Arm-mounted surgical robotic tool cassettes and methods for their use

Abstract

A robotic system can obtain tools from tool cassettes disposed on the robotic arms of a centrally coordinated surgical robotic system. The tool exchange is useful in performing minimally invasive and other robotic surgical procedures where automation and maintenance of the tool cassettes within a sterile field are desired.

Description

ARM-MOUNTED SURGICAL ROBOTIC TOOL CASSETTES ANDMETHODS FOR THEIR USECROSS-REFERENCE

[0001] This application claims the benefit of U.S. Provisional application 63 / 606,001 filed December 4, 2023, the full disclosure of which is incorporated herein by reference.BACKGROUNDField

[0002] The disclosed technology relates generally to medical apparatus and methods. In particular, the disclosed technology relates to robotic apparatus, systems and methods for interchanging surgical tools and tool tips among robotic arms during robotic surgical procedures.

[0003] Surgical robots are available for performing orthopedic, laparoscopic, urologic, cardiac, ophthalmologic, and other surgical procedures. Robotic surgical systems include both “teleoperated” systems, such as the da Vinci® robotic surgery system from Intuitive Surgical, Inc. and locally controlled, multi-arm robotic surgical systems used for performing spinal and other robotic surgical procedures, such as those available from Medtronic pic under the Mazor tradename. Some systems comprise a plurality of “single” arms deployed separately on separate carts, while others comprise multiple arms mounted on single carts. Control units may be remote but in other instances controllers may be mounted on the same cart or base which holds the surgical arm or arms.

[0004] Performance of spinal and other robotic surgical procedures often requires the use of multiple tools or end effectors, such as tool tips screws, cages, plates, implants and the like deployed by two or more robotic arms where the tools may often be exchanged among the arms during a procedure. At present, mounting, removing, and replacing tools and end effectors on individual surgical robotic arms during a robotic surgical procedure is typically done manually, which can be both time-consuming and a distraction for the surgeon and other personnel.

[0005] For example, spinal robotic surgical procedures are complicated by the need to use and exchange multiple different tool sets as the procedure progresses. Placing multiple pedicle screws in the spine of a patient may require the use of different types of screws in each vertebra and different pedicle screw often require a different tool set for placement. This in turn creates the need for tool changes during the surgical procedure.

[0006] It has been suggested that an inventory of surgical tools can be held and a tool cart or equivalent structure located adjacent to a surgical robot, allowing arms of the surgical robot to locate and retrieve needed tools from the cart. See, for example, the surgical robotic systemsdescribed in WO2019 / 096933; US2015 / 119637; US2018 / 168757; and W02004 / 014244. While a useful improvement, the need to reach out to an adjacent cart or other storage structure can cause undesirable time delays and complications in the surgical procedures.

[0007] For these reasons, it would be desirable to provide apparatus, systems, and methods that reduce or eliminate the need for surgical personnel to manually or otherwise exchange surgical tools and end effectors while performing robotic surgical procedures. It would be particularly desirable to provide a surgical robotic system that is able to select and deploy tools, tool tips, implants, and other surgical objects from one or more tool repositories located within the surgical field, preferably within the surgical robotic system itself. Robotically synchronizing the selection and deployment of varied tool sets during surgery would be greatly simplify the performance of repetitive and complex tasks. The actions of the robotic system and its multiple arms would be coordinated and controlled from a central chassis, thus achieving the aims of a high degree of independence and accuracy, with the added benefit of visualization and navigation capabilities being deployed from the same central chassis. At least some of these objectives are met by the disclosed technologies.Background Art

[0008] Background art includes patent publication nos. WO2019 / 096933; US2015 / 119637; US2018 / 168757; WO2019 / 005921; and W02004 / 014244 as well as commonly owned WO / 2022 / 195460 and PCT / EP2024 / 068766, the full disclosures of which are incorporated herein by reference.SUMMARY

[0009] In a first aspect of the disclosed technologies, a method for selecting surgical tools during a robotic surgical procedure being performed on a patient comprises providing a first plurality of surgical tools held in a first tool cassette supported on a first arm of a surgical robot. A second robotic arm of the surgical robot is positioned to locate a second tool-receiving structure carried by the second robotic arm adjacent to the first tool cassette, and the second tool-receiving structure is coupled to a first tool held in the first tool cassette. The second robotic arm is repositioned to withdraw the first tool from a receptacle on the first tool cassette, and the first tool is robotically manipulated to perform a first surgical task on the patient.

[0010] Typically, the methods further comprise repositioning the second robotic arm to return the first tool to an open receptacle on the first or another tool cassette, leaving the second robotic arm available to retrieve another surgical tool for use in the same or another robotic surgical task on the patient.

[0011] In some instances, the disclosed methods may further comprise providing a second plurality of surgical tools held in a second tool cassette supported on the second or another robotic arm of the surgical robot. The first robotic arm may be used to position a first toolreceiving structure carried by the first robotic arm adjacent to the second tool cassette, and the first tool-receiving structure can couple and withdraw a second tool held in the second tool cassette. The first robotic arm is typically used to repositioned and withdraw the second tool from a receptacle on the second tool cassette, and the second tool is used to perform a second surgical task on the patient.

[0012] Typically, the first robotic arm is repositioned to return the second tool to an open receptacle on the second tool cassette, leaving the first robotic arm available to retrieve another surgical tool for use in the same or another robotic surgical task on the patient.

[0013] In some instances, the tool-receiving structure of at least one of the first and second robotic arms may be positioned adjacent to at least one of the second and first tool cassettes, respectively, and the first or second tool cassette may be moved toward the tool-receiving structure held by the first or second robotic arm.

[0014] In other instances, the tool-receiving structure of at least one of the first and second robotic arms may be positioned adjacent to at least one of the second and first tool cassettes, respectively, and the tool-receiving structure held by the first or second robotic arm may be moved toward the first or second tool cassette.

[0015] In some instances, all robotic arms of the surgical robot are mounted on one or more bases and share a common surgical coordinate system and a controller for moving the arms through the common coordinate system. The controller may positions the arms at least partially based on robotic kinematics.

[0016] Alternatively or additionally, the controller may position the arms at least partially based on tracking arm movement with one or more cameras or sensors.

[0017] In some instances, positioning of the surgical arms and coupling and decoupling of tools to the tool-receiving structures may be controlled at least partly automatically by the controller.

[0018] In other instances, positioning of the surgical arms and coupling and decoupling of tools to the tool-receiving structures may be controlled at least partly by a user. For example, positioning of the surgical arms and coupling of tools to the tool-receiving structures may be performed by a user while the user views the surgical space with a camera which can visualize the tools and the tool-receiving structures of the robotic arms.

[0019] In a second aspect of the disclosed technologies, a tool cassette is configured for use with a surgical robot having at least first and second surgical robotic arms. The tool cassette may comprise a cassette body having a plurality of receptacles and being configured to be coupled toand moved through space by the first surgical robotic arm. Each receptacle is adapted to allow a tool-receiving structure on the second surgical arm to retrieve a surgical tool from the receptacle of the cassette body and return the surgical tool to the same or another receptacle of the cassette body.

[0020] In some embodiments, the cassette body may be configured to be mounted on the first surgical robotic arm while the first surgical robotic arm is coupled to another surgical tool.

[0021] In some embodiments, the cassette body may be configured to be mounted on the first surgical robotic arm in place of another surgical tool.

[0022] In a third aspect of the disclosed technologies, a system for deployment of an interchangeable tool set for use in minimally invasive surgery comprises a first robotic arm terminating at a first flange which the comprises a first tool cassette, first end effector with a proximal end and a distal end is connected at its proximal end to the first flange, and the distal end of the first end effector may be configured to be attached to a surgical tool. A second robotic arm terminates at a second flange which comprises a second tool cassette. A second end effector has a proximal end and a distal end and is connected at its proximal end to the second flange. The distal end of the second end effector is typically configured to be attached to a surgical tool. The system is configured such that the first end effector may deposit a surgical tool connected to the first end effector in the second tool cassette or select a surgical tool from second tool cassette and cause it to be attached to the first end effector, and the system is further configured such that the second end effector may deposit a surgical tool connected to the second end effector in the first tool cassette or select a surgical tool from first tool cassette and cause it to be attached to the second end effector.

[0023] In some instances, the first robotic arm and the second robotic arm originate from a common base comprising a central controller in an integrated surgical robotic system, where the depositing or selection of surgical tools by the first end effector or by the second end effector may be effected robotically through the central controller coordinating the movement of the first robotic arm and the second robotic arm.

[0024] In some instances, the first flange and the second flange each comprise a motor and electrical components for the operation of surgical tools.

[0025] For example, the system may further comprise a first drive mechanism running the interior length of the first end effector for forming a mechanical, electrical or magnetic connection between the motor of the first flange and a surgical tool attached to the distal end of the first end effector. In such instances, the system may further comprise a second drive mechanism running the interior length of the second end effector for forming a mechanical connection between the motor of the second flange and a surgical tool attached to the distal endof the second end effector.

[0026] In some instances, a portion of the first flange, e.g., comprising a motor or other non- sterilizable component, will be non-sterile and positioned outside the sterile field in use while other sterile or sterilizable components will be positioned within the sterile field.

[0027] In some instances, the systems may be configured to place one or both of the first end effector and the second end effector inside a patient body through an incision, a trocar or other access port during the surgical procedure.

[0028] In some instances, the central controller is configured to cause at least one of one of the first end effector and the second end effector to be withdrawn from the patient body through the incision, trocar or other access port and further causes the withdrawn end effector to deposit a tool in and / or withdraw a tool from the tool cassette on the flange of the robotic arm whose end effector is not being withdrawn from the surgical field. For example, the depositing, selecting and / or exchanging of surgical tools may take place while maintaining the tool cassettes, end effectors, and surgical tools in the sterile field.

[0029] In some instances, the central controller is configured to cause at least two exchanges of surgical tools take place.

[0030] In some instances, at least some tool exchanges are carried out robotically in response to user input to the central controller of the integrated surgical robotic system.

[0031] In some instances, at least some tool exchanges are carried out fully autonomously in response to a central controller algorithm.

[0032] In some instances, the disclosed systems may further comprise at least one camera configured to positioned in the surgical field and to observe the surgical procedure. For example, an endoscopic or other camera may be deployed on a third robotic arm, where the third robotic arm may originate from the common base and movement of the third robotic arm may be coordinated by the central controller of the integrated surgical robotic system.

[0033] In some instances, the systems may comprise at least one additional robotic arm terminating at an additional flange. The additional flange may comprise an additional tool cassette and an additional end effector with a proximal end and a distal end connected at its proximal end to the additional flange where the distal end of the additional end effector is configured to be attached to a surgical tool. Typically, the at least one additional robotic arm originates from the common base of the integrated surgical robotic system.BRIEF DESCRIPTION OF THE DRAWINGS

[0034] FIG. 1 illustrates a mobile surgical robotic cart having surgical robotic arms configured to carry tool holders incorporating tool cassettes in accordance with the disclosed technologies.

[0035] FIGS. 2A to 2C illustrate a tool cassette (FIG. 1 A) mounted on a flange attached to a robotic arm and carrying an end effector such as a tool retriever (FIG. IB) where the tool retriever has extracted a tool from a slot or receptacle of the tool cassette (FIG. 1C) according to an embodiment of the disclosed technology.

[0036] FIG. 3 is a detailed, exploded view of the tool holders of FIG. 2 shown in partial section.

[0037] FIGS. 4A to 4C illustrates use of the tool holders of the mobile surgical robotic cart of FIG. 2 in retrieving a tool from a tool cassette.DETAILED DESCRIPTION

[0038] The disclosed technology provides robotic apparatus, systems, and methods which simplify the performance of repetitive tasks such as the exchange of multiple tool sets during robotic surgical procedures. The surgical tools are stowed in cassettes located in the surgical space, typically one or more robotic arms of the surgical robot. In this way, the robot arms can be controlled to pass and load the tools and end effectors from one robot arm to another. While examples herein show the cassettes mounted on the surgical robot arms (i.e., those which have tools mounted thereon and which perform the surgical procedures), it will be appreciated that one or more tool cassettes can be mounted on any surgical arm of the surgical robot, including surveillance arms which carry a camera or other sensor and dedicated robotic arms which carry tool cassettes. It will also be appreciated that the cassettes may be mounted on robotic arms which are carried on a different base or cart, although it will usually be preferred that all arms be on the same cart or base.

[0039] A principal advantage of the disclosed technology is that by mounting the tool cassette(s) on one or more surgical arms, the location and orientation of each tool cassette can be “kinematically” tracked and controlled by the robotic controller reducing or eliminating the need to optically track or locate the tool cassettes and coordinate movement of the surgical arms to allow a tool-receiving component attached to the end of a robotic arm of the surgical robot to be positioned adjacent to a tool cassette to allow the robotic arm to extract or replace a surgical tool into the cassette. The concept of kinematic control is well understood in surgical robotics and refers to positioning a distal end of the surgical arm (including any end effector or tool attached to the distal end) based on the dimensions and angulations of the arm including the relationshipsbetween the arm joint coordinates and their spatial layout in the surgical robotic coordinate space.

[0040] While optical or other sensor-based tracking of the tool cassette and / or the individual surgical arms is not necessary and generally not employed, in some instances and embodiments, the disclosed technology can incorporate optical or other sensor-based tracking of the tool cassette and / or the individual surgical arms in combination with or in place of kinematic positioning, although any use of sensor-based tracking will not generally be preferred.

[0041] A further advantage of the disclosed technology is that the one or more tool cassettes can be carried by robotic arms of the surgical robot. In this way, the tool cassettes can be moved through the surgical space to facilitate tool extraction and replacement with others of the robotic arms. That is, both the arm carrying the tool cassette arm and the arm extracting the tool from the tool cassette can be simultaneously or sequentially positioned by the controller or the user to effect tool extraction or replacement at a desired location in the surgical space, for example a safe location where accidental release of the tool would not endanger the patient. Repositioning the tools cassettes can also be useful to reduce or eliminate interference between the tool cassettes and the other robotic arms.

[0042] While locating the tool cassettes on robotic arms of the surgical robot is preferred, in some less preferred instances and embodiments, the tool cassettes could be fixedly or detachably mounted on other components and / or surfaces of the surgical robot.

[0043] In further preferred implementations of the disclosed technology, the tool cassettes are carried by robotic arms which are intended primarily for other purposes, e.g., for carrying and manipulating the tools which are available in the cassettes, for carrying camaras or other sensors, and the like.

[0044] While locating the tool cassettes on such “dual purpose” arms is generally preferred, in some instances and embodiments, the tool cassettes of the disclosed technology can be mounted on robotic arms which are dedicated to carrying the tool cassettes (i. e. , have a sole purpose of carrying the tool cassettes).

[0045] In some specific embodiments of the disclosed technology, the tool cassettes will be mounted on one or more, usually two more, of the surgical arms configured to detachably carry surgical tools at their distal ends (i.e. , ends which are remote from the base end of the arm.) For example, the cassettes may be fixedly or detachably poisoned between a distal end or flange of the surgical robotic arm and a tool retriever or other interface configured to mate with one of the surgical tools held in the tool cassette. In an illustrated embodiment, the tool cassette can have generally circular periphery with a plurality of receptacles, slots or the like, which extend radially are configured to removably hold individual surgical tools.

[0046] As a robotic surgical arm will not be able to remove or replace a tool from or to a tool cassette held by that arm, the systems of the disclosed technology will usually comprise at least two surgical robotic arms, each carrying at least one tool cassette, allowing a first robotic arm to extract / retum tools from a tool cassette caried by a second robotic arm and the second robotic arm to extract / retum tools from a tool cassette caried by the first robotic arm.

[0047] In specific instances of the disclosed technology, the placement and movement of the robotic elements are controlled and coordinated by a single control unit, and wherein all of the robotic elements are based on a single rigid chassis and, thus, are robotically coordinated at a single origin point. Specifically, multiple robotic elements may be attached to, and controlled by, a single control unit and may be used in a coordinated fashion to deploy and / or relate to surgical tools and instruments, trackers, cameras, and other surgical tools as part of a robotic surgical procedure. More particularly, in the context of robotic spinal surgery, multiple tools, implants, or other end effectors may be deployed on multiple robotic arms and controlled by a control unit used in a centrally coordinated fashion to perform a robotic surgical procedure, with the relative movements of each robotic arm, tool and / or other end effector element being coordinated by the central control unit.

[0048] The actions of the robotic system and its multiple arms would be coordinated and controlled from a central chassis, thus achieving the aims of a high degree of independence, accuracy, with the added benefit of visualization and navigation capabilities being deployed from a single location on the same central chassis.

[0049] Provided herein is a mobile robotically controlled surgical system. Specifically, the inventive system is a centrally coordinated and synchronized robotic system for spinal robotic surgery procedures, optionally for bilateral approach in spinal robotic surgery procedures. The system comprises multiple robotic arms that each can hold, place and / or manipulate at least one end effector, camera or navigation element for use in a spinal surgery procedure. The end effectors may include any surgical tools useful for performing spinal surgical procedures and are interchangeable. The surgical tools may be interchangeable within the surgical or sterile field from tool cassettes disposed on the robotic arms. The cameras and navigation elements are for another layer of accuracy and confidence providing guidance for the movement of the robotic arms and deployment of the end effectors and tools.

[0050] The disclosed technology comprises multiple robotic arms which access and visualize the surgical field in an automatic and safe way because they are robotically synchronized. In one embodiment, there may be two robotic arms, one of which place, guide and / or hold end effectors and / or tools and one holding a navigation and imaging camera. In another embodiment, there are three arms in which two are using different surgical tools and different end effectors. In such anembodiment, the arms holding the tools may, after the tools have been placed, bring and manipulate other end effectors or tools in the surgical field. In such an embodiment, the first arm may optionally position and then control the use of, for example, a drilling tool. The second arm may optionally position and then control the placement of an element such as a screwdriver. A third arm may optionally hold a camera that provides an image of the process from an optimal distance and angulation. The camera is able to operate from optimal distance and angulation because it is sized appropriately and its deployment on an appropriately sized and positioned robotic arm. Optionally, the robotic arms may also hold additional imaging or navigation cameras to provide redundancy and diversity of information. Also optionally, the robotic arms, tools, and / or end effectors may have active or passive markers placed on them that may assist the robotic system in positioning the robotic arms, the tools and / or the end effectors.

[0051] In one embodiment, the already robotically synchronized movement of the robotic arms is enhanced by the interaction of the navigation cameras with active or passive markers that are placed during or at the beginning of the procedure on portions of the patient's anatomy. The movement of the robotic arms is synchronized by a central control unit from a single base that knows where the arms are based upon. The additional navigation information provided by the various markers and the one or more cameras can improve that accuracy in some cases or add another layer of protection and verification.

[0052] In some embodiments of the disclosed technology, a system for deployment of an interchangeable tool set for use in minimally invasive surgery is provided. The system may comprise at least two robotic arms, with each robotic arm terminating at a flange comprising a tool cassette. The system may further comprise an end effector attached to each flange, with the end effectors being configured to be attached to a variety of surgical tools. In various embodiments, the end effector on one of the robotic arms may deposit a tool in the tool cassette on the flange of the other robotic arm or may select a tool from the tool cassette.

[0053] In various embodiments, the at least two robotic arms may originate from a common base on a single robotic chassis and their movement may be controlled and coordinated by a central controller incorporated into the single robotic chassis.

[0054] In other embodiments, the flanges of the robotic arms may comprise motors and electrical components for the operation of surgical tools. In these and other embodiments, the robotic system may include drive mechanisms running the interior length of the end effectors from the motors of the flanges to surgical tools attached to the end effectors. In some embodiments, the drive mechanism may be purely mechanical and in other embodiments it may include electrical or magnetic components.

[0055] In some embodiments, a portion of the flanges of the robotic arms comprising the motorsand other electrical components may not be provided sterile — i.e., they may be configured to be positioned outside the sterile field. In these and other embodiments, a different portion of the flanges comprising the tool cassettes may be provided sterile and intended to be positioned in the sterile surgical field during a surgical field. In these embodiments, tools may then be exchanged from the tool cassettes within the sterile field during a surgical procedure.

[0056] In some embodiments, the provided systems are configured to be deployed in minimally invasive surgical procedures. Accordingly, the end effectors and surgical tools may be inserted through a trocar or other access port into a minimally invasive surgical field. In these and other embodiments, one robotic arm that is deployed into a minimally invasive surgical field through a trocar or other access port may be withdrawn from the internal surgical field but may stay in the sterile field and deposit or select a surgical tool to or from a tool cassette on the flange of another robotic arm.

[0057] In some embodiments, an endoscopic camera may be inserted into a minimally invasive surgical field through a trocar or other access port to track the movement of surgical tools or end effectors deployed into the surgical filed by other robotic arms. In some of these embodiments, the endoscopic camera may be deployed on a robotic arm that is deployed from a common chassis that is also the base for the deployment of other robotic arms carrying tools into the surgical field. Solely by way of example, a robotic system according to these embodiments may have three robotic arms deposed on a common base with a central controller, wherein two of the robotic arms carry tools into the surgical field (and may exchange tools from tool cassettes on each other's robotic flanges) and the third arm may deploy an endoscopic camera into the surgical field.

[0058] One of skill in the art will understand that a robotic system according to an embodiment of the disclosed technology could have any number of robotic arms deployed on a common base with a central controller, with any useful combination of robotic arms carrying tools and robotic arms carrying endoscopic cameras or other visualization elements.

[0059] In various embodiments of the disclosed technology, the robotic system may further comprise navigation capabilities. Navigation modalities may be deployed on additional robotic arms on a common base upon which robotic arms carrying tools and endoscopic cameras are disposed. In this context, navigation capabilities may be used for surveillance of the surgical field, for patient surface mapping, for collision avoidance and, in certain instances, for the identification of elements of the surgical filed that are outside of the user's line of sight.

[0060] The inventive embodiments take advantage of multiple feedback loops to ensure precision and safety in the performance of a bilateral robotic spinal surgical procedure. The movement of the robotic arms is robotically synchronized to the greatest possible level ofprecision because the relatively small robotic arms are all co-mounted on a single rigid chassis that has a central control unit. The robotic arms are also mounted on the central chassis relatively far from each other, for example at least one meter apart — thus providing for greater reachability, maneuverability and force application. Robotic navigation is provided by one or more cameras / sensors that are deployed by one or more robotic arms that are also co-mounted on the same single chassis and are also controlled by the same central control unit.

[0061] In another aspect, the disclosed technology provides a method for interchanging tools during a robotic surgical procedure being performed on a patient. The method comprises providing a first plurality of surgical tools in a first tool cassette supported on a surgical robot, positioning a tool- receiving end of a first robotic arm of the surgical robot adjacent to the first tool cassette, coupling the tool-receiving end of the first robotic arm to a first tool held in the first tool cassette, separating the tool-receiving end of the first robotic arm from first tool cassette, and using the first tool to perform a first surgical task on the patient.

[0062] Usually, these methods further comprise providing a second plurality of surgical tools in a second tool cassette supported on the surgical robot, positioning a tool-receiving end of a second robotic arm adjacent to the second tool cassette, coupling the tool-receiving end of the second robotic arm to the second tool held in the second tool cassette, separating the toolreceiving end of the second robotic arm from second tool cassette, and using the second tool to perform a second surgical task on the patient. In preferred instances of these methods, at least one of the first and second tool cassettes is held by a robotic arm.

[0063] In preferred instances of these methods, positioning the tool-receiving end of at least one of the first and second robotic arms adjacent to at least one of the first or second tool cassette, respectively, comprises moving the first or second robotic arm toward the first or second tool cassette.

[0064] In preferred instances of these methods, positioning the tool-receiving end of at least one of the first and second robotic arms adjacent to at least one of the first or second tool cassette, respectively, comprises moving the first or second tool cassette toward the first or second robotic arm toward.

[0065] In preferred instances of these methods, the first tool cassette is held by the second robotic arm and second tool cassettes is held by the first robotic arm.

[0066] In preferred instances of these methods, positioning the tool -receiving end of first robotic arms adjacent to the first tool cassette comprises moving the first robotic arm toward the first tool cassette.

[0067] In preferred instances of these methods, positioning the tool -receiving end of first robotic arms adjacent to the first tool cassette comprises moving the first tool cassette toward the firstrobotic arm.

[0068] In preferred instances of these methods, positioning the tool-receiving end of second robotic arms adjacent to the second tool cassette comprises moving the second robotic arm toward the second tool cassette.

[0069] In preferred instances of these methods, positioning the tool-receiving end of second robotic arms adjacent to the second tool cassette comprises moving the second tool cassette toward the second robotic arm.

[0070] In preferred instances of these methods, all robotic arms of the surgical robot are mounted on one or more bases that have a common surgical coordinate system and a single controller for moving the arms through the common coordinate system.

[0071] In preferred instances of these methods, positioning of the surgical arms and coupling of the tool-receiving ends of the robotic arms are controlled by the controller.

[0072] In preferred instances of these methods, positioning of the surgical arms and coupling of the tool-receiving ends of the robotic arms are controlled by a user.

[0073] In preferred instances of these methods, wherein positioning of the surgical arms and coupling of the tool-receiving ends of the robotic arms are performed while the user views the surgical space with a camera which can visualize the tool-receiving ends of the robotic arms.

[0074] In another aspect, the disclosed technology provides a tool cassette configured for use with a surgical robot having at least first and second surgical robotic arms, said tool cassette comprising a cassette body comprising a plurality of receptacles and configured to be mounted on and moved through space by the first surgical robotic arm, wherein each receptacle is adapted to allow the second surgical arm to place a surgical tool therein and retrieve the surgical tool therefrom when a distal end of the second surgical end is in proximity to the tool cassette carried by the first surgical robot arm.

[0075] In specific instances of the tool cassettes, the cassette body is configured to be mounted on the first surgical robotic arm while the first surgical robotic arm coupled to another surgical tool.

[0076] In specific instances of the tool cassettes, the cassette body is configured to be mounted on the first surgical robotic arm in place of another surgical tool.

[0077] With reference now to the figures and several representative embodiments of the disclosed technology, the following detailed description is provided.

[0078] An exemplary robotic surgical system 10 suitable for use with the methods and tool cassettes of the disclosed technology is shown in FIG. 1, The robotic surgical system 10 typically comprises a chassis 12, usually consisting of a single, rigid frame which provides a base or platform for three robotic arms 20, 22 and 24 that are placed relatively far apart onopposite longitudinal ends 14 and 16 of an upper surface 18 of the chassis 12, typically approximately one meter apart, thus allowing for desirable attributes such as reachability, maneuverability, and an ability to apply significant force. In the illustrated embodiment, robotic surgical arms 20 and 22 are on the first end 14 of the chassis 12 and robotic surgical arm 22 is on the second end 16 of the chassis. The chassis can be mobile, e.g., being in the form of a mobile cart as described in commonly owned PCT application no. PCT / IB2022 / 052297 (published as WO2022 / 195460), previously incorporated herein by reference. In other embodiments and implementations, the surgical arms 20, 22 and 24 can be mounted on a base or other structure of a surgical table. Placement of the robotic surgical arms on a common, stable platform allows the arms to be moved kinematically or otherwise within a common robotic coordinate system under the control of a surgical robotic controller, typically an on-board controller have a user interface, such as display screen 32.

[0079] The single, rigid chassis of the disclosed technology will usually comprise, consist of, or consist essentially of a single mobile cart, as disclosed for example in commonly owned PCT application no. PCT / IB2022 / 052297 (published as WO2022 / 195460), the full disclosure of which has been previously incorporated herein by reference. In other instances, however, the single, rigid chassis may comprise separate modules, platforms, or components, that are assembled at or near the surgical table, as described for example in commonly owned PCT application no. PCT / EP2024 / 052353, entitled Integrated Multi-Arm Mobile Surgical Robotic System, filed on January 29, 2024, the full disclosure of which is incorporated herein by reference. The only requirement of the single, rigid chassis is that it provide a stable base for all the surgical arms so that they may be accurately and precisely kinematically positioned and tracked by the surgical robotic controller in a single surgical robotic coordinate space.

[0080] The chassis 12 of the robotic surgical system 10 can be configured to be temporarily placed under a surgical table (not shown) when performing the robotic surgical procedure, allowing the robotic surgical system 10 to be stored remotely before and after the procedure. The robotic arms 20, 22, and 24 may optionally be configured to be retracted into the chassis 12 of the robotic surgical system, allowing the system to be moved into or out of the surgical field in a compact configuration.

[0081] The first and second robotic surgical arms 28 and 28 typically have flanges 26 and 28, respectively, mounted at their distal ends. The flanges 26 and 28 may each hold a tool holder 100 and 102, respectively, each of which in turn hold a tool-retrieving structure 106, as described in more detail with reference to FIG. 3 below. In other instances, the tool holders 106 may hold operative tools to be used in performing a surgical task as part of a robotic surgery. The flanges 26 and 28 typically include all electronics and other sensitive system componentsthat cannot be sterilized under harsh conditions, for example, using heat (autoclave) or radiation. The tool holders 102 and 104, in contrast, typically include only robust mechanical components that can be sterilized and reused in a conventional manner. By providing a surgical drape or other isolation barrier between the tool holders 102 and 104 and the flanges 26 or 28, the flange can be used in a non-sterile environment and can be reused without needing full sterilization.The first robotic arm 20 can hold a first tool holder 100, and the second robotic arm 22 can hold a second tool holder 102, typically but not necessarily identical to the first tool holder.At least one of the surgical robotic arms 20 and 22 will hold a tool cassette 120 in addition to or in place of the tool holder 26 or 28. The tool cassettes 120 hold a plurality of tools, tool tips, screws, cages, plates, and other implants that are intended to be used in a particular robotic surgical procedure. By manipulating each of the tool cassette and the tool-retrieving structure with a separate robotic arm, retrieval or exchange of a specific tool or other surgical object can be performed more quickly and without the need to reach outside of the sterile field to access the tools.

[0082] As shown in FIGS. 2A to 2C, the tool cassette 120 may comprise a disc-like body 122 having a plurality of receptacles 124 distributed about its periphery 126. Individual surgical attachments, such as tool tips 130a, 130b, and 130c, are removably held in the receptacles 124 by detents 132 or other retention structures. The tool tips 130a, b, and c can be removed from the receptacles 124 using a hook or other releasably grasper 108 to pull on a hub 132 at the base of the tool tip. Once the tool tip 132a has been removed from the receptacle 124, as shown for example in FIG. 2C, it can be manipulated by the tool -retrieving structure 106 or be transferred to a different tool shaft (not shown) to allow for robotic manipulation.

[0083] Attachments of both the tool holder 100 and the tool cassette 120 to the robotic surgical arm 20 can take a variety of forms. A principal requirement is that the attachments be stable so that the locations of both the tool holder 100 and the tool cassette 120 can be kinematically determined by the robotic controller with high levels of accuracy and precision (repeatability). A secondary feature is that the system be reconfigurable so that the tool cassette and tool holders can be conveniently removed and replaced.

[0084] Such objectives are met by the combination assembly shown in FIG. 3. The tool cassette 120 has an axial passage 128 configured to positioned over the tool holder 100 and flange 26. The tool-retrieving structure 106 can be removed and replaced in the tool -holder, for example as described in commonly owned PCT Application PCT / EP2024 / 068766 which claimed priority to US Provisional Application 63 / 524,911, the full disclosures of which are incorporated herein by reference. As shown in FIG 3, the hook 108 is mounted to both axially translate and rotate about its axis, as indicated by the arrows.

[0085] Referring now to FIGS. 4A to 4C, tool-retrieving structure 106 of tool holder 102 can be used to retrieve a tool tip 130 by positioning the second robotic surgical arm 22 to align the hook 108 with receptacle 124 on tool cassette 120, as shown in FIG. 4B. After engaging the hook 108 onto the hub 110 (FIG. 2C), either or both of robotic arms 20 and 22 can be repositioned to withdraw the tool tip 130 from the receptacle, 124 as shown in FIG. 4C. The tool tip 130 is then in a position to be driven by the tool holder 102 or to be transferred to another tool shaft (not shown) for use.List of Reference Numbers.

[0086] One of skill in the art will realize that several variations on the disclosed embodiments are possible while staying within the bounds of the disclosed technology. Solely by way of example, different variations in the number and type of robotic arms, end effectors, surgical tools, endoscopic cameras and navigation elements can be used without departing from the disclosed technology. As yet another example, numerous variations of surgical tools and surgical approaches to unilateral or bilateral spinal surgical can be employed without departing from the technology disclosed herein. The embodiments provided are representative in nature.

Claims

WHAT IS CLAIMED IS:

1. A method for selecting surgical tools during a robotic surgical procedure being performed on a patient, said method comprising: providing a first plurality of surgical tools held in a first tool cassette supported on a first arm of a surgical robot; positioning a second robotic arm of the surgical robot to locate a second toolreceiving structure carried by the second robotic arm adjacent to the first tool cassette; coupling the second tool-receiving structure to a first tool held in the first tool cassette; repositioning the second robotic arm to withdraw the first tool from a receptacle on the first tool cassette; and using the first tool to perform a first surgical task on the patient.

2. The method of claim 1, further comprising repositioning the second robotic arm to return the first tool to an open receptacle on the first tool cassette.

3. The method of claim 1 or 2, further comprising: providing a second plurality of surgical tools held in a second tool cassette supported on the second robotic arm of the surgical robot; positioning the first robotic arm to locate a first tool -receiving structure carried by the first robotic arm adjacent to the second tool cassette; coupling the first tool-receiving structure to a second tool held in the second tool cassette; repositioning the first robotic arm to withdraw the second tool from a receptacle on the second tool cassette; and using the second tool to perform a second surgical task on the patient.

4. The method of claim 3, further comprising repositioning the first robotic arm to return the second tool to an open receptacle on the second tool cassette.

5. The method of claim 3 or 4, wherein positioning the tool-receiving structure of at least one of the first and second robotic arms adjacent to at least one of the second and first tool cassettes, respectively, comprises moving the first or second tool cassette toward the toolreceiving structure held by the first or second robotic arm.

6. The method of claim 3 or 4, wherein positioning the tool-receiving structure of at least one of the first and second robotic arms adjacent to at least one of the second and first tool cassettes, respectively, comprises moving the tool-receiving structure held by the first or second robotic arm toward the first or second tool cassette.

7. The method of claims 1 to 6, wherein all robotic arms of the surgical robot are mounted on one or more bases that share a common surgical coordinate system and a controller for moving the arms through the common coordinate system.

8. The method of claim 7, wherein the controller positions the arms at least partially based on robotic kinematics.

9. The method of claim 7 or 8, wherein the controller positions the arms at least partially based on tracking arm movement with one or more cameras or sensors.

10. The method of claims 7 to 9, wherein positioning of the surgical arms and coupling and decoupling of the tool-receiving structures of the robotic arms to the tools are controlled at least partly automatically by the controller.

11. The method of claims 7 to 9, wherein positioning of the surgical arms and coupling and decoupling of the tool-receiving structures of the robotic arms to the tools are fully controlled automatically by the controller.

12. The method of claims 1 to 11, wherein positioning of the surgical arms and coupling and decoupling of the tool-receiving structures of the robotic arms to the tools are controlled at least partly by a user.

13. The method of claim 12, wherein positioning of the surgical arms and coupling of the tool-receiving structures of the robotic arms are performed by a user while the user views the surgical space with a camera which can visualize the tool-receiving structures of the robotic arms.

14. A tool cassette configured for use with a surgical robot having at least first and second surgical robotic arms, said tool cassette comprising: a cassette body comprising a plurality of receptacles and configured to be coupled to andmoved through space by the first surgical robotic arm, wherein each receptacle is adapted to allow a tool -receiving structure on the second surgical arm to retrieve a surgical tool from the receptacle of the cassette body and return the surgical tool to the same or another receptacle of the cassette body.

15. The tool cassette of claim 14, wherein the cassette body is configured to be mounted on the first surgical robotic arm while the first surgical robotic arm is coupled to another surgical tool.

16. The tool cassette of claim 14, wherein the cassette body is configured to be mounted on the first surgical robotic arm in place of another surgical tool.

17. A system for deployment of an interchangeable tool set for use in minimally invasive surgery, comprising: a first robotic arm terminating at a first flange, the first flange comprising a first tool cassette; and a first end effector with a proximal end and a distal end, connected at its proximal end to the first flange, wherein the distal end of the first end effector is configured to be attached to a surgical tool; a second robotic arm terminating at a second flange, the second flange comprising a second tool cassette; and a second end effector with a proximal end and a distal end, connected at its proximal end to the second flange, wherein the distal end of the second end effector is configured to be attached to a surgical tool; wherein the system is configured such that the first end effector may deposit a surgical tool connected to the first end effector in the second tool cassette or select a surgical tool from second tool cassette and cause it to be attached to the first end effector; and wherein the system is further configured such that the second end effector may deposit a surgical tool connected to the second end effector in the first tool cassette or select a surgical tool from first tool cassette and cause it to be attached to the second end effector.

18. The system of claim 17, wherein the first robotic arm and the second robotic arm originate from a common base comprising a central controller in an integrated surgical robotic system.

19. The system of claim 18, wherein the depositing or selection of surgical tools by thefirst end effector or by the second end effector is effectuated robotically through the central controller coordinating the movement of the first robotic arm and the second robotic arm.

20. The system of any of claims 17 to 19, wherein the first flange and the second flange each comprise a motor and electrical components for the operation of surgical tools.

21. The system of claim 20, wherein the system further comprises a first drive mechanism running the interior length of the first end effector for forming a mechanical, electrical or magnetic connection between the motor of the first flange and a surgical tool attached to the distal end of the first end effector and wherein the system further comprises a second drive mechanism running the interior length of the second end effector for forming a mechanical connection between the motor of the second flange and a surgical tool attached to the distal end of the second end effector.

22. The system of claim 21, wherein a portion of the first flange comprising its motor is not provided sterile and used during a surgical procedure and wherein the portion of the first flange comprising the first tool cassette is positioned inside the sterile field during the surgical procedure wherein a portion of the second flange comprising its motor is not provided sterile during the surgical procedure and wherein the portion of the second flange comprising the second tool cassette is positioned inside the sterile field during the surgical procedure.

23. The system of claim 22, wherein one or both of the first end effector and the second end effector are placed inside a patient body through an incision, a trocar or other access port during the surgical procedure.

24. The system of claim 23, wherein both of the first end effector and the second end effector are placed inside the patient body through an incision, a trocar or other access port during the surgical procedure.

25. The system of claim 24, wherein the central controller of the integrated surgical robotic system robotically causes one of the first end effector or the second end effector to be withdrawn from the patient body through the incision, trocar or other access port and further causes the withdrawn end effector to deposit a tool in and / or withdraw a tool from the tool cassette on the flange of the robotic arm whose end effector is not being withdrawn from the surgical field.

26. The system of claim 25, wherein the depositing and / or selection of surgical tools takes place while maintaining the tool cassettes, end effectors and surgical tools in the sterile field.

27. The system of claim 26, wherein at least two exchanges of surgical tools take place.

28. The system of claim 27, wherein all exchanges of surgical tools are carried out robotically with the only operator input being the transmission of commands to the central controller of the integrated surgical robotic system.

29. The system of claim 27, wherein all exchanges of surgical tools are carried out fully autonomously through an artificial intelligence algorithm.

30. The system of any of claims 17 to 29, further comprising at least one camera positioned in the surgical field to observe the surgical procedure.

31. The system of claim 30, wherein the endoscopic camera is deployed on a third robotic arm.

32. The system of claim 31 , wherein the third robotic arm originates from the common base and wherein its movement is coordinated by the central controller of the integrated surgical robotic system.

33. The system of any of claims 17 to 32, further comprising at least one additional robotic arm terminating at an additional flange, the additional flange comprising an additional tool cassette and an additional end effector with a proximal end and a distal end, connected at its proximal end to the additional flange, wherein the distal end of the additional end effector is configured to be attached to a surgical tool.

34. The system of claim 33, wherein the at least one additional robotic arm originates from the common base of the integrated surgical robotic system.

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