduction in cognitive load on surgeons during a surgical procedure. Current methods for assessing cognitive load largely rely on the surgeon's self-reporting after the surgical procedure (e.g., using the NASA-TLX tool or Surg-TLX). However, analyzing cognitive load retrospectively (i.e., not in real time) may not capture intraoperative fluctuations in cognitive load. In some examples, the systems and methods of the present disclosure can assist in quantifying cognitive load in real time and measuring its impact during various phases of an actual surgical procedure. For example, in some examples, the systems and methods of the present disclosure provide for measuring a surgeon's cognitive load level based on information provided by one or more surgeon monitoring devices capable of detecting one or more physiological states of the surgeon during a surgical procedure. The physiological states detected by the surgeon monitoring device(s) can, in some cases, additionally provide an indication of the surgeon's psychological state (e.g., the surgeon's mental and / or emotional state). By way of example, the wearable device may include one or more devices selected from a smart ring, eye-tracking glasses, strap-based sensors (e.g., chest strap sensors, thigh strap sensors, and shank strap sensors), a smart watch, an immersive device (e.g., an augmented reality (AR) headset and an extended reality (XR) headset), and a flexible epidermal sensor (e.g., a wireless heart rate patch monitor). In some embodiments, the system and method may further provide intra-operative feedback to the surgeon based on the surgeon's sensed physiological state to assist in reducing the level of cognitive load on the surgeon.

[0016] In some examples, the systems and methods of the present disclosure may be applied in non-robotic and / or robotic surgical procedures. Additionally, in some examples, the systems and methods of the present disclosure may be implemented in one or more surgical disciplines, including, for example, neurosurgery, spinal surgery, endoscopy, orthopedics, and ear, nose, and throat (ENT) / otolaryngology.

[0017] 1, a simplified block diagram of a system 100 for determining multiple surgical performance metrics is shown, according to one example. As shown in FIG. 1, the system 100 includes a controller 110 and one or more surgical devices 112 that are operated during one or more surgical procedures. In this example, the one or more surgical devices 112 include at least one surgical instrument 114 and at least one surgical navigation system 116. As described in more detail below, the surgical device(s) 112 can include additional or alternative devices in other examples.

[0018] Generally, each of the surgical instrument(s) 114 is operable to perform a surgical task during a surgical procedure. By way of example, the surgical instrument 114 may include at least one instrument selected from the group consisting of a drill, a bone cutter, an electrosurgical tool, a suction tool, an irrigation tool, a shaver, a microscope, a camera (e.g., an endoscope), a surgical retractor, and an illumination device. Additionally or alternatively, the surgical instrument 114 may include one or more surgical instruments capable of performing at least one surgical task selected from the group consisting of a drilling operation, a cutting operation, a shaving operation, a tissue retraction operation, a suction operation, an irrigation operation, a probing operation, a clamping operation, a coagulation operation, a heating operation, a cooling operation, an ablation operation, an electrical stimulation operation, an image capture operation, a sawing operation, and a grinding operation.

[0019] In some examples, one or more of the surgical instruments 114 can include a working element operable to perform at least one surgical task. For example, the working element can include a drill bit, an electrosurgical electrode, an ablation end effector (e.g., a cryoablation balloon, an electrode, a laser emitter, and / or a heating element), a fluid valve, a vacuum source, and a cutting blade. In some examples, the surgical instrument 114 can include one or more user input devices that can be actuated to operate the working elements of the surgical instrument 114. For example, the user input device(s) can include one or more devices selected from the group consisting of one or more buttons, one or more switches, one or more foot pedals, one or more touchscreens, one or more dials, one or more triggers, one or more cranks, and one or more suction control ports.

[0020] In some examples, the surgical instrument(s) 114 can include one or more handheld devices that the surgeon can grasp, manipulate, and move during the surgical procedure. In other examples, the surgical instrument(s) 114 can include one or more fixed devices that remain in a fixed position relative to the patient (and / or operating room) during the surgical procedure. In other examples, the surgical instrument(s) 114 can include both handheld device(s) and fixed device(s). For example, in one example, the surgical instrument(s) 114 can include an electrosurgical pencil and an electrosurgical generator, where the electrosurgical pencil is held and moved by the surgeon while the electrosurgical generator remains in a fixed position during the surgical procedure.

[0021] In some examples, the surgical instrument(s) 114 can be operated entirely by the surgeon without robotic assistance. In other examples, the surgical instrument(s) 114 can include partially automated robotic devices operated by the surgeon and / or fully automated robotic devices that perform the surgical procedure based on pre-operative programming inputs into the surgical instrument(s) 114 by the surgeon.

[0022] 1, the controller 110 may receive instrument data from the surgical instrument(s) 114 related to the operation of the surgical instrument(s) 114 during the surgical procedure(s). The instrument data may be based on one or more instrument parameters determined by the surgical instrument 114 at multiple time points during each surgical procedure.

[0023] In some embodiments, the instrument parameter(s) can be sensed by an instrument sensor 118 coupled to the surgical instrument 114. By way of example, the instrument sensor 118 can include one or more sensors selected from the group consisting of a current sensor, a voltage sensor, a power sensor, a flow sensor configured to detect a flow rate of a liquid, a flow sensor configured to detect a flow rate of a gas, a temperature sensor, an accelerometer, a piezoelectric sensor, a force sensor (e.g., a ground reaction force sensor), a vibration sensor, a chemical sensor, an optical sensor, a pressure sensor, a humidity sensor, a position sensor, a Hall effect sensor, a capacitive sensor, and a Doppler flow sensor. In some examples, the instrument sensor 118 can be removably coupled to the housing of the surgical instrument(s) 114. In other examples, the instrument sensor 118 can additionally or alternatively be non-removably coupled to the housing of the surgical instrument(s) 114 (e.g., disposed within an internal cavity of the housing of the surgical instrument(s) 114).

[0024] In other embodiments, the surgical instrument(s) 114 may additionally or alternatively determine the instrument parameter(s) separately from the instrument sensor 118. For example, in some embodiments, the surgical instrument(s) 114 may determine the instrument parameter(s) based on a setting and / or operating mode of the surgical instrument(s) 114. As an example, in one embodiment in which the surgical instrument(s) 114 comprises a bone drill, the instrument parameter(s) of drilling rate and / or torque may be determined based on a setting selected from among multiple settings of the surgical instrument(s) 114. As another example, in one embodiment in which the surgical instrument(s) 114 comprises an electrosurgical pencil and an electrosurgical generator, the instrument parameter(s) of power and waveform of the electrosurgical energy applied to tissue by the electrosurgical pencil may be determined based on a setting selected from among multiple settings of the electrosurgical generator.

[0025] Generally, the surgical navigation system 116 is configured to determine the position of one or more of the surgical instrument(s) 114 relative to the patient's anatomy during a surgical procedure. In some embodiments, the surgical navigation system 116 can additionally or alternatively determine the orientation of the surgical instrument(s) 114 relative to the patient's anatomy. By way of example, the surgical navigation system 116 can be configured to determine the position data using at least one surgical navigation modality selected from the group consisting of: (i) electromagnetic surgical navigation, (ii) optical surgical navigation, (iii) ultrasound surgical navigation, and (iv) machine vision surgical navigation.

[0026] For example, in one embodiment in which the surgical navigation system 116 is configured to use electromagnetic surgical navigation, the surgical navigation system 116 can include an electromagnetic field generator and a position sensor. The electromagnetic field generator can be positioned to emit an electromagnetic field at the patient's anatomy. The position sensor can include a current sensor (e.g., a sensor coil) that can sense the electromagnetic field and, in response, generate a position sensor signal based on one or more characteristics of the electromagnetic field at a given location of the position sensor. In this example, the position sensor can be coupled to the surgical instrument(s) 114 such that the position signal generated by the position sensor indicates the position and / or orientation of the surgical instrument(s) relative to the patient's anatomy.

[0027] In one embodiment in which the surgical navigation system 116 is configured to use optical surgical navigation, the surgical navigation system 116 can include one or more cameras configured to track one or more fiducial markers coupled to the surgical instrument(s) 114 and / or the patient's anatomy. The fiducial markers can include one or more passive markers (e.g., one or more markers that reflect light) and / or one or more active markers (e.g., one or more markers that emit light).

[0028] In one embodiment in which the surgical navigation system 116 is configured to use ultrasonic surgical navigation, the surgical navigation system 116 may include one or more ultrasonic signal emitters and one or more ultrasonic signal detectors coupled to the surgical instrument(s) 114 and / or the patient's anatomy. The ultrasonic signal emitter(s) may emit ultrasonic signals, the ultrasonic signal detectors may detect the ultrasonic signals emitted by the ultrasonic signal emitter(s), and the surgical navigation system 116 may determine position data based on the ultrasonic signals emitted by the ultrasonic signal emitter(s) and the ultrasonic signals received by the ultrasonic signal detector(s) (e.g., based on the time of flight(s) between the ultrasonic signal emitter(s) and the ultrasonic signal detector(s)).

[0029] In one embodiment in which the surgical navigation system 116 is configured to use machine-vision based surgical navigation, the surgical navigation system 116 may include one or more light sources and / or one or more cameras. The light source(s) may illuminate the patient's anatomy and / or the surgical instrument(s) 114. The camera(s) may capture one or more images of the patient's anatomy and / or the surgical instrument(s) 114 at the surgical site during the surgical procedure. The surgical navigation system 116 may process the image(s) to determine position data indicative of the position of the surgical instrument(s) 114 relative to the patient's anatomy.

[0030] In some examples, the surgical navigation system 116 can include one or more position sensors 120 that can be coupled to the surgical instrument(s) 114 and / or the patient's anatomy. The position sensor(s) 120 can be detectable by one or more components of the surgical navigation system 116 (e.g., via electromagnetic, optical, and / or ultrasonic detection), and the surgical navigation system 116 can determine position data based on the detected position sensor(s) 120. In other examples, the surgical navigation system 116 can omit the position sensor(s) 120.

[0031] In some examples including position sensor(s) 120, the surgical navigation system 116 may include a registration system configured to establish a frame of reference for the patient's anatomy and the position sensor(s) 120 (and thus the position of the surgical instrument(s) 114 as indicated by the position sensor(s) 120). For example, in one embodiment, the position sensor(s) 120 may be traced along features of the patient's anatomy to establish the frame of reference. In another embodiment, for example, the surgical navigation system 116 may include one or more contact points in the patient's anatomy. At each contact point, the surgical navigation system 116 may register the contact point in space and use the registered contact point to determine the frame of reference for the patient's anatomy in space (e.g., using a three-dimensional coordinate system). In this manner, the position sensor(s) 120 and the patient's anatomical structure can be mapped to a common frame of reference such that the position of the surgical instrument(s) 114 sensed by the position sensor(s) 120 can be correlated (e.g., mapped in space) to the patient's anatomical structure.

[0032] In some examples, the surgical navigation system 116 can be an image-guided surgery system configured to correlate the sensed position of the surgical instrument(s) 114 with one or more images of the patient's anatomy (e.g., pre-operative image(s) of the patient's anatomy acquired prior to a surgical procedure) in real time. By way of example, the image(s) can be at least one image type selected from the group consisting of a computerized tomography (CT) scan, a magnetic resonance imaging (MRI), and a three-dimensional map. In some embodiments in which the surgical navigation system 116 is an image-guided surgery system, the surgical navigation system 116 can be configured to provide positional data and image data related to the patient's anatomy to the controller 110. In such embodiments, both the image data and the positional data can be related to a common frame of reference related to the patient's anatomy. In other embodiments, the surgical navigation system 116 can provide positional data to the controller 110 without providing image data.

[0033] As described above, the surgical instrument(s) 114 can provide instrument data to the controller 110, and the surgical navigation system 116 can provide position data to the controller 110. In some examples, the surgical instrument(s) 114 and / or the surgical navigation system(s) 116 can be communicatively coupled to the controller 110 via a network. Examples of networks can include one or more of the following: a direct or indirect physical communication connection, a mobile communication network, the Internet, an intranet, a local area network, a wide area network, a storage area network, and any other form of connecting two or more systems, components, or storage devices together.

[0034] The controller 110 is a computing device configured to receive data (e.g., instrument data and / or position data) from surgical devices 112 operated during one or more surgical procedures and, based on this data, determine a plurality of surgical performance metrics that characterize surgical performance. The controller 110 can be implemented using hardware, software, and / or firmware. For example, the controller 110 can include one or more processors 122 and a non-transitory computer-readable medium 124 (e.g., volatile and / or non-volatile memory) that stores machine instructions or other executable instructions. These instructions, when executed by the one or more processors 122, cause the system 100 to perform the various operations described herein. The controller 110 can thus receive data (including data indicated by the surgical instrument(s) 114 and / or surgical navigation system(s) 116) and can also store this data in memory.

[0035] The processor(s) 122 and / or non-transitory computer-readable medium 124 may be implemented in any number of physical devices / machines. For example, the controller 110 may include one or more shared or dedicated general-purpose computer systems / servers. Accordingly, principles and advantages of distributed processing, such as redundancy, replication, etc., may also be implemented as desired to increase the robustness and performance of the controller 110 devices and systems.

[0036] The physical devices / machines may be implemented by preparing integrated circuits or by interconnecting an appropriate network of conventional component circuits, as will be appreciated by those skilled in the electrical art(s). The physical devices / machines may include, for example, field programmable gate arrays (FPGAs), application-specific integrated circuits (ASICs), digital signal processors (DSPs), etc. The physical devices / machines may reside on wired or wireless networks, e.g., LANs, WANs, the Internet, the cloud, near-field communications, etc., to communicate with each other and / or with other systems, e.g., Internet / web resources.

[0037] As described above, the controller 110 can receive data from the surgical devices 112 operated during one or more surgical procedures and, based on this data, determine a plurality of surgical performance metrics that characterize the surgical performance. In one example, a non-transitory computer-readable medium 124 has executable instructions stored on it to cause the processor(s) 122 to perform functions including determining a plurality of treatment datasets for a plurality of surgical procedures and, based on the plurality of treatment datasets, determining a plurality of surgical performance metrics that characterize the surgical performance.

[0038] In this example, determining the multiple treatment data sets may include, for each surgical procedure of the plurality of surgical procedures, determining a respective treatment data set of the plurality of treatment data sets by: (i) receiving instrument data from the surgical instrument(s) 114 related to operation of the surgical instrument(s) 114 during the surgical procedure, the instrument data being based on one or more instrument parameters determined by the surgical instrument(s) 114 at multiple time points during the surgical procedure; (ii) receiving position data from the surgical navigation system(s) 116 indicating the position of the surgical instrument(s) 114 relative to the patient's anatomy at the multiple time points during the surgical procedure; (iii) determining kinematic data at the multiple time points based on at least one of the position data or the instrument data; and (iv) correlating the instrument data, position data, and kinematic data for each of the multiple time points to determine a respective treatment data set for the surgical procedure.

[0039] By way of example, the kinematic data may include (i) the trajectory of the surgical instrument(s) 114, (ii) the velocity of the surgical instrument(s) 114, (iii) the motion of the surgical instrument(s) 114 in three-dimensional space, (iv) the inertia of the surgical instrument(s) 114, (v) the acceleration of the surgical instrument(s) 114, (vi) the chatter of the surgical instrument(s) 114 (e.g., movement due to interaction between the surgical instrument(s) 114 and the patient's anatomy, such as the surgical instrument(s) 114 bouncing off the patient's bone), and (vii) the movement of the surgical instrument due to, for example, unsteadiness of the surgeon's hand. The kinematic data may include data for one or more kinematic parameters selected from the group consisting of: (i) jitter of the surgical instrument(s) 114, (ii) smoothness of the movement of the surgical instrument(s) 114 (e.g., clumsiness of the movement of the surgical instrument(s) 114 due to relatively rapid starts and stops and / or relatively rapid changes in direction of movement), (iii) applied force applied by the surgical instrument(s) 114 to the patient's anatomy at the surgical site, (iv) deviation of the movement of the surgical instrument(s) 114 relative to the pre-operative planned path, and (v) the location of motion of the surgical instrument(s) 114 relative to the pre-operative planned target site. Thus, the kinematic data may include information regarding the intended movement of the surgical instrument(s) 114 by the surgeon relative to the patient's anatomy, the unintended movement of the surgical instrument(s) 114 by the surgeon relative to the patient's anatomy, and / or the movement of the surgical instrument(s) 114 due to interaction with the patient's anatomy.

[0040] As described above, the processor 122 can correlate the instrument data, position data, and kinematic data with each other at multiple points in time. In one example, the processor 122 can correlate the instrument data, position data, and kinematic data with each other based on timing information (e.g., timestamp information) provided by the surgical instrument(s) 114 and the surgical navigation system(s) 116. This temporal synchronization of the instrument data, position data, and kinematic data can enable each procedure data set to more completely represent a picture of how the surgeon used the surgical instrument(s) 114 and / or how the surgical instrument(s) 114 themselves performed during the surgical procedure compared to considering such data alone. Additionally, because the underlying data for the procedure data sets is obtained from the surgical device(s) 112 used to perform the surgical procedure, the processor 122 can determine surgical performance metrics based on objective data, which can provide a more consistent and superior basis for evaluating and characterizing surgical performance compared to traditional approaches (e.g., based on subjective peer review of video footage).

[0041] In some examples, the processor 122 can determine surgical performance metrics using descriptive, diagnostic, predictive, and / or prescriptive analytics to analyze the procedure data sets. The processor 122 can, for example, analyze the procedure data sets to identify patterns in surgical techniques (e.g., as indicated by instrument data, positional data, and kinematic data) that are predictive of clinical outcomes. In some examples, the processor 122 can additionally or alternatively determine surgical performance metrics by using the procedure data sets as training data for machine learning algorithms. Because the surgical performance metrics are determined based at least in part on procedure data sets from multiple surgical procedures, the processor 122 can analyze procedure data sets from multiple surgical performances to gain insights that may be useful for future surgical procedures. Indeed, as described in further detail below, the surgical performance metrics can provide a basis for pre-operative planning of future surgical procedures, provide intra-operative feedback to the surgeon during the surgical procedure, and / or provide post-operative feedback to the surgeon and / or patient regarding the performance of the surgical procedure.

[0042] In some examples, determining the surgical performance metric can include (i) detecting the occurrence of a surgical event during one or more of the surgical procedures based on the procedure datasets, (ii) identifying one or more portions of the procedure datasets indicative of a cause of the occurrence of the surgical event, and (iii) determining the surgical performance metric based on the one or more portions of the procedure datasets identified as indicative of a cause of the occurrence of the surgical event. By way of example, the surgical event can be at least one event selected from the group consisting of: (i) rattle of the surgical instrument(s) 114; (ii) a wrap event (e.g., wrapping of gauze and / or tissue around a rotating element of the surgical instrument(s) 114); (iii) overheating of the surgical instrument(s) 114; and (iv) proximity of the surgical instrument to a critical anatomical structure. In such examples, the surgical performance metric can provide information that can assist in better understanding characteristics of surgical performance that may increase and / or decrease the risk of the occurrence of a surgical event. This information can assist in pre-operative planning of upcoming surgical procedures, providing intra-operative feedback to the surgeon during the surgical procedure, and / or providing post-operative information that provides feedback regarding the performance of the surgical procedure.

[0043] As described above, surgical performance metrics characterize surgical performance. In one example, a surgical performance metric can include one or more thresholds that define a range of expected values ​​for at least one of (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data. In some embodiments, the threshold(s) can be communicated to the surgeon pre-operatively to provide guidance for performing a future surgical procedure, intra-operatively to provide the surgeon with real-time feedback during the surgical procedure, and / or post-operatively to provide the surgeon with feedback regarding when and / or when the surgeon exceeds and / or deviates from the threshold(s) during the surgical procedure and / or the amount by which the threshold(s) are exceeded and / or deviated from. Further uses of surgical performance metrics, including threshold(s), are described in more detail below.

[0044] In another example, the surgical performance metric may additionally or alternatively define a scoring system that evaluates instrument data, positional data, and kinematic data of at least one surgical procedure selected from the plurality of surgical procedures. For example, in one embodiment, the surgical performance metric may define data for comparison with the instrument data, positional data, and / or kinematic data of the surgical procedure being scored. The surgical performance metric may further define one or more scores that may be based on a comparison between the surgical performance metric and the instrument data, positional data, and / or kinematic data of the surgical procedure being scored.

[0045] In another example, the surgical performance metric may additionally or alternatively define a classification system that classifies multiple types of surgical techniques. For example, the multiple types of surgical techniques may include two or more types selected from the group consisting of: (i) an aggressive approach to surgical performance, (ii) a conservative approach to surgical performance, (iii) a smoother approach to surgical performance, (iv) a jerky approach to surgical performance, (v) a relatively fast approach to surgical performance (e.g., less time to perform the surgical procedure), and (vi) a relatively slow approach to surgical performance.

[0046] In another example, the surgical performance metric may additionally or alternatively provide for determining multiple reference fingerprints. For example, the controller 110 may use one or more dimensionality reduction techniques to identify, extract, and summarize characteristics of a surgical technique into a unique identifier. In one example, the controller 110 may be further configured to provide recommendations and / or guidance related to a surgical technique, settings for the surgical instrument(s) 114, selection of a subset of the surgical instrument(s) 114 from among the plurality of surgical instruments 114, and / or selection of work elements for the surgical instrument(s) 114 from among the plurality of work elements based on the reference fingerprints. For example, the controller 110 may be configured to determine a query fingerprint for a particular surgeon based on one or more surgical procedures performed by the surgeon, compare the query fingerprint to the reference fingerprints, identify a reference fingerprint that best matches the query fingerprint, and provide information associated with the identified reference fingerprint to the surgeon before and / or during the surgery to facilitate the surgical procedure.

[0047] In some embodiments, the surgical instrument(s) 114 and the surgical navigation system(s) 116 can be a single surgical instrument 114 and a single surgical navigation system 116 used during an entire surgical procedure. For example, the surgical procedure can be performed using reusable surgical instrument(s) 114 and reusable surgical navigation system(s) 116 in a single location (e.g., in a single operating room). In other embodiments, different surgical instruments 114 and / or different surgical navigation systems 116 can be used during a surgical procedure. For example, instrument data can be obtained from the surgical instrument 114 and / or position data can be obtained from the surgical navigation system 116 at multiple different locations. Additionally or alternatively, for example, the surgical instrument 114 and / or the surgical navigation system 116 can be disposable devices intended to be discarded after use during a single surgical procedure.

[0048] In the example described above, the controller 110 can determine surgical performance metrics based on instrument data and position data. In other examples, the controller 110 can evaluate and / or assist surgical performance based on additional or alternative sources of information.

[0049] Figure 2 shows a simplified schematic diagram of a system 200 including one or more additional surgical devices 112 and / or one or more data sources 226, according to another example. As shown in Figure 2, system 200 includes controller 110 and surgical device(s) 112, as described above with respect to Figure 1. In Figure 2, controller 110 includes processor(s) 122 and non-transitory computer-readable medium 124, and surgical device(s) 112 can include surgical instrument(s) 114 and surgical navigation system(s) 116, as described above with respect to Figure 1.

[0050] 2, data source(s) 226 can include one or more data sources selected from the group consisting of outcome data source 228, surgeon history data source 230, and patient-specific data source 232. Data source(s) 226 can each be communicatively connected to controller 110 (e.g., via a network such as described above with respect to surgical instrument(s) 114, surgical navigation system(s) 116, and controller 110). Processor 122 can use the data provided by data source(s) 226 regarding the procedural dataset to determine surgical performance metrics.

[0051] In examples including outcome data source 228, outcome data source 228 can store outcome data related to post-operative outcomes of surgical procedures. In such examples, processor 122 can additionally or alternatively receive, for each surgical procedure, respective outcome data related to the post-operative outcomes of that surgical procedure, and processor 122 can determine a plurality of surgical performance metrics further based on the respective outcome data. By way of example, the outcome data can include an indication of at least one post-operative outcome selected from the group consisting of: (i) patient-reported pain score, (ii) length of hospital stay, (iii) post-operative complications, (iv) recovery of function, (v) relief of presenting symptoms, and (vi) mortality. Determining surgical performance metrics based on sets of procedure data and outcome data associated with each set of procedure data can assist in identifying aspects of instrument data, positional data, and kinematic data (which can be indicative of surgical technique) that may result in positive and / or negative surgical outcomes. This can further assist in determining surgical performance metrics that can provide actionable insights to surgeons.

[0052] In examples including surgeon historical data source 230, the historical surgeon data source can store historical surgeon data. In such examples, processor 122 can additionally or alternatively receive, for each surgical procedure of the plurality of surgical procedures, historical surgeon data regarding one or more surgical procedures previously performed by the surgeon performing the surgical procedure, and processor 122 can further determine surgical performance metrics based on this historical surgeon data. By way of example, the historical surgeon data can include at least one item of information selected from the group consisting of: the number of surgical procedures previously performed, the type of surgical procedure previously performed, years of experience, the number of hours of surgical treatment performed by the surgeon, the surgeon's license, and the average time to complete a surgical procedure. Determining surgical performance metrics based on sets of procedure data and the historical surgeon data associated with each set of procedure data can also assist in identifying aspects of instrument data, positional data, and kinematic data that may result in positive and / or negative surgical outcomes for surgical procedures performed by surgeons with certain experience levels and / or surgical tendencies. As described in further detail below, historical surgeon data can additionally or alternatively be used to determine surgical performance metrics based on pre-operative information provided about future surgical performance performed by a particular surgeon.

[0053] In examples including patient-specific data source 232, the patient-specific data source can store patient-specific data related to one or more health records of a patient of a surgical procedure. In such examples, processor 122 can additionally or alternatively receive, for each surgical procedure of the plurality of surgical procedures, patient-specific data related to one or more health records of the patient of that surgical procedure, and processor 122 can determine the surgical performance metric further based on the patient-specific data. By way of example, the patient-specific data can include at least one item of information selected from the group consisting of age, sex, height, weight, bone mineral density, body mass index, allergy indications, the patient's medical history, demographics, family health history, laboratory and test results, medications, medical history, progress notes, medical images (e.g., radiology images, CT images, and / or MRI images), immunizations, patient reported outcome measures (PROMs), and information related to the nature of the patient's medical condition (e.g., tissue and / or bone characteristics). Determining surgical performance metrics based on sets of procedure data and patient-specific data associated with each set of procedure data can also assist in identifying aspects of the instrument, positional, and kinematic data that may result in good and / or poor surgical outcomes for patients with certain medical histories and / or health conditions. As described in further detail below, the patient-specific data can additionally or alternatively be used to determine surgical performance metrics based on pre-operative information provided about the performance of upcoming surgeries to be performed on particular patients.

[0054] As mentioned above, in some examples, the processor(s) 122 may receive image data related to the patient's anatomy from the surgical navigation system 116. In other examples, the processor(s) 122 may additionally or alternatively receive image data from a patient-specific data source 232. The image data received from the patient-specific data source 232 and the position data received from the surgical navigation system may both be relative to a common frame of reference related to the patient's anatomy. For example, the image data received from the patient-specific data source may be generated using a registration system separate from the surgical navigation system 116.

[0055] As shown in FIG. 2, the surgical device(s) 112 may additionally or alternatively include one or more patient monitoring device(s) 234 communicatively connected to the controller 110. The patient monitoring device(s) 234 may determine patient physiological data related to the patient's physiological state at multiple points during the surgical procedure. By way of example, the patient physiological data may relate to at least one physiological parameter selected from the group consisting of: (i) the patient's heart rate, (ii) the patient's respiratory rate, (iii) the patient's temperature, (iv) the patient's blood pressure, and (v) the patient's oxygen saturation. As shown in FIG. 2, the patient monitoring device(s) 234 may include one or more patient sensors 236 configured to sense the physiological parameter.

[0056] In examples including one or more patient monitoring devices 234, the processor 122 may receive, for each surgical procedure of the plurality of surgical procedures, patient physiological data related to the patient's physiological state at multiple time points during the surgical procedure. Additionally, for each surgical procedure of the plurality of surgical procedures, the processor 122 may determine a respective treatment dataset by correlating the instrument data, position data, kinematic data, and patient physiological data for each of the multiple time points to determine a respective treatment dataset for the surgical procedure.

[0057] As shown in FIG. 2, the surgical device(s) 112 can additionally or alternatively include one or more surgeon monitoring devices 238 communicatively connected to the controller 110. The surgeon monitoring device(s) 238 can determine surgeon physiological data related to the surgeon's physiological state at multiple points during the surgical procedure. By way of example, the surgeon physiological data can relate to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's respiratory rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) the surgeon's degree of pupil dilation, (vi) the surgeon's degree of eye fixation, (vii) the surgeon's degree of saccades, and (viii) the surgeon's degree of body movement. As shown in FIG. 2, the surgeon monitoring device(s) 234 can include one or more surgeon sensors 240 configured to sense the physiological parameters. By way of example, the surgeon monitoring device(s) 238 may include wearable sensors that contact the surgeon's skin (e.g., an Oura ring and / or a strap-based sensor) and / or wearable sensors that can monitor the surgeon's eyes (e.g., eyeglasses with eye-tracking features).

[0058] In examples including one or more surgeon monitoring devices 238, processor 122 may receive, for each surgical procedure of the plurality of surgical procedures, surgeon physiological data related to the surgeon's physiological state at multiple time points during the surgical procedure. Additionally, for each surgical procedure of the plurality of surgical procedures, processor 122 may determine a respective treatment dataset by correlating instrument data, position data, kinematic data, and surgeon physiological data for each of the multiple time points to determine a respective treatment dataset for that surgical procedure. By determining surgical performance metrics based on treatment datasets including surgeon physiological data, the surgical performance metrics may provide insight into how the surgeon physiological data may affect patient outcomes.

[0059] The surgeon physiological data can additionally or alternatively provide an indication regarding the cognitive load on a surgeon performing a surgical procedure. As described in further detail below, processor 122 can use the surgeon physiological data to determine when the surgeon's cognitive load is high and, accordingly, can provide feedback to assist in reducing the cognitive load.

[0060] In other examples, one or more of the surgeon monitoring device(s) 238 may be coupled to the surgeon, and at least one of the surgeon monitoring device(s) 238 may be coupled to one or more other members of the surgical team. In such examples, the surgeon monitoring device(s) 238 may determine surgeon physiological data related to the physiological state of the surgeon and other members of the surgical team at multiple points during the surgical procedure, as described above.

[0061] Additionally, as noted above, the physiological conditions sensed by the surgeon monitoring device(s) may, in some instances, further provide an indication of the surgeon's state of mind. Thus, in some instances, determining surgical performance metrics based on a procedural dataset that includes surgeon physiological data may also provide insight into how the mental or emotional state of the surgeon and / or other members of the surgical team may affect patient outcomes.

[0062] 2, system 200 may additionally or alternatively include a user interface 242 that may receive one or more inputs from a user and / or provide one or more outputs to a user. By way of example, user interface 242 may include one or more buttons, one or more switches, one or more dials, one or more keypads, one or more touch screens, one or more displays 244, one or more indicator lights, one or more speakers, and / or one or more tactile output devices. User interface 242 may be communicatively coupled to controller 110.

[0063] As described above, the controller 110 can determine surgical performance metrics and provide pre-operative, intra-operative, and / or post-operative information regarding one or more surgical procedures to a surgeon and / or patient. Exemplary embodiments for providing pre-operative, intra-operative, and / or post-operative information regarding a surgical procedure to a surgeon and / or patient are described below.

[0064] In one example, processor 122 can receive pre-operative information for a surgical procedure to be performed. Processor 122 can receive the pre-operative information from, for example, user interface 242 and / or data source 226. The pre-operative information can include patient-specific data for a patient for the surgical procedure to be performed and / or historical surgeon data for a surgeon for the surgical procedure to be performed. The pre-operative information can additionally or alternatively include surgeon preference data 246 related to one or more preferences of the surgeon performing the surgical procedure. By way of example, surgeon preference data 246 can include one or more preferences selected from the group consisting of: (i) preferences regarding the type of surgical instrument(s) 114, (ii) preferences regarding the settings of the surgical instrument(s) 114, (iii) preferences regarding the manner in which the surgical instrument(s) 114 are held or grasped, and (iv) preferences regarding the order of steps for performing the surgical procedure.

[0065] The processor 122 may use the pre-operative information to determine a plurality of surgical performance metrics. For example, the processor 122 may be configured to determine the surgical performance metrics using the pre-operative information and the procedure dataset as inputs. In this manner, the surgical performance metrics may be tailored to the particular conditions of the surgical procedure being performed, as compared to implementations that do not use pre-operative information as inputs.

[0066] The processor 122 can receive instrument data from the surgical instrument(s) 114 related to the operation of the surgical instrument(s) 114 at multiple time points during the surgical procedure. The processor 122 can also receive position data from the surgical navigation system(s) 116 indicating the position of the surgical instrument relative to the patient's anatomy at multiple time points during the surgical procedure. The processor 122 can determine kinematic data at the multiple time points based on the position data. The processor 122 can then perform an analysis of (i) the kinematic data and the instrument data against (ii) multiple surgical performance metrics.

[0067] The processor 122 may cause the user interface 242 to output information based on the analysis to provide feedback to the surgeon regarding the performance of the surgical procedure. The user interface 242 may output the information via the display device 244, speaker(s), indicator light(s), and / or tactile device(s). Examples of information that may be displayed on the display device 244 are shown in and described below with respect to Figures 3-8.

[0068] In some embodiments, the processor 122 can determine multiple surgical performance metrics pre-operatively and output the information. For example, the processor 122 can determine a treatment plan for performing a surgical procedure based on the pre-operative information and / or the surgical performance metrics. The processor 122 can output information related to the treatment plan to the user interface 242. By way of example, the treatment plan can include at least one item of information selected from the group consisting of: (i) a pre-operative planned trajectory of movement of the surgical instrument(s) 114 and / or surgical implants, (ii) a target location for actuating the surgical instrument(s) 114, (iii) a selection of the surgical instrument(s) 114 from among multiple possible surgical instruments 114, and (iv) a potential complication that may occur.

[0069] In some embodiments, processor 122 may additionally or alternatively perform intra-operative analysis in real time during a surgical procedure and output information to user interface 242. By way of example, user interface 242 may output at least one item of information selected from the group consisting of: (i) a prediction of the occurrence of an adverse event (e.g., violation of a critical anatomical structure), (ii) an alert of suboptimal performance of surgical instrument 114, (iii) an alert of deviation from a pre-operative plan, and (iv) an alert of suboptimal psychological and / or physiological state of the surgeon and / or surgical team. This may assist in providing real-time feedback to assist in enhancing surgical performance during a surgical procedure.

[0070] In some embodiments including surgeon monitoring device(s) 238, processor 122 may receive surgeon physiological data related to the physiological state of the surgeon performing the surgical procedure. Processor 122 may further determine, based on the surgeon physiological data, that the cognitive load on the surgeon is greater than a threshold amount of cognitive load. In response to determining that the cognitive load on the surgeon is greater than a threshold amount of cognitive load, processor 122 may cause this information to be output to user interface 242. In some examples, the information output by user interface 242 may include instrument guidance information for operating a surgical instrument based on a plurality of surgical performance metrics. In other examples, the information output by user interface 242 may additionally or alternatively include kinematic guidance for navigating surgical instrument(s) 114 based on a plurality of surgical performance metrics.

[0071] In some embodiments, processor 122 may additionally or alternatively perform post-operative analysis and output that information to user interface 242. For example, user interface 242 may provide information that provides a post-operative review of the surgeon's surgical performance during the surgical procedure.

[0072] In another example, the processor 122 can additionally or alternatively determine and / or iteratively update surgical performance metrics based on instrument data, position data, and / or kinematic data received during a surgical procedure. For example, in another example, the processor 122 can receive instrument data from the surgical instrument(s) 114 related to the operation of the surgical instrument(s) 114 at multiple time points during the surgical procedure. The processor 122 can additionally receive position data from the surgical navigation system 116 indicating the position of the surgical instrument(s) 114 relative to the patient's anatomy at multiple time points during the surgical procedure. The processor 122 can determine kinematic data at multiple time points based on the position data, and can use the instrument data and kinematic data to determine surgical performance metrics that characterize surgical performance. The processor 122 can also perform an analysis of (i) the kinematic data and the instrument data against (ii) multiple surgical performance metrics. Processor 122 may further cause user interface 242 to output information based on this analysis that provides feedback to the surgeon regarding the performance of the surgical procedure. Processor 122 may cause user interface 242 to output this information pre-operatively, intra-operatively, and / or post-operatively, as described above. In one embodiment in which processor 122 may output information to user interface 242 intra-operatively, processor 122 may determine and analyze surgical performance metrics in real time during the surgical procedure and output the information to the user interface. Processor 122 may additionally or alternatively output information to the user interface in response to processor 122 determining that the cognitive load level is greater than a threshold amount of cognitive load, as described above.

[0073] In some examples, the processor 122 may additionally or alternatively cause the surgical instrument 114 to automatically adjust one or more of the instrument parameter(s) based on instrument data, positional data, kinematic data, surgeon physiological data, patient physiological data, and / or surgical performance metrics received during a surgical procedure. For example, the processor 122 may cause the surgical instrument 114 to adjust motor speed, direction of motor rotation, motor torque, motor temperature, motor current, and motor power consumption, electrosurgical current, electrosurgical voltage, electrosurgical waveform, electrosurgical impedance (e.g., resistance experienced by the surgical instrument(s) 114 while cutting / aspirating / coagulating tissue), irrigation flow rate, aspiration flow rate, depth control (e.g., screw placement depth level and / or cutting depth), and camera visibility settings (e.g., lighting intensity, white balance setting, image magnification setting, focus setting, image enhancement function, and / or air and water inhalation settings) during surgery. This can assist, for example, in automatically adjusting the operation of the surgical instrument 114 to (i) guide the surgical procedure toward surgical performance metrics, (ii) reduce the risks associated with high cognitive load, and / or (iii) reduce the risks associated with changes in the patient's condition during the surgical procedure.

[0074] In one embodiment, the processor 122 may perform an analysis of (i) the kinematic data and the instrument data against (ii) a plurality of surgical performance metrics. Based on this analysis, the processor 122 may further determine adjustments to the instrument parameter(s) and, in response, cause the surgical instrument 114 to adjust one or more instrument parameters according to the adjustments to the instrument parameter(s).

[0075] In some embodiments, processor 122 can additionally or alternatively receive surgeon physiological data related to the physiological state of a surgeon performing a surgical procedure. Processor 122 can determine, based on the surgeon physiological data, that the cognitive load on the surgeon is greater than a threshold amount of cognitive load. In response to determining that the cognitive load on the surgeon is greater than the threshold amount of cognitive load, processor 122 can cause surgical instrument 114 to adjust one or more instrument parameters.

[0076] In some examples, processor 122 and user interface 242 can be configured to enable a surgeon and / or an institution (e.g., the surgeon's employer and / or hospital administrator for whom the surgeon has practice privileges) to set one or more goals for surgical performance. For example, processor 122 can additionally or alternatively be configured to receive surgical performance goal data from user interface 242 regarding one or more goals for surgical performance. By way of example, the one or more goals for surgical performance may include one or more of the following goals selected from the group consisting of: (i) understanding a surgeon's surgical technique; (ii) understanding the management of workflow in the operating room; (iii) improving safety associated with surgical technique; (iv) achieving a balance between safety and effectiveness; (v) understanding the surgical outcomes of surgical procedures performed by the surgeon; (vi) reducing complication rates; (vii) earning continuing professional development (CPD) credits; (viii) training operating room staff; (ix) understanding patient factors; (x) reducing the surgeon's physical fatigue; and / or (xi) learning and improving surgical skills.

[0077] The user interface 242 can receive user input selecting one or more of the surgical performance goals and communicate this user input to the processor 122. In some embodiments, the processor 122 can determine surgical performance goal data based on the user input. The processor 122 can further set and / or adjust surgical performance metrics based on the surgical performance goal data. In such embodiments, the surgical performance goals can help fine-tune the surgical performance metrics and guide current and / or future surgical performance toward the surgeon's and / or institution's desired values.

[0078] In some embodiments, processor 122 can additionally or alternatively be configured to provide information based on surgical performance metrics to the surgeon pre-operatively, intra-operatively, and / or post-operatively. In such embodiments, processor 122 can use surgical performance goal data to determine what information to provide, when to provide that information, and how to provide that information to the surgeon to facilitate the surgeon's improvement toward surgical performance goals (e.g., selected via user interface 242). Accordingly, processor 122 can (i) perform an analysis of one or more data sets (e.g., instrument data, positional data, kinematic data, outcome data, historical surgeon data, patient-specific data, image data, patient physiological data, and / or surgeon physiological data) as described above, and (ii) determine information based on this analysis and the surgical performance goal data that can be output to the surgeon via user interface 242. In this example, for a given data set, processor 122 is configured to cause user interface 242 to output a first informational set of first surgical performance goal data and a second informational set of second surgical performance goal data. Here, the first surgical performance goal data is different from the second surgical performance goal data, and the first information set is different from the second information set.

[0079] In some embodiments, the processor 122 and user interface 242 can be configured to provide information indicative of progress toward surgical performance goals and / or information indicative of a lack of progress toward surgical performance goals, which can assist the surgeon and / or institution in better understanding how the surgeon performed and where the surgeon may want to focus their attention to further improve performance.

[0080] Referring now to FIG. 3 , a display screen 350 of an application for evaluating and / or assisting surgical performance is shown, according to an example. As shown in FIG. 3 , display screen 350 may include a summary of historical surgeon data for a particular surgeon. For example, display screen 350 may include a first display 352A of the number of surgical procedures performed within a given time frame and / or a second display 352B of the average amount of time it took to complete that number of surgical procedures. Display screen 350 may additionally include a first link 354A to upcoming scheduled surgical procedures to be performed by that surgeon, a second link 354B to past surgical procedures previously performed by that surgeon, and / or a third link 354C to personalized insights based on an analysis of a procedure dataset associated with that surgeon and surgical performance metrics determined by processor 122.

[0081] 4, another example display screen 450 of an application for assessing and / or assisting surgical performance is shown. In FIG. 4, processor 122 causes user interface 242 to display a graphical representation of at least one of instrument data, positional data, or kinematic data over time. For example, in FIG. 4, display screen 450 includes a respective identifier 456A-456E for each surgical instrument 114 and graphical representations 458A-458E of instrument data for surgical instruments 114 relative to an axis 460 representing multiple time points during a surgical procedure.

[0082] In this example, display screen 450 includes a first drill identifier 456A corresponding to a first graphical representation 458A of drill instrument data, a second camera identifier 456B corresponding to a second graphical representation 458B of camera instrument data, a third aspirator identifier 456C corresponding to a third graphical representation 458C of aspirator instrument data, a fourth bipolar electrosurgical device identifier 456D corresponding to a fourth graphical representation 458D of bipolar electrosurgical device instrument data, and a fifth aspirator identifier 456E corresponding to a fifth graphical representation 458E of aspirator instrument data.

[0083] In Figure 4, the plurality of surgical performance metrics define one or more ranges of expected values ​​for at least one of (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data. As shown in Figure 4, the processor 122 can cause the user interface to display an indication 462 that a portion of the instrument data was outside of at least one of the one or more ranges of expected values ​​defined by the plurality of surgical performance metrics.

[0084] As shown in FIG. 4, the processor 122 may additionally or alternatively cause the user interface 242 to display a link 464A to a pre-operative image of the anatomy of the surgical site and / or to display a link 464B to a post-operative image of the anatomy.

[0085] While FIG. 4 shows graphical representations 458A-458E of instrument data and an indication that the instrument data was outside of a range(s) of expected values, in other examples, processor 122 may cause user interface 242 to display a graphical representation of the kinematic data and / or an indication that a portion of the kinematic data was outside at least one of one or more ranges of expected values ​​defined by multiple surgical performance metrics.

[0086] 5, an example display screen 550 of an application for assessing and / or assisting surgical performance is shown, according to one example. In FIG. 5, display screen 550 includes multiple indicators 556A-556C corresponding to respective graphical representations 558A-558C of instrument parameters represented by instrument data at multiple time points (e.g., as indicated by axis 560) during a surgical procedure.

[0087] In Figure 5, the plurality of surgical performance metrics define one or more ranges of expected values ​​for at least one of (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data. As shown in Figure 5, the processor 122 can cause the user interface to display an indication 562 that a portion of the instrument data was outside at least one of the one or more ranges of expected values ​​defined by the plurality of surgical performance metrics.

[0088] 5 , the processor 122 can cause the user interface 242 to display an animation 564 of the movement of the surgical instrument 114 overlaid on an image of the anatomical structure based on the positional data and the kinematic data. In one example, the animation 564 can include multiple colors, each color based on the kinematic data. For example, the colors can provide a color-coded representation of the kinematic data such that the range of kinematic data values ​​is represented by N ranges, respectively, where N is an integer value greater than or equal to 3. In one exemplary embodiment, a first range of smoothness of movement can be represented by a first color, a second range of smoothness of movement can be represented by a second color, and an nth range of smoothness of movement can be represented by an nth color, where n is an integer value greater than or equal to 3.

[0089] Also, as shown in Figure 5, in embodiments where the kinematic data pertains to multiple kinematic parameters, the processor 122 may correlate the kinematic parameters with each other at multiple time points. Similarly, in embodiments where the instrument data pertains to multiple instrument parameters, the processor 122 may correlate the instrument parameters with each other at multiple time points.

[0090] 5, the tool data relates to the speed, chatter, and current of the surgical tool 114. In another example, the tool data may relate to the operation of the motor of the surgical tool(s) 114, and the tool data may relate to one or more tool parameters selected from the group consisting of motor speed, motor torque, motor temperature, motor current, and motor power consumption.

[0091] Referring now to Figure 6, a display screen 650 of an application for assessing and / or assisting surgical performance is shown, according to an example. In Figure 6, the processor 122 can cause the user interface 242 to display the amount of misalignment between (i) the actual location of the device implanted by the surgical instrument 114 and (ii) the pre-operatively planned location where the device was to be implanted by the surgical instrument 114. Additionally, in Figure 6, the processor 122 can cause the user interface to display an indication 666 of a threshold amount of misalignment defined by a plurality of surgical performance metrics.

[0092] 7, another example display screen 750 of an application for assessing and / or assisting surgical performance is shown. In FIG. 7, processor 122 can cause user interface 242 to simultaneously display (i) an animation 768 of the surgical procedure and (ii) a graphical representation of at least one of instrument data, positional data, or kinematic data of the surgical procedure over time.

[0093] 7, display screen 750 includes multiple indicators 756A-756C corresponding to respective graphical representations 758A-758C. In this example, graphical representations 758A-758C include (i) a first graphical representation 758A of the acceleration of the tip of surgical instrument 114 as indicated by kinematic data over multiple time points, (ii) a second graphical representation 758B of the force (e.g., measured by a force sensor) as indicated by instrument data over multiple time points, and (iii) the revolutions per minute (RPM) of the work element (e.g., a drill bit) of surgical instrument 114 over multiple time points. As shown in FIG. 7, processor 122 can be configured to time-synchronize the playback of animation 768 with the display of graphical representations 758A-758C such that display screen 750 can provide an indication of how surgical instrument 114 was operated at each time point during a surgical procedure.

[0094] As shown in FIG. 7 , the animation 768 can include animated objects representing the surgical instrument 114 and animated objects representing the patient's anatomy. In some examples, the processor 122 can determine the objects representing the patient's anatomy based on image data relating to the patient's anatomy. For example, as described above, the processor 122 can receive image data relating to the patient's anatomy from the surgical navigation system 116 and / or the patient-specific data source 232, and the processor 122 can determine the animated objects representing the anatomy based on this image data. This can provide a more realistic and / or more accurate visual representation of the surgical procedure compared to other examples in which the animated objects representing the anatomy are general representations of the anatomy. Meanwhile, in other examples, the animated objects representing the anatomy can be general representations of the anatomy. This can help, for example, to reduce the computational load on the processor 122.

[0095] In some examples, the processor 122 can determine the animation 768 based on instrument data, positional data, and kinematic data of the surgical procedure. Thus, the animation 768 can display (i) the relative position, orientation, and / or movement of the surgical instrument 114 with respect to the patient's anatomy, (ii) the actuation of the surgical instrument 114, and / or (iii) the interaction between the surgical instrument 114 and the patient's anatomy at multiple points during the surgical procedure. In such examples, the animation 768 can be specific to the procedure being performed by the practitioner, as opposed to a general animation. Additionally, this can help provide an improved visual representation of the use of the surgical instrument 114 and / or surgical technique. Meanwhile, in other examples, the animation 768 can be a general animation displayed for all performances of a particular type of surgical procedure. This can help, for example, to reduce the computational load on the processor 122.

[0096] In some examples, display screen 750 can further include surgical performance metrics displayed on animation 768. For example, in one example, processor 112 can cause display screen 750 to include a tool tip trajectory that is color-coded according to the smoothness of the movement of surgical instrument 114.

[0097] Additionally, in Figure 7, processor 122 can cause display screen 750 to display text 770 that can provide technique recommendations to the surgeon as feedback regarding the performance of the surgical procedure. In Figure 7, displayed text 770 provides technique recommendations regarding the technique of handling the surgical instrument 114. In another example, displayed text 770 can provide technique recommendations regarding recommendations for using different surgical instruments 114 and / or different work elements on the surgical instrument 114. Processor 122 can determine the text and technique recommendations based on one or more of an analysis of instrument data, positional data, kinematic data, and / or surgical performance metrics.

[0098] Referring now to Figure 8, another example display screen 850 of an application for evaluating and / or assisting surgical performance is shown. In Figure 8, the processor 122 can cause the user interface 242 to simultaneously display (i) an animation 768 of the surgical procedure and (ii) a video 872 recorded by an image capture device during the surgical procedure. As shown in Figure 8, the processor 122 can be configured to time-synchronize the playback of the animation 768 and the display of the video 872 so that the display screen 850 can provide an indication of how the surgical instrument 114 was operated at each point during the surgical procedure.

[0099] 8 , the image capture device is external to the surgical site such that the video 872 shows the practitioner's hands and / or body from outside the surgical site. In contrast, the animation 768 can show how the surgical instrument 114 interacted with the patient's anatomy within the surgical site. In this manner, the video 872 can help show how the practitioner grasped, moved, and / or actuated the surgical instrument in time synchronization with the animation 768 showing the resulting effects at the surgical site. This can help provide additional or alternative insight into the surgical techniques used during the surgical procedure.

[0100] In other examples, the image capture device may be one of the surgical instruments 114 such that video is acquired from within the surgical site. For example, the video may be captured by an endoscope, a surgical microscope, and / or an exoscope. In such examples, displaying the animation 768 time-synchronized with the video 872 may assist the practitioner in reviewing the surgical procedure in conjunction with a view from the surgical site that was actually available to the practitioner during the surgical procedure.

[0101] 9, a flowchart of a process 900 for evaluating surgical performance of a surgical procedure, according to an example, is shown in FIG. 9. As shown in FIG. 9, the process 900 includes determining, at block 910, a plurality of treatment data sets for a plurality of surgical procedures, and determining, at block 912, a plurality of surgical performance metrics characteristic of the surgical performance based on the plurality of treatment data sets. Determining the multiple treatment data sets in block 910 may include, for each surgical procedure of the multiple surgical procedures, determining a respective treatment data set of the multiple treatment data sets by: (i) receiving, in block 914, instrument data related to operation of the surgical instrument during the surgical procedure from the surgical instrument, the instrument data being based on one or more instrument parameters determined by the surgical instrument at multiple time points during the surgical procedure; (ii) receiving, in block 916, position data from the surgical navigation system indicative of a position of the surgical instrument relative to the patient's anatomical structure at multiple time points during the surgical procedure; (iii) determining, in block 918, kinematic data at the multiple time points based on at least one of the position data or the instrument data; and (iv) correlating, in block 920, the instrument data, position data, and kinematic data for each of the multiple time points to determine a respective treatment data set for the surgical procedure.

[0102] 10, a process 1000 for evaluating the surgical performance of a surgical procedure according to another example is shown. As shown in FIG. 10, the process 1000 includes (i) receiving instrument data from the surgical instrument related to the movement of the surgical instrument at multiple time points during the surgical procedure at block 1010, (ii) receiving position data from the surgical navigation system indicative of the position of the surgical instrument relative to the patient's anatomy at multiple time points during the surgical procedure at block 1012, (iii) determining kinematic data at the multiple time points based on the position data at block 1014, (iv) determining a plurality of surgical performance metrics characterizing the surgical performance using the instrument data and the kinematic data at block 1016, (v) performing an analysis of (a) the kinematic data and the instrument data against (b) the plurality of surgical performance metrics at block 1018, and (vi) outputting information to a user interface based on the analysis at block 1020 that provides feedback to the surgeon regarding the performance of the surgical procedure.

[0103] Referring now to FIG. 11, another example process 1100 for evaluating the surgical performance of a surgical procedure is shown. As shown in FIG. 11 , process 1100 includes (i) receiving pre-operative information for the surgical procedure to be performed in block 1110; (ii) determining a plurality of surgical performance metrics using the pre-operative information in block 1112; (iii) receiving instrument data from the surgical instrument related to the movement of the surgical instrument at a plurality of time points during the surgical procedure in block 1114; (iv) receiving position data from the surgical navigation system indicative of the position of the surgical instrument relative to the patient's anatomical structure at a plurality of time points during the surgical procedure in block 1116; (v) determining kinematic data at a plurality of time points based on the position data in block 1118; (vi) performing an analysis of (a) the kinematic data and instrument data against (b) a plurality of surgical performance metrics in block 1120; and (vii) outputting information to a user interface based on the analysis in block 1122 that provides feedback to the surgeon regarding the performance of the surgical procedure.

[0104] Any of the blocks shown in Figures 9-11 may represent a module, segment, or portion of program code, which comprises one or more instructions executable by a processor to implement a particular function or step in a process. The program code may be stored on any type of computer-readable medium or data storage, such as, for example, a storage device including a disk or hard drive. Furthermore, the program code may be encoded in a machine-readable format on a computer-readable storage medium or other non-transitory medium or article of manufacture. The computer-readable medium may include, for example, non-transitory computer-readable medium or memory, such as a computer-readable medium that stores data for a short period of time, such as a register memory, a processor cache, and a random access memory (RAM). The computer-readable medium may also include non-transitory media, such as secondary or permanent long-term storage, such as a read-only memory (ROM), an optical or magnetic disk, or a compact disc read-only memory (CD-ROM). The computer-readable medium may also be any other volatile or non-volatile storage system. The computer-readable medium may be considered, for example, a tangible computer-readable storage medium.

[0105] In some examples, components of the devices and / or systems described herein can be configured to perform a function such that the components are actually configured and constructed (using hardware and / or software) to enable the performance of the function. Example configurations include one or more processors that execute instructions to cause the system to perform the function. Similarly, components of the devices and / or systems can be configured to be arranged or adapted to perform a function, enable the performance of a function, or be suitable for the performance of a function, such as when operated in a particular manner.

[0106] The description of various advantageous configurations has been presented for purposes of illustration and description and is not intended to be exhaustive or to limit the embodiments to the disclosed forms. Many modifications and variations will be apparent to those skilled in the art. Moreover, various advantageous embodiments may describe different advantages over other advantageous embodiments. One or more embodiments have been selected and described to explain the principles and practical uses of the embodiments and to enable those skilled in the art to interpret the disclosure as various embodiments with various modifications suitable for the particular uses envisioned.

Claims

1. A non-transitory computer-readable medium having stored thereon instructions executable to cause a processor to perform functions, the functions comprising: Determining a plurality of treatment data sets for a plurality of surgical procedures, wherein determining the plurality of treatment data sets includes, for each surgical procedure of the plurality of surgical procedures: receiving instrument data from the surgical instrument related to operation of the surgical instrument during the surgical procedure, the instrument data being based on one or more instrument parameters determined by the surgical instrument at multiple time points during the surgical procedure; receiving position data from a surgical navigation system indicative of a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data at the plurality of time points based on at least one of the position data or the instrument data; correlating the instrument data, the position data, and the kinematic data for each of the plurality of time points to determine a respective procedure data set for the surgical procedure; determining the respective treatment data set of the plurality of treatment data sets by determining a plurality of surgical performance metrics characteristic of surgical performance based on the plurality of procedural data sets; 1. A non-transitory computer-readable medium comprising:

2. 10. The non-transitory computer-readable medium of claim 1, wherein determining the plurality of surgical performance metrics comprises using the plurality of treatment data sets as training data for a machine learning algorithm.

3. The instruction: receiving image data relating to the patient's anatomy from the surgical navigation system; and The non-transitory computer-readable medium of claim 1 or 2, wherein the image data and the position data are both relative to a common frame of reference with respect to the patient's anatomy.

4. 4. The non-transitory computer-readable medium of claim 1, wherein the surgical navigation system is configured to determine the position data using at least one surgical navigation modality selected from the group consisting of: (i) electromagnetic surgical navigation, (ii) optical surgical navigation, (iii) ultrasound surgical navigation, and (iv) machine vision surgical navigation.

5. The instruction: receiving, for each surgical procedure, respective outcome data relating to a post-operative outcome of the surgical procedure; and The non-transitory computer-readable medium of any one of claims 1 to 4, wherein determining the plurality of surgical performance metrics is further based on the respective outcome data.

6. 6. The non-transitory computer-readable medium of claim 1, wherein the kinematic data comprises data of one or more kinematic parameters selected from the group consisting of: (i) trajectory of the surgical instrument, (ii) velocity of the surgical instrument, (iii) motion of the surgical instrument in three-dimensional space, (iv) inertia of the surgical instrument, (v) acceleration of the surgical instrument, (vi) chatter of the surgical instrument, (vii) jitter of the surgical instrument due to unsteadiness of the surgeon's hand, (ix) smoothness of the surgical instrument movement, (x) applied forces applied by the surgical instrument to the patient's anatomical tissue at the surgical site, (xi) deviation of the surgical instrument movement relative to a pre-operative planned path, and (xii) location of motion of the surgical instrument relative to a pre-operative planned target site.

7. The non-transitory computer-readable medium of any one of claims 1 to 6, wherein the tool data relates to operation of a motor of the surgical tool.

8. 8. The non-transitory computer-readable medium of claim 7, wherein the appliance data relates to one or more appliance parameters selected from the group consisting of motor speed, motor torque, motor temperature, motor current, and motor power consumption.

9. the one or more instrument parameters include a plurality of instrument parameters; The non-transitory computer-readable medium of claim 8 , wherein the processor is configured to correlate the plurality of instrument parameters with one another at the plurality of time points.

10. 10. The non-transitory computer-readable medium of any one of claims 1 to 9, wherein the surgical instrument comprises at least one instrument selected from the group consisting of a drill, a bone cutter, an electrosurgical tool, a suction tool, an irrigation tool, a shaver, a microscope, a camera, a surgical retractor, and a lighting device.

11. 11. The non-transitory computer-readable medium of any one of claims 1 to 10, wherein the surgical instrument comprises an instrument sensor coupled to the surgical instrument, the instrument sensor comprising one or more sensors selected from the group consisting of an accelerometer, a ground reaction force sensor, a flow sensor configured to detect a flow rate of a liquid, a flow sensor configured to detect a flow rate of a gas, a power sensor, a temperature sensor, a piezoelectric sensor, a vibration sensor, a chemical sensor, an optical sensor, a pressure sensor, a humidity sensor, a position sensor, a Hall effect sensor, a capacitance sensor, and a Doppler flow sensor.

12. The instruction: For each surgical procedure of the plurality of surgical procedures, receiving patient-specific data related to one or more health records of a patient of the surgical procedure; and The non-transitory computer-readable medium of any one of claims 1 to 11, wherein determining the plurality of surgical performance metrics is further based on the patient-specific data.

13. The instruction: for each surgical procedure of the plurality of surgical procedures, receiving historical surgeon data regarding one or more surgical procedures previously performed by a surgeon performing the surgical procedure; and The non-transitory computer-readable medium of any one of claims 1 to 12, wherein determining the plurality of surgical performance metrics is further based on the historical surgeon data.

14. The instruction: receiving, for each surgical procedure of the plurality of surgical procedures, surgeon physiological data related to a physiological state of the surgeon performing the surgical procedure at the plurality of time points; and 14. The non-transitory computer-readable medium of claim 1, wherein determining the respective treatment data set for each surgical procedure of the plurality of surgical procedures comprises correlating the instrument data, the position data, the kinematic data, and the surgeon physiological data for each of the plurality of time points to determine the respective treatment data set for the surgical procedure.

15. 15. The non-transitory computer-readable medium of claim 14, wherein the surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's respiratory rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) the surgeon's degree of pupil dilation, (vi) the surgeon's degree of eye fixation, (vii) the surgeon's degree of saccades, and (viii) the surgeon's degree of body movement.

16. The instruction: receiving, for each surgical procedure of the plurality of surgical procedures, patient physiological data related to a physiological state of the patient at the plurality of time points during the surgical procedure; and 16. The non-transitory computer-readable medium of claim 1, wherein determining the respective treatment data set for each surgical procedure of the plurality of surgical procedures comprises correlating the instrument data, the position data, the kinematic data, and the patient physiological data for each of the plurality of time points to determine the respective treatment data set for the surgical procedure.

17. 17. The non-transitory computer-readable medium of claim 16, wherein the patient physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the patient's heart rate, (ii) the patient's respiratory rate, (iii) the patient's temperature, (iv) the patient's blood pressure, and (v) the patient's oxygen saturation.

18. Determining the plurality of surgical performance metrics comprises: Detecting an occurrence of a surgical event during one or more of the plurality of surgical procedures based on the plurality of procedure datasets; identifying one or more portions of the treatment dataset indicative of a cause of the occurrence of the surgical event; determining the plurality of surgical performance metrics based on the one or more portions of the treatment dataset identified as indicative of the cause of the occurrence of the surgical event; 18. The non-transitory computer-readable medium of any one of claims 1 to 17, comprising:

19. 20. The non-transitory computer-readable medium of claim 18, wherein the surgical event is at least one event selected from the group consisting of: (i) rattling of the surgical instrument, (ii) binding, (iii) overheating of the surgical instrument, and (iv) proximity of the surgical instrument to a critical anatomical structure.

20. The instruction: receiving pre-operative information for an upcoming surgical procedure to be performed; determining a treatment plan for performing the upcoming surgical procedure based on the pre-operative information and the plurality of surgical performance metrics; 20. The non-transitory computer-readable medium of any one of claims 1 to 19, executable to cause the processor to perform the functions further comprising:

21. 21. The non-transitory computer-readable medium of any one of claims 1 to 20, wherein the plurality of surgical performance metrics comprises one or more thresholds defining a range of expected values ​​for at least one of: (i) one or more instrument parameters of the instrument data; or (ii) one or more kinematic parameters of the kinematic data.

22. 21. The non-transitory computer-readable medium of any one of claims 1 to 20, wherein the plurality of surgical performance metrics define a scoring system that evaluates the instrument data, the positional data, and the kinematic data of at least one surgical procedure selected from the plurality of surgical procedures.

23. A non-transitory computer-readable medium having stored thereon instructions executable to cause a processor to perform functions, the functions comprising: receiving instrument data from the surgical instrument related to operation of the surgical instrument at multiple points during the surgical procedure; receiving position data from a surgical navigation system indicating a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data at the plurality of time points based on the position data; determining a plurality of surgical performance metrics characterizing surgical performance using the instrument data and the kinematic data; (i) analyzing the kinematic data and the instrument data for (ii) the plurality of surgical performance metrics; outputting information to a user interface based on said analysis, said information providing feedback to the surgeon regarding the performance of said surgical procedure; 1. A non-transitory computer-readable medium comprising:

24. 24. The non-transitory computer-readable medium of claim 23, wherein determining the plurality of surgical performance metrics comprises using the instrument data and the kinematic data as input to a machine learning algorithm trained on a plurality of procedure datasets, each procedure dataset including respective instrument data and respective kinematic data for a respective previously performed surgical procedure.

25. 25. The non-transitory computer-readable medium of claim 23 or 24, wherein causing the user interface to output the information based on the analysis occurs post-operatively after the surgical procedure is completed.

26. 26. The non-transitory computer-readable medium of claim 25, wherein causing the user interface to output the information includes displaying on a display device a graphical representation of the at least one of the instrument data, the position data, or the kinematic data over time.

27. 27. The non-transitory computer-readable medium of claim 26, wherein the plurality of surgical performance metrics define one or more ranges of expected values ​​for at least one of: (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data.

28. 28. The non-transitory computer-readable medium of claim 27, wherein displaying the information further comprises displaying an indication indicating that a portion of the instrument data was outside at least one of the one or more ranges of expected values ​​defined by the plurality of surgical performance metrics.

29. 28. The non-transitory computer-readable medium of claim 27, wherein displaying the information further comprises displaying an indication indicating that a portion of the kinematic data was outside of at least one of the one or more ranges of expected values ​​defined by the plurality of surgical performance metrics.

30. 30. The non-transitory computer-readable medium of any one of claims 27-29, wherein displaying the information further comprises displaying a link to a pre-operative image of the anatomy of the surgical site and displaying a link to a post-operative image of the anatomy.

31. 31. The non-transitory computer-readable medium of any one of claims 27 to 30, wherein displaying the information further comprises displaying an animation of the surgical instrument movement overlaid on the image of the anatomical structure based on the position and the kinematic data.

32. 32. The non-transitory computer-readable medium of any one of claims 23 to 31, wherein displaying the information further comprises displaying an amount of deviation between (i) an actual location of a device implanted by the surgical instrument and (ii) a pre-operatively planned location where the device was to be implanted by the surgical instrument.

33. 33. The non-transitory computer-readable medium of claim 32, wherein displaying the information further comprises displaying an indication of a threshold amount of deviation defined by the plurality of surgical performance metrics.

34. 24. The non-transitory computer-readable medium of claim 23, wherein the determining of the plurality of surgical performance metrics, performing the analysis, and outputting the information to the user interface occurs intra-operatively in real time during the surgical procedure.

35. The instruction: receiving surgeon physiological data from a surgeon monitoring device relating to a physiological state of the surgeon performing the surgical procedure; determining, based on the surgeon physiological data, that the cognitive load on the surgeon is greater than a threshold amount of cognitive load; and 35. The non-transitory computer-readable medium of claim 34, wherein causing the information to be output occurs in response to the determination that the cognitive load on the surgeon is greater than a threshold amount of cognitive load.

36. 36. The non-transitory computer-readable medium of claim 35, wherein the surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's respiratory rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) the surgeon's degree of pupil dilation, (vi) the surgeon's degree of eye fixation, (vii) the surgeon's degree of saccades, and (viii) the surgeon's degree of body movement.

37. 37. The non-transitory computer-readable medium of claim 34, wherein the information output by the user interface includes instrument guidance information for operating the surgical instrument based on the plurality of surgical performance metrics.

38. 38. The non-transitory computer-readable medium of any one of claims 34 to 37, wherein the information output by the user interface includes kinematic guidance for navigating the surgical instrument based on the plurality of surgical performance metrics.

39. A non-transitory computer-readable medium having stored thereon instructions executable to cause a processor to perform functions, the functions comprising: receiving pre-operative information for a surgical procedure to be performed; determining a plurality of surgical performance metrics using the pre-operative information; receiving instrument data from the surgical instrument related to operation of the surgical instrument at multiple points during the surgical procedure; receiving position data from a surgical navigation system indicating a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data at the plurality of time points based on the position data; (i) analyzing the kinematic data and the instrument data for (ii) the plurality of surgical performance metrics; outputting information to a user interface based on said analysis, said information providing feedback to the surgeon regarding the performance of said surgical procedure; 1. A non-transitory computer-readable medium comprising:

40. 40. The non-transitory computer-readable medium of claim 39, wherein determining the plurality of surgical performance metrics comprises using the instrument data and the kinematic data as input to a machine learning algorithm trained on a plurality of procedure datasets, each procedure dataset including respective instrument data and respective kinematic data for a respective previously performed surgical procedure.

41. 41. The non-transitory computer-readable medium of claim 39 or 40, wherein the pre-operative information includes patient-specific data related to one or more health records of a patient of the surgical procedure.

42. 42. The non-transitory computer-readable medium of claim 41, wherein the patient-specific data includes an image of the anatomy captured prior to the surgical procedure.

43. 43. The non-transitory computer-readable medium of claim 41 or 42, wherein the pre-operative information includes historical surgeon data regarding one or more surgical procedures previously performed by the surgeon performing the surgical procedure.

44. 44. The non-transitory computer-readable medium of any one of claims 41 to 43, wherein the pre-operative information includes surgeon preference data regarding one or more preferences for performing the surgical procedure.

45. Determining a plurality of treatment data sets for a plurality of surgical procedures, wherein determining the plurality of treatment data sets includes, for each surgical procedure of the plurality of surgical procedures: receiving instrument data from the surgical instrument related to operation of the surgical instrument during the surgical procedure, the instrument data being based on one or more instrument parameters determined by the surgical instrument at multiple time points during the surgical procedure; receiving position data from a surgical navigation system indicative of a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data at the plurality of time points based on at least one of the position data or the instrument data; correlating the instrument data, the position data, and the kinematic data for each of the plurality of time points to determine a respective procedure data set for the surgical procedure; determining the respective treatment data set of the plurality of treatment data sets by determining a plurality of surgical performance metrics characteristic of surgical performance based on the plurality of procedural data sets; 10. A method for assessing surgical performance of a surgical procedure, comprising:

46. receiving instrument data from the surgical instrument related to operation of the surgical instrument at multiple points during the surgical procedure; receiving position data from a surgical navigation system indicating a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data at the plurality of time points based on the position data; determining a plurality of surgical performance metrics characterizing surgical performance using the instrument data and the kinematic data; (i) analyzing the kinematic data and the instrument data for (ii) the plurality of surgical performance metrics; outputting information to a user interface based on said analysis, said information providing feedback to the surgeon regarding the performance of said surgical procedure; 10. A method for assessing surgical performance of a surgical procedure, comprising:

47. receiving pre-operative information for a surgical procedure to be performed; determining a plurality of surgical performance metrics using the pre-operative information; receiving instrument data from the surgical instrument related to operation of the surgical instrument at multiple points during the surgical procedure; receiving position data from a surgical navigation system indicating a position of the surgical instrument relative to the patient's anatomy at the plurality of time points during the surgical procedure; determining kinematic data at the plurality of time points based on the position data; (i) analyzing the kinematic data and the instrument data for (ii) the plurality of surgical performance metrics; outputting information to a user interface based on said analysis, said information providing feedback to the surgeon regarding the performance of said surgical procedure; 10. A method for assessing surgical performance of a surgical procedure, comprising:

48. 48. The method of any one of claims 45 to 47, wherein determining the plurality of surgical performance metrics comprises using the plurality of treatment data sets as training data for a machine learning algorithm.

49. The instruction: receiving image data relating to the patient's anatomy from the surgical navigation system; and A method according to any one of claims 45 to 48, wherein the image data and the position data are both relative to a common frame of reference with respect to the patient's anatomy.

50. 50. The method of any one of claims 45 to 49, wherein the surgical navigation system is configured to determine the position data using at least one surgical navigation modality selected from the group consisting of: (i) electromagnetic surgical navigation, (ii) optical surgical navigation, (iii) ultrasound surgical navigation, and (iv) machine vision surgical navigation.

51. The instruction: receiving, for each surgical procedure, respective outcome data relating to a post-operative outcome of the surgical procedure; and The method of any one of claims 45 to 50, wherein determining the plurality of surgical performance metrics is further based on the respective outcome data.

52. 52. The method of any one of claims 45 to 51, wherein the kinematic data comprises data of one or more kinematic parameters selected from the group consisting of: (i) trajectory of the surgical instrument, (ii) velocity of the surgical instrument, (iii) motion of the surgical instrument in three-dimensional space, (iv) inertia of the surgical instrument, (v) acceleration of the surgical instrument, (vi) chatter of the surgical instrument, (vii) jitter of the surgical instrument due to unsteadiness of the surgeon's hand, (ix) smoothness of the surgical instrument movement, (x) applied forces applied by the surgical instrument to the patient's anatomical tissue at the surgical site, (xi) deviation of the surgical instrument movement relative to a pre-operative planned path, and (xii) location of motion of the surgical instrument relative to a pre-operative planned target site.

53. A method according to any one of claims 45 to 52, wherein the tool data relates to the operation of a motor of the surgical tool.

54. 54. The method of claim 53, wherein the appliance data relates to one or more appliance parameters selected from the group consisting of motor speed, motor torque, motor temperature, motor current, and motor power consumption.

55. the one or more instrument parameters include a plurality of instrument parameters; 55. The method of claim 54, wherein the processor is configured to correlate the plurality of instrument parameters with each other at the plurality of time points.

56. 56. The method of any one of claims 45 to 55, wherein the surgical instrument comprises at least one instrument selected from the group consisting of a drill, a bone cutter, an electrosurgical tool, a suction tool, an irrigation tool, a shaver, a microscope, a camera, a surgical retractor, and a lighting device.

57. 57. The method of any one of claims 45 to 56, wherein the surgical instrument comprises an instrument sensor coupled to the surgical instrument, the instrument sensor comprising one or more sensors selected from the group consisting of an accelerometer, a ground reaction force sensor, a flow sensor configured to detect a flow rate of a liquid, a flow sensor configured to detect a flow rate of a gas, a power sensor, a temperature sensor, a piezoelectric sensor, a vibration sensor, a chemical sensor, an optical sensor, a pressure sensor, a humidity sensor, a position sensor, a Hall effect sensor, a capacitive sensor, and a Doppler flow sensor.

58. The instruction: For each surgical procedure of the plurality of surgical procedures, receiving patient-specific data related to one or more health records of a patient of the surgical procedure; and The method of any one of claims 45 to 57, wherein determining the plurality of surgical performance metrics is further based on the patient-specific data.

59. The instruction: for each surgical procedure of the plurality of surgical procedures, receiving historical surgeon data regarding one or more surgical procedures previously performed by a surgeon performing the surgical procedure; and The method of any one of claims 45 to 58, wherein determining the plurality of surgical performance metrics is further based on the historical surgeon data.

60. The instruction: receiving, for each surgical procedure of the plurality of surgical procedures, surgeon physiological data related to a physiological state of the surgeon performing the surgical procedure at the plurality of time points; and 60. The method of any one of claims 45 to 59, wherein determining the respective treatment data set for each surgical procedure of the plurality of surgical procedures comprises correlating the instrument data, the position data, the kinematic data, and the surgeon physiological data for each of the plurality of time points to determine the respective treatment data set for the surgical procedure.

61. 61. The method of claim 60, wherein the surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's respiratory rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) the surgeon's degree of pupil dilation, (vi) the surgeon's degree of eye fixation, (vii) the surgeon's degree of saccades, and (viii) the surgeon's degree of body movement.

62. The instruction: receiving, for each surgical procedure of the plurality of surgical procedures, patient physiological data related to a physiological state of the patient at the plurality of time points during the surgical procedure; and 62. The method of any one of claims 45 to 61, wherein determining the respective treatment data set for each surgical procedure of the plurality of surgical procedures comprises correlating the instrument data, the position data, the kinematic data, and the patient physiological data for each of the plurality of time points to determine the respective treatment data set for the surgical procedure.

63. 63. The method of claim 62, wherein the patient physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the patient's heart rate, (ii) the patient's respiratory rate, (iii) the patient's temperature, (iv) the patient's blood pressure, and (v) the patient's oxygen saturation.

64. Determining the plurality of surgical performance metrics comprises: Detecting an occurrence of a surgical event during one or more of the plurality of surgical procedures based on the plurality of procedure datasets; identifying one or more portions of the treatment dataset indicative of a cause of the occurrence of the surgical event; determining the plurality of surgical performance metrics based on the one or more portions of the treatment dataset identified as indicative of the cause of the occurrence of the surgical event; 64. The method of any one of claims 45 to 63, comprising:

65. 65. The method of claim 64, wherein the surgical event is at least one event selected from the group consisting of: (i) rattling of the surgical instrument, (ii) binding, (iii) overheating of the surgical instrument, and (iv) proximity of the surgical instrument to a critical anatomical structure.

66. The instruction: receiving pre-operative information for an upcoming surgical procedure to be performed; determining a treatment plan for performing the upcoming surgical procedure based on the pre-operative information and the plurality of surgical performance metrics; 66. The method of any one of claims 45 to 65, wherein the method is executable to cause the processor to perform the functions further comprising:

67. 67. The method of any one of claims 45 to 66, wherein the plurality of surgical performance metrics comprises one or more thresholds defining a range of expected values ​​for at least one of: (i) one or more instrument parameters of the instrument data; or (ii) one or more kinematic parameters of the kinematic data.

68. 68. The method of any one of claims 45 to 67, wherein the plurality of surgical performance metrics define a scoring system that evaluates the instrument data, the positional data, and the kinematic data of at least one surgical procedure selected from the plurality of surgical procedures.

69. 69. The method of any one of claims 45 to 68, wherein determining the plurality of surgical performance metrics comprises using the instrument data and the kinematic data as input to a machine learning algorithm trained on a plurality of procedure datasets, each procedure dataset comprising respective instrument data and respective kinematic data for a respective previously performed surgical procedure.

70. 70. The method of any one of claims 46 to 69, wherein causing the user interface to output the information based on the analysis occurs post-operatively after the surgical procedure is completed.

71. 71. The method of claim 70, wherein causing the user interface to output the information includes displaying a graphical representation of the at least one of the instrument data, the position data, or the kinematic data over time on a display device.

72. 72. The method of claim 71, wherein the plurality of surgical performance metrics define one or more ranges of expected values ​​for at least one of: (i) one or more instrument parameters of the instrument data or (ii) one or more kinematic parameters of the kinematic data.

73. 73. The method of claim 72, wherein displaying the information further comprises displaying an indication indicating that a portion of the instrument data was outside at least one of the one or more ranges of expected values ​​defined by the plurality of surgical performance metrics.

74. 73. The method of claim 72, wherein displaying the information further comprises displaying an indication indicating that a portion of the kinematic data was outside of at least one of the one or more ranges of expected values ​​defined by the plurality of surgical performance metrics.

75. 75. The method of any one of claims 72 to 74, wherein displaying the information further comprises displaying a link to a pre-operative image of the anatomy of the surgical site, and displaying a link to a post-operative image of the anatomy.

76. 76. The method of any one of claims 72 to 75, wherein displaying the information further comprises displaying an animation of the surgical instrument movement overlaid on the image of the anatomical structure based on the position and the kinematic data.

77. 77. The method of any one of claims 45 to 76, wherein displaying the information further comprises displaying the amount of deviation between (i) the actual location of a device implanted by the surgical instrument and (ii) the pre-operative planned location where the device was to be implanted by the surgical instrument.

78. 78. The method of claim 77, wherein displaying the information further comprises displaying an indication of a threshold amount of deviation defined by the plurality of surgical performance metrics.

79. 79. The method of any one of claims 46 to 78, wherein the determining of the plurality of surgical performance metrics, performing the analysis, and outputting the information to the user interface occurs intra-operatively in real time during the surgical procedure.

80. The instruction: receiving surgeon physiological data from a surgeon monitoring device relating to a physiological state of the surgeon performing the surgical procedure; determining, based on the surgeon physiological data, that the cognitive load on the surgeon is greater than a threshold amount of cognitive load; and 80. The method of any one of claims 45 to 79, wherein causing the information to be output is in response to the determination that the cognitive load on the surgeon is greater than a threshold amount of cognitive load.

81. 81. The method of claim 80, wherein the surgeon physiological data relates to at least one physiological parameter selected from the group consisting of: (i) the surgeon's heart rate, (ii) the surgeon's respiratory rate, (iii) the surgeon's body temperature, (iv) the surgeon's blink rate, (v) the surgeon's degree of pupil dilation, (vi) the surgeon's degree of eye fixation, (vii) the surgeon's degree of saccades, and (viii) the surgeon's degree of body movement.

82. 82. The method of any one of claims 79 to 81, wherein the information output by the user interface includes instrument guidance information for operating the surgical instrument based on the plurality of surgical performance metrics.

83. 83. The method of any one of claims 79 to 82, wherein the information output by the user interface includes kinematic guidance for navigating the surgical instrument based on the plurality of surgical performance metrics.

84. The method of any one of claims 47 to 83, wherein the pre-operative information includes patient-specific data relating to one or more health records of a patient of the surgical procedure.

85. 85. The method of claim 84, wherein the patient-specific data includes an image of the anatomy captured prior to the surgical procedure.

86. 86. The method of claim 84 or 85, wherein the pre-operative information includes historical surgeon data regarding one or more surgical procedures previously performed by the surgeon performing the surgical procedure.

87. 87. The method of any one of claims 84 to 86, wherein the pre-operative information includes surgeon preference data regarding one or more preferences for performing the surgical procedure.

88. 88. The method of any one of claims 46 to 87, further comprising causing the surgical instrument to automatically adjust one or more instrument parameters based on at least one data selected from the group consisting of the instrument data, the positional data, and the kinematic data.

89. 90. The method of claim 88, wherein the one or more instrument parameters include at least one parameter selected from the group consisting of motor speed, direction of motor rotation, motor torque, motor temperature, motor current, motor power consumption, electrosurgical current, electrosurgical voltage, electrosurgical waveform, electrosurgical impedance, irrigation flow rate, aspiration flow rate, depth control, and camera visibility setting.

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