Surgical instrument with navigational assistance

Abstract

A navigation assistance system may determine a position of a tool portion of an operating surgical instrument relative to a bounding condition. A navigation assistance system may apply, responsive to determining that the position does not satisfy the bounding condition, a navigational assistance measure.

Description

SURGICAL INSTRUMENT WITH NAVIGATIONAL ASSISTANCECross Reference To Related Applications

[0001] The present application claims priority to U.S. Provisional Patent Application No. 63 / 681,662 filed on August 9, 2024, entitled “SURGICAL INSTRUMENT WITH NAVIGATIONAL ASSISTANCE.” the entirety of which is incorporated by reference herein.Background

[0002] The use of powered surgical instruments is common in many surgical procedures. Examples of such instruments may include drills, saws, grinders, or the like that may be electric, pneumatic, hydraulic, or otherwise powered. Often times, use of such powered surgical instruments may allow for more efficient surgical operations, thus resulting in reduced risk to the patient, improved efficiency for the surgeon, lower costs, and improved outcomes.Summary

[0003] In some aspects, the techniques described herein relate to a method for providing navigation assistance for operating a surgical instrument within a bounding condition, including: determining a position of a tool portion of an operating surgical instrument relative to the bounding condition; and responsive to determining that the position does not satisfy the bounding condition, applying a navigational assistance measure.

[0004] In some aspects, the techniques described herein relate to a system for providing navigation assistance for an operating surgical instrument, including: a navigation component configured to determine a position of a tool portion of an operating surgical instrument relative to the bounding condition; and a navigation assistance component configured to apply, responsive to determining that the position does not satisfy the bounding condition, a navigational assistance measure.

[0005] This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify’ key features or essential features of the claimed subject matter, nor is it intended to be used to limit the scope of the claimed subject matter.

[0006] Other implementations are also described and recited herein.Brief Description of the Figures

[0007] FIG. 1 depicts a schematic representation of an embodiment of a system 100 that may be used as described herein to provide navigation data and navigation assistanceHolzer Patel Drennan 1 Attorney Docket No.: 708038PCTmeasures in connection with the use of a surgical instrument to perform an operation on a patient.

[0008] FIG. 2 illustrates an example surgical instrument that includes integrated sensors.

[0009] FIG. 3 illustrates an example of navigation data that may be displayed on the display where the internal anatomical features are provided from imaging data such that the position of the surgical instrument relative to the imaged anatomical features and one or more bounding conditions for operation of the surgical instrument may be shown.

[0010] FIG. 4 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions.

[0011] FIG. 5 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions.

[0012] FIG. 6 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions.

[0013] FIG. 7 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions.Detailed Description

[0014] While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that it is not intended to limit the invention to the particular form disclosed, but rather, the invention is to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the claims.

[0015] While powered surgical instruments may provide advantages over human powered instruments, a risk for inadvertent damage to the anatomy of the patient is also present when using powered instruments. Even when navigational data is provided to a surgeon that specifies one or more bounding conditions (e.g., one or more paths, boundaries, proximities, targeted areas / volumes, prohibited areas / volumes, or other bounding conditions) for manipulating the powered surgical instrument, the surgeon still must manually manipulate the powered surgical instrument to cut, drill, or otherwise operate along the one or more bounding conditions. Such manipulation requires fine motor movements of the surgeon’sHolzer Patel Drennan 2 Attorney Docket No.: 708038PCThands and is prone to error. Certain anatomical structures of a patient may be vulnerable to being inadvertently damaged by powered surgical instruments when a surgeon does not precisely manipulate the powered surgical instrument along the appropriate path. The technology described herein improves a surgeon’s ability to manipulate the instrument along a boundary (or in accordance with another bounding condition) by providing a navigation assistance measure (e.g., a counterweight, a resistive force, a shift in a center of g rawly, an alert, or other navigational assistance measure) when the instrument nears the boundary to increase the difficulty in manipulating the instrument outside of the boundary.

[0016] FIG. 1 depicts a schematic representation of an embodiment of a system 100 that may be used as described herein to provide navigation assistance measures in connection with the use of a surgical instrument 130 to perform an operation on a patient 140. The system 100 may include a navigation module 110. The navigation module 110 may include a navigation component 111 and a navigation assistance component 112. The navigation component 111 may determine, based on data received from sensors (e.g., sensors on the surgical instrument 130 and / or communicatively coupled to the surgical instrument 130) and / or based on imaging data received from an image repository 150. one or more positions (e.g., a current position) of the surgical instrument 130 with regard to one or more bounding conditions 180 for operating the surgical instrument 130. The navigation assistance component 112 may instruct the surgical instrument 130 and / or the display 160 to implement one or more navigational assistance measures to facilitate operation of the surgical instrument 130 within the one or more bounding conditions 180. The bounding conditions 180 may include, but are not limited to boundaries, paths, areas, volumes, proximities, targeted paths / areas / volumes, prohibited paths / areas / volumes or other bounding conditions that provide guidance to and / or otherwise specify where and / or how the surgical instrument 130 should be operated. For example, the surgical instrument 130 can implement navigational assistance measures that increase a difficulty of the operator to continue a trajectory that violates a bounding condition 180. The display 160 may implement navigational assistance measures such as alerting the operator via visual and / or audio output (e.g.. flashing / sounding an alert on a user interface of the display 160).

[0017] The navigation module 110 may be in operative communication with one or more sensors, for example, on-board sensors 120 and wide-field sensors 122. As will be described in greater detail below, the on-board sensors 120 and / or wide-field sensors 122 may be operative to detect a reference anatomical feature (e.g., reference anatomical features 142) of the patient 140. It may be appreciated that on-board sensors 120 may be used in the absence of wide-fieldHolzer Patel Drennan 3 Attorney Docket No.: 708038PCTsensors 122, wide-field sensors 122 may be used in the absence of on-board sensors 120, or a combination of wide-field sensors 122 and on-board sensors 120 may be used. Based on the detected reference anatomical feature (e.g., reference anatomical features 142), positioning data may be generated (e.g., via the navigation component 111) that describes the relative position between a surgical instrument 130 and a patient 140. For example, the navigation module 110 can determine a position of the surgical instrument 130 (e.g., the tool portion 132 thereof) relative to a surgical reference frame (e.g., including one or more anatomical features of the patient) of the patient 140 and relative to the bounding conditions 180. The sensors (e.g., wide-field sensors 122 and on-board sensors 120) described herein are examples and other types of sensors may be used in addition to and / or instead of the example sensors described herein.

[0018] The navigation module 110 may comprise any appropriate hardware or software components to perform as recited herein. In this regard, the navigation module 110 may include one or more hardware components including, for example, a field programmable gate array, an application specific integrated circuit, or other hardware component. Additionally or alternatively, the navigation module 110 may be implemented using software. As such, reference to the navigation module 110 may include corresponding computer hardware for execution of the module including one or more processors that may be in operative communication with a physical memory device. Specifically, the one or more processors may retrieve instructions comprising non-transitory machine-readable instructions that may be stored digitally on the physical memory device. In turn, the instructions, when executed by the processor, may configure the processor to perform the functionality7described herein. Additional computer hardware (e.g., the computing device illustrated in FIG. 9) may be provided to facilitate operation of the processor including busses, networking components, or the like, and may be included as part of the navigation module 110.

[0019] In some implementations, the navigation module 110 may also be in operative communication with an image repository7150. The image repository 150 may include a physical memory device that may be operative to store imaging data digitally on the physical memory device. Specifically, the image repository 150 may include imaging data that may be obtained by way of an imaging study conducted using a medical imager 152 that may be operative to image the patient 140. As referenced above, the medical imager 152 may comprise hardware corresponding to any appropriate medical imaging technology including, but not limited to, x-ray, magnetic resonance imaging (MRI), computer tomography (CT), positron emission tomography (PET), or any other appropriate medical imaging technology. TheHolzer Patel Drennan 4 Attorney Docket No.: 708038PCTmedical imager 152 may provide digital imaging data regarding the patient 140 resulting from an imaging study directly to the image repository 150. Alternatively, the imaging data may be digitized for storage in the image repository 150. Furthermore, the imaging data may be transferred from the imager 152 to the image repository 150 using any appropriate means. The navigation module 110 may determine a position of the surgical instrument 130 (e.g., a tool portion 132 thereof) relative to the surgical reference frame and relative to the bounding conditions 180 based on the imaging data

[0020] The navigation module 110 may also be in operative communication with a display 160. The display 160 may present the navigation data generated by the navigation module 110 to a user of the system 100. As will be described in greater detail below, the display 160 may include any one or more of a variety of display technologies that may allow a user to perceive the navigation data as generated by the navigation module 110. In some implementations, the display 160 displays a representation or other indication of one or more bounding conditions 180 of the navigation data in relation to the tool portion 132 of the surgical instrument 130. In some implementations, the display 160 presents, during operation of the surgical instrument 130, a current position of the surgical instrument (e.g.. or a portion thereof, e.g., the tool portion 132) with respect to the bounding conditions 180. In some implementations, the navigation module 110 detects, during the operation of the surgical instrument 130 (e.g., using the navigation component 111), changes in position (e.g., location and / or orientation) of the surgical instrument 130 and the display 160 indicates one or more positions of the surgical instrument 130 to the operator of the surgical instrument 130 relative to the bounding conditions 180 and, in some implementations, relative to the surgical reference frame. In some implementations, the display 160 provides an indication of a proximity of the current position of the surgical instrument 130 to one or more of the bounding conditions 180. For example, if the bounding condition 180 is a one dimensional boundary, the indication of the proximity may include a measurement (e.g. , a current distance from a bounding condition 180), a color scheme (e.g., green is greater than a threshold distance away from the bounding condition 180, yellow is within the threshold distance from the bounding conditionl80, red is at or past the bounding condition 180). an alert (e.g., flashing light when bounding condition 180 is reached), or other indication of closeness. In some examples, the bounding condition 180 is a two dimensional boundary' (e.g., an area, a plane) or a three dimensional boundary (e.g., a volume) and the indication of the proximity may include one or more of an axis of advancement, a rotational proximity, a translational proximity, or other indication of proximity’ to the bounding condition 180.Holzer Patel Drennan 5 Attorney Docket No.: 708038PCT

[0021] The navigation module 110 may also be in operative communication with the surgical instrument 130. The surgical instrument 130 may have a tool portion 132 that acts upon the patient 140 during the operation of the surgical instrument 130. The surgical instrument may be, but is not limited to, a drill, saw, ream, grinder, or another surgical tool. In this regard, the tool portion 132 may comprise a drill bit, a reamer, a grinding tool, or other appropriate tool. The navigation data generated by the navigation module 110 includes the bounding conditions 180. In some implementations, the bounding conditions 180 define edges (e.g., a left edge, a right edge) and an extent of a path through which the surgeon should manipulate the tool portion 132. In some implementations, the bounding conditions 180 define a volume (e.g., a 3-dimensional section), an area (e.g.. a 2-dimensional section), or a line (e.g., a 1 -dimensional path) over which the surgeon must manipulate the tool portion 132 and / or over which the surgeon must avoid manipulating the tool portion 132 during the operation of the surgical instrument 130. In one example, the surgeon must excise, extract, or otherwise remove all tissue of an anatomical feature (e.g., anatomical feature 142, anatomical feature 144) that falls within the bounding conditions 180. In another example, the surgeon must drill, with the tool portion 132. a straight (or curved) path defined by bounding conditions 180, including a left boundary, a right boundary, and an end boundary, as depicted in the example of FIG. 1. In another example, the surgeon must drill or otherwise operate, with the tool portion 132, along one or more straight (or curved) paths, planar or curved areas, and / or volumes defined by bounding conditions 180 along one or more axes of translation, one or more axes of rotation, or other axis, as appropriate, over which the tool portion 132 may be manipulated. The navigation data including the bounding conditions 180 may be generated by an operator of the surgical instrument 130 prior to surgery. In some instances, the bounding conditions 180 may be generated with respect to anatomical features defined based on imaging data of the patient 140.

[0022] The surgical instrument 130 may also include a measurement system 134 such as those described above. As may be appreciated, the surgical instrument 130 may include onboard sensors 120 that may be disposed at or integrated with the surgical instrument 130. In this regard, bi-directional communication may be established between the navigation module 110 and the surgical instrument 130. As such, data from the surgical instrument 130 may be provided to the navigation module 110 such as outputs from the sensors (e.g., on-board sensors 120) and / or measurement system 134. Furthermore, the navigation module 110 may provide (e.g., via the navigation assistance component 112) data to the surgical instrument 130 (e.g.,Holzer Patel Drennan 6 Attorney Docket No.: 708038PCTincluding a control signal that controls operation of the surgical instrument 130 (e.g., including controlling one or more navigational assistance measures as described above).

[0023] In some implementations, and as shown schematically in FIG. 1, the patient 140 may present reference anatomical features 142 (e.g., that may comprise external or visible anatomical features). In addition, the patient may have internal anatomical features 144 which may appear in the imaging data. Such internal anatomical features may be alternatively referred to as imaged anatomical features. The reference anatomical features 142 may be visible from an exterior the patient 140. In contrast, the internal anatomical features 144 may not be visible from an exterior of the patient 140. However, the medical imager 152 may be operative to image the patient 140 in an imaging study such that both reference anatomical features 142 as well as imaged anatomical features 144 are included the imaging data stored in the image repository 150. The imaging data may be generated by the medical imager 152 in real time to provide real time imaging data regarding the patient 140. Alternatively, the medical imager 152 may image the patient 140 prior to use of the surgical instrument 130 such that the imaging data regarding the patient 140 from a previously conducted imaging study may be stored in the image repository 150. As described above, the imaging data from the previously conducted imaging study may include imaging data corresponding to the patient in a number of configurations having the patient in various physical positions. In addition, the imaging data may include or be analyzed to produce imaging data corresponding to digital manipulations of the imaging data (e.g., a 3D model) to result in different configurations of the patient anatomy.

[0024] In some embodiments, wide-field sensors 122 may be provided separate from the surgical instrument 130. The wide-field sensor may include within its field of observation both the surgical instrument 130 and the patient 140. In this regard, the wide-field sensor may observe the surgical instrument 130 in relation to one or more reference anatomical features 142. This may be used to generate positioning data that is provided to the navigation module 110 for generation of navigation data (e.g., via the navigation component 111) as will be described in greater detail below.

[0025] Additionally or alternatively, the surgical instrument 130 may include on-board sensors 120 that are provided at or integrated with the surgical instrument 130. FIG. 2 illustrates an example surgical instrument 130 that includes integrated sensors (e.g., on-board sensors 120). The surgical instrument 130 has been disposed relative to the patient 140. As can be seen, the tool portion 132 may be in contact with a reference anatomical feature 142 of the patient 140. In this regard, the on-board sensors 120 may define a field of observation that may capture the reference anatomical features 142. As described above, the reference anatomical featuresHolzer Patel Drennan 7 Attorney Docket No.: 708038PCT142 may correspond to appendages such as arms, legs, hands, feet, fingers, toes; a portion of the body such as a torso, head, pelvis; or may correspond to contours of the skin of the patient 140 to provide the positioning data that relates the relative position of the surgical instrument 130 to the reference anatomical features 142 observed by the sensors (e.g., on-board sensors 120).

[0026] In some implementations, the one or more bounding conditions 180 are defined wi th respect to one or more locations of one or more reference anatomical features 142. For example, the bounding conditions 180 define a 5 mm hole to be drilled a distance of 10 mm through a specific anatomical feature 142 and a further 3mm into an internal anatomical feature 144. In another example, a 10 mm cube volume (e.g., representing a cancerous tumor and some surrounding healthy tissue) to be excised from a specific region of an anatomical feature 142. Accordingly, the bounding conditions 180 may be defined as a region of interest defined in terms of one or more anatomical features 142 and internal anatomical features 144. In some implementations, the operator of the surgical instrument 130 can configure the one or more bounding conditions 180.

[0027] A number of potential sensors and sensor configurations are contemplated as potentially applicable in various embodiments of the present disclosure. For instance, the sensors (e.g., on-board sensors 120 and / or wide-field sensors 122) may include ultrasonic, infrared, laser, and / or optical sensors. A number of potential technologies for interpreting sensor inputs may be provided without limitation. For instance, a time-of-flight sensor may be employed as any one of an ultrasonic, infrared, laser, or optical sensor. Moreover, in relation to optical sensors, the sensors may include stereo-optic sensors, time-of-flight sensors, structure light sensors, and / or light field sensors. In connection with any of the foregoing sensors, the surgical instrument may include appropriate emitters and receptors for use in connection with any of the sensors described herein, as will be described in greater detail below. Additionally, it is contemplated that the sensors (e.g., on-board sensors 120 and / or wide-field sensors 122) may include inertial measurement sensors and / or mechanical sensors (e.g., including an articulated arm).

[0028] In this regard, specific combinations of the foregoing sensors have been contemplated. Accordingly, certain combinations of sensors are to be described herein, yet it should be understood such descriptions are not to be limiting and other combinations not specifically addressed herein are contemplated. Moreover, description of a sensor configuration as comprising a combination of sensor types is intended to confer a specific combination of sensor technologies without necessarily implying a quantity of sensors used. As such,Holzer Patel Drennan 8 Attorney Docket No.: 708038PCTdescription of a sensor configuration as including an optic sensor and an ultrasound sensor does not necessarily limit such a configuration to a single optic sensor and a single ultrasound sensor.

[0029] In an embodiment, the sensor configuration may include a multi-imager optical sensor array. In this embodiment, a plurality of sensors (e.g., three or more optical sensors) may be arrayed to observe the surgical site. In turn, the imaging data obtained by the optical sensor array may be provided to a controller that stitches the images together to create depth and / or orientation information.

[0030] In another embodiment, the sensor configuration may include a three-dimensional imager and infrared time-of-flight sensor. This may include a single imager with an infrared light source and a time-of-flight controller hardware. This approach may utilize infrared wavelength input of an imager to measure the time of flight of infrared light from the emitter to determine image field depth and to capture a surgical site image.

[0031] In another embodiment, the sensor configuration may include a structured light imager. This approach may include a single imager plus a micromirror array controller. This may include use of a micromirror array (e.g., utilizing digital light processing technology) to create depth information for an image.

[0032] In another embodiment, the senor configuration may include a light field (plenoptic) lens and imager. This approach may employ a single imager that utilizes a special light field lens called a plenoptic lens that captures information about the light field emanating from a scene including the intensity of light in a scene and the direction that the light rays are traveling in space. In turn, software may process the captured light field information to create a three-dimensional image.

[0033] In another embodiment, the sensor configuration may include an imager and articulating arm. In this approach, the interment may be engaged with an articulating arm that may measure the position and / or orientation of the instrument in the field. This may be coupled with an imager to capture information regarding the surgical site.

[0034] In still another embodiment, the sensor configuration may include an imager, an inertial measurement unit, and a laser time of flight sensor. In this approach, the inertial measurement unit may measure the orientation of the drill and may utilize the laser time of flight sensor to determine the depth of the instrument relative to the patient.

[0035] In another embodiment, the sensor configuration may include an imager, an inertial measurement unit, and a laser time of flight sensor. In this approach, a single imager may be provided in combination with an inertial measurement unit to generate orientation information regarding the instrument. Additionally, a time-of-flight infrared sensor mayHolzer Patel Drennan 9 Attorney Docket No.: 708038PCTprovide a depth measurement of the instrument relative to the patient. This may utilize an image to locate the surgical site and then uses the inertial measurement unit data to orient the instrument.

[0036] In an embodiment, the sensor configuration may include an imager, an inertial measurement unit, and an ultrasound sensor. In this approach, a single imager may be provided in combination with an inertial measurement unit to generate orientation information regarding the instrument. Additionally, an ultrasound sensor may provide a depth measurement of the instrument relative to the patient. This may utilize an image to locate the surgical site and then uses the inertial measurement unit data to orient the instrument.

[0037] In yet another embodiment, the sensor configuration may include a multi -imager optic sensor and an infrared time of flight sensor. In this embodiment, a plurality of sensors (e.g., three or more optical sensors) may be arrayed to observe the surgical site. In turn, the imaging data obtained by the optical sensor array may be provided to a controller that stitches the images together to create depth and / or orientation information. Additionally, the time-of- flight infrared sensor may be utilized to determine a depth of the instrument relative to a starting datum.

[0038] The navigation data generated by the navigation module 110 includes the one or more bounding conditions 180 for operation of the surgical instrument 130. In some implementations, the navigation module 110 may be operative to retrieve imaging data from the image repository 150. The navigation module 110 may be operative to identify a corresponding reference feature from the imaging data corresponding to the reference anatomical features 142 of the positioning data generated by the sensors (e.g., on-board sensors 120). In turn, the imaging data may be correlated to the positioning data. As such, the navigation data generated by the navigation module 110 may describe the position of the surgical instrument 130 relative to the imaging data including imaged anatomical features 144.

[0039] FIG. 3 illustrates one example of navigation data that may be displayed on the display 160 where the internal anatomical features 144 are provided from the imaging data such that the position of the surgical instrument 130 relative to the imaged anatomical features 144 and the one or more bounding conditions 180 for operation of the surgical instrument 130 may be shown.

[0040] As w ay of illustration, the internal anatomical features 144 may include a number of different structures. For example, the anatomical feature 200 (e.g., skin layer) may be represented in the imaging data corresponding to the imaged anatomical features 144. Moreover, muscle tissue 202 may be represented. Further still, features such as blood vesselsHolzer Patel Drennan 10 Attorney Docket No.: 708038PCT204 and / or nen es 206 may also be represented in the imaging data and correspond to imaged anatomical features 144. Abone of the patient 140 may be represented in the imaged anatomical features 144. Specifically, a hard outer cortex 208 of a bone may be represented as well as an inner medullary layer 210. While a number of anatomical features have been illustrated in FIG. 3 is relating to internal or imaged anatomical features 144, it may be appreciated that any variety of other imaged anatomical features 144 capable of being imaged and included in the imaging data may be provided without limitation.

[0041] FIG. 3 also illustrates that a trajectory 136 of the surgical instrument 130 may be provided in the navigation data. The trajectory 136 may correspond to a projected trajectory of the surgical instrument 130 (e.g., the tool portion 132) if the surgical instrument 130 were to be advanced along a working axis of the surgical instrument 130. For instance, the working axis may correspond to the axis of rotation for a rotary tool such as a drill or the like. In any regard, the trajectory' 136 may be presented in relation to the imaged anatomical features 144 of the imaging data. As may be appreciated, this trajectory 136 may be provided to the user even prior to the surgical instrument 130 initiating the operation using the surgical instrument 130. The trajectory 136 can also be displayed, as illustrated in FIG. 2. with regard to the one or more bounding conditions 180 for operation the surgical instrument 130. In this regard, a user may be operative to modify the position of the surgical instrument 130 to modify' the trajectory' 136 (so that the operated surgical instrument (e.g., the tool portion 132 thereo ) remains within one or more defined bounding conditions 180). In the example of FIG. 2, if the operator maintained the trajectory 136, the surgical instrument 130 would operate outside of the bounding conditions 180 when it passes the anatomical feature 200, unless the operator rotates the surgical instrument 130 to change the trajectory 136). Furthermore, while Fig. 3 represents the navigation data relative to the imaged anatomical features 144 and the bounding conditions 180 as two-dimensional, it may be appreciated that the navigation and / or imaging data may include three-dimensional data such that the position, orientation, trajectory' 136 and / or bounding conditions 180 of operation of the surgical instrument 130 relative to the imaged anatomical features 144 may be presented in three-dimensions.

[0042] In certain embodiments, the surgical instrument 130 includes a navigation assistance system 170. In some implementations, the navigation module 110 determines (e.g., via the navigation assistance component 112) one or more navigational assistance measures to be applied and instructs (e.g., via the navigation assistance component 112) the navigation assistance system 170 and / or the display 160 to implement one or more navigation assistance measures.Holzer Patel Drennan 11 Attorney Docket No.: 708038PCT

[0043] The navigation assistance system 170 may implement one or more navigational assistance measures of the navigation module 110 that facilitate the operation of the surgical instrument 130 within the defined one or more bounding conditions 180. In some implementations, the navigation assistance system 170 can generate a force in one or more directions upon the surgical instrument 130, change a center of gravity or a center of balance of the surgical instrument 130, and / or can otherwise affect the surgical instrument 130. The operation of the navigation assistance system 170 may increase an operator’s difficulty in navigating the surgical instrument 130 in certain ways relative to the one or more bounding conditions 180. For example, the difficulty may be increased when the surgical instrument 130 deviates away from one or more bounding conditions 180 (e.g., deviates from a predefined path, orientation, area, volume, etc.) or is within a proximity to deviation away from the one or more bounding conditions 180 (e.g., the surgical instrument 130 is within a predefined proximity, e.g., 15 mm, 10 mm or other predefined proximity from a predefined path, orientation, area, volume, etc.). For example, the navigation assistance system 170 may be a gyroscope, a shiftable weight, a magnetic resistance system, an attached robotic arm, or another system that can apply a force to, shift a center of balance of, or otherwise affect the surgical instrument 130 so that a difficulty of the operator guiding the surgical instrument 130 in one or more directions is increased. In some instances, the navigation module 110 instructs (e.g., via the navigation assistance component 112) the navigation assistance system 170 to generate force(s) in one or more directions based on a detected position and / or trajectory 136 of the surgical instrument 130 (e g., of the tool portion 132 thereof) with respect to the one or more determined bounding conditions 180.

[0044] For example, the navigation module 110 instructs (e.g., via the navigation assistance component 112) the navigation assistance system 170 to generate forces, generate haptic feedback (e.g., vibrations), change a center of balance of, or otherwise affect the surgical instrument 130 such that maintaining a trajectory 136 (e.g., operation along a particular path and / or orientation) that approaches an extent of a bounding condition 180 (e.g., an edge of a predefined path, orientation, area, volume, etc.) becomes increasingly difficult for the operator as the tool portion 132 of the surgical instrument 130 approaches the extent of the bounding condition 180. In some implementations, the navigation assistance system 170 acts upon the surgical instrument 130 such that changing the trajectory 136 of the surgical instrument 130 to approach the extent of the bounding condition 180 becomes increasingly difficult for the operator as the tool portion 132 approaches the bounding condition 180. In some implementations, the navigation assistance system 170 generates forces, changes a center ofHolzer Patel Drennan 12 Attorney Docket No.: 708038PCTbalance of, a center of gravity of, or otherwise affects the surgical instrument 130 such that passing the bounding condition 180 becomes impossible without the surgeon applying a predefined amount of force (e.g., one foot pound, five foot pounds, or another predefined amount of force that is greater than an amount of force that would be required in the absence of application of the navigational assistance measure) to the surgical instrument 130, which may be configured to generate a resistive force (e.g., via a gyroscope). In some implementations, the navigation assistance system 170 generates haptic feedback to alert the surgeon when the current position of the surgical instrument 130 reaches a bounding condition 180 or is within a threshold proximity to the bounding condition 180.

[0045] The display 160 may implement one or more navigational assistance measures of the navigation module 110 that facilitate the operation of the surgical instrument 130 within the defined one or more bounding conditions 180. For example, the navigation module 110 may instruct the display to display a first indicator (e.g., a green icon) when the surgical instrument 130 is operating within the one or more bounding conditions 180and to display a second indicator (e.g., a red icon) when the surgical instrument 130 reaches and / or passes one or more of the one or more bounding conditions 180. In some implementations, instead of and / or addition to the first indicator vs. the second indicator, the display 160 may be instructed to output no sound vs. an alarm sound, to output no special effect vs. a special effect (e.g., flashing / blinking), and / or other display-based navigational assistance measures that indicate to the surgeon when the surgical instrument 130 is being operated within the one or more bounding conditions 180 vs. outside of the one or more bounding conditions 180.

[0046] FIG. 4 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions. The surgical instrument 430 includes tool portion 432 that a surgeon is operating within anatomical feature 442. Operation of the surgical instrument 430 is represented by force 490 in FIG. 4, which represents the surgeon changing the trajectory of the surgical instrument 430 during the operation of the surgical instrument 430.

[0047] The navigation module 410 generates navigation data defining bounding conditions 480 for the operating surgical instrument 430. The example bounding conditions 480 are within the anatomical feature 442 (e.g., bone) and do not extend into anatomical feature 444 (e.g., tissue within the bone). In some implementations, a navigation module 410 determines that a position (e.g., including a location along an x-y axis and a measured depth along a z-axis, with respect to a surgical reference frame) of the operating surgical instrument 430 and / or a trajectory of the operating surgical instrument 430 approaches one or more of the boundingHolzer Patel Drennan 13 Attorney Docket No.: 708038PCTconditions 180 and instructs the navigational assistance system 470 to generate a force 495 or other countermeasure (e.g.. a change in a center of balance) to increase a difficulty in maintaining the current trajectory, as illustrated by an arrow in FIG. 4.

[0048] The navigation module 410 is communicatively coupled to the display 460. In some implementations, the display 460 displays the current position of the surgical instrument 430, the bounding conditions 480, a current trajectory of the surgical instrument 430 with respect to anatomical features of the patient, or other navigation data during the operation of the surgical instrument 430, as instructed by the navigation module 410. In some implementations, the navigation module 410 instructs the display 460 to display a first indicator (e.g., a green icon) when the surgical instrument 430 is operated within the bounding conditions 480 and a second indicator (e.g., a red icon) when the surgical instrument 430 is operated outside of the bounding conditions 480. In some implementations, instead of and / or addition to the first indicator vs. the second indicator, the display 460 may be instructed to output no sound vs. an alarm sound, to output no special effect vs. a special effect (e.g., flashing / blinking), and / or other displaybased navigational assistance measures that indicate to the surgeon when the surgical instrument 430 is being operated within the one or more bounding conditions 480 vs. outside of the one or more bounding conditions 480.

[0049] FIG. 5 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions. The surgical instrument 530 includes tool portion 532 that a surgeon is operating within anatomical feature 542. Operation of the surgical instrument 530 is represented by arrow 590 in FIG. 5. In the example depicted in FIG. 5, the surgeon maintains the trajectory of operation of the surgical instrument 430 / 530 despite the force 495 navigational assistance measure applied by the navigational assistance system 470 / 570 that is depicted in FIG. 4.

[0050] The navigation module 510 generates navigation data defining bounding conditions 580 for the operating surgical instrument 530. The example bounding conditions 580 depicted in FIG. 5 correspond to the bounding conditions 580 depicted in FIG. 5. The example bounding conditions 580 are within the anatomical feature 542 and do not extend into anatomical feature 544. In some implementations, the navigation module 510 determines that a position of the operating surgical instrument 530 and / or a trajectory of the operating surgical instrument 530 approaches one or more of the bounding conditions 580 and instructs the navigational assistance system 570 to generate a force 595 (or other countermeasure, for example, a change in center of balance) to increase a difficulty in maintaining the current trajectory, as illustrated by an arrow in FIG. 5. When compared to the force 495, the force 595 (e.g., or change in theHolzer Patel Drennan 14 Attorney Docket No.: 708038PCTcenter of balance) is greater because the surgeon has continued to approach the rightmost bounding condition 580. The surgeon must now exert a greater amount of force (e.g., represented by arrow 590) to operate the surgical instrument 530 in the current trajectory compared to the force 490 required to maintain the same trajectory in the situation depicted in FIG. 4.

[0051] The navigation module 510 is communicatively coupled to the display 560. In some implementations, the display 560 displays the current position of the surgical instrument 530. the bounding conditions 580, a current trajectory of the surgical instrument 530 with respect to anatomical features of the patient, or other navigation data during the operation of the surgical instrument 530, as instructed by the navigation module 510. In some implementations, the navigation module 510 instructs the display 560 to display a first indicator (e.g., a green icon) when the surgical instrument 530 is operated within the bounding conditions 580 and a second indicator (e.g., a red icon) when the surgical instrument 530 is operated outside of the bounding conditions 580. In some implementations, instead of and / or addition to the first indicator vs. the second indicator, the display 560 may be instructed to output no sound vs. an alarm sound, to output no special elfect vs. a special elfect (e.g., flashing / blinking), and / or other displaybased navigational assistance measures that indicate to the surgeon when the surgical instrument 530 is being operated within the one or more bounding conditions 580 vs. outside of the one or more bounding conditions 580. As depicted in FIG. 5, when the surgical instrument 530 reaches the rightmost bounding condition 580, the display 560 outputs an alert 599 (e.g., a visual and / or sound output) that notifies the surgeon that the bounding condition 580 has been reached.

[0052] FIG. 6 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions. The surgical instrument 630 includes tool portion 632 that a surgeon is operating within anatomical feature 642. Operation of the surgical instrument 630 is represented by force 690 in FIG. 6, which represents the surgeon changing the trajectory of the surgical instrument 630 during the operation of the surgical instrument 630. For example, the surgeon is pushing or otherw ise guiding the operating surgical instrument 630 in a downward trajectory.

[0053] The navigation module 610 generates navigation data defining bounding conditions 680 for the operating surgical instrument 630. The example bounding conditions 680 are within the anatomical feature 642 (e.g., bone) and do not extend into anatomical feature 644 (e.g., tissue within bone). In some implementations, the navigation module 610 determines that a position of the operating surgical instrument 630 and / or a trajectory of the operating surgicalHolzer Patel Drennan 15 Attorney Docket No.: 708038PCTinstrument 630 approaches one or more of the bounding conditions 680 (e.g., the bottommost bounding condition 680 depicted in FIG. 6) and instructs the navigational assistance system 670 to generate a force 695 to increase a difficulty in maintaining the cunent trajectory, as illustrated by an arrow in FIG. 6. The navigation module 610 is communicatively coupled to the display 660.

[0054] The navigation module 610 is communicatively coupled to the display 660. In some implementations, the display 660 displays the current position of the surgical instrument 630. the bounding conditions 680, a current trajectory of the surgical instrument 630 with respect to anatomical features of the patient, or other navigation data during the operation of the surgical instrument 630, as instructed by the navigation module 610. In some implementations, the navigation module 610 instructs the display 660 to display a first indicator (e.g., a green icon) when the surgical instrument 630 is operated within the bounding conditions 680 and a second indicator (e.g., a red icon) when the surgical instrument 630 is operated outside of the bounding conditions 580. In some implementations, instead of and / or addition to the first indicator vs. the second indicator, the display 660 may be instructed to output no sound vs. an alarm sound, to output no special effect vs. a special effect (e.g., flashing / blinking), and / or other displaybased navigational assistance measures that indicate to the surgeon when the surgical instrument 630 is being operated within the one or more bounding conditions 680 vs. outside of the one or more bounding conditions 680.

[0055] FIG. 7 illustrates navigational assistance measures of an operating surgical instrument for maintenance of a surgical instrument within one or more defined bounding conditions. The surgical instrument 730 includes tool portion 732 that a surgeon is operating within anatomical feature 742. Operation of the surgical instrument 730 is represented by arrow 790 in FIG. 7. For example, the surgeon is pushing or otherwise guiding the operating surgical instrument 730 farther along the downward trajectory from its depicted position in FIG. 6 despite the force 695 navigational assistance measure applied by the navigational assistance system 670 / 770 that is depicted in FIG. 6.

[0056] The navigation module 710 generates navigation data defining bounding conditions 780 for the operating surgical instrument 730. The example bounding conditions 780 depicted in FIG. 7 corresponds to the bounding conditions 680 depicted in FIG. 6. The example bounding conditions 780 are within the anatomical feature 742 and do not extend into anatomical feature 744. In some implementations, the navigation module 710 determines that a position of the operating surgical instrument 730 and / or a trajectory of the operating surgical instrument 730 approaches one or more of the bounding conditions 780 and instructs theHolzer Patel Drennan 16 Attorney Docket No.: 708038PCTnavigational assistance system 770 to generate a force 795 to increase a difficulty in maintaining the current trajectory, as illustrated by an arrow in FIG. 7. When compared to the force 695, the force 795 is greater because the surgeon has continued to cause the surgical instrument 730 to approach the bottommost bounding condition 780. The surgeon must now exert a greater amount of force (e.g., represented by arrow 790) to operate the surgical instrument 730 in the current trajectory compared to the force 690 required to maintain the same trajectory in the situation depicted in FIG. 6.

[0057] The navigation module 710 is communicatively coupled to the display 760. In some implementations, the display 760 displays the current position of the surgical instrument 730, the bounding conditions 780, a current trajectory of the surgical instrument 730 with respect to anatomical features of the patient, or other navigation data during the operation of the surgical instrument 730, as instructed by the navigation module 710. In some implementations, the navigation module 710 instructs the display 760 to display a first indicator (e.g., a green icon) when the surgical instrument 730 is operated within the bounding conditions 780 and a second indicator (e.g., a red icon) when the surgical instrument 730 is operated outside of the bounding conditions 780. In some implementations, instead of and / or addition to the first indicator vs. the second indicator, the display 760 may be instructed to output no sound vs. an alarm sound, to output no special effect vs. a special effect (e.g., flashing / blinking), and / or other displaybased navigational assistance measures that indicate to the surgeon when the surgical instrument 730 is being operated within the one or more bounding conditions 780 vs. outside of the one or more bounding conditions 780. As depicted in FIG. 7, when the surgical instrument 730 reaches the bottommost bounding condition 780, the display 760 outputs an alert 799 (e.g., a visual and / or sound output) that notifies the surgeon that the bounding condition 780 has been reached.

[0058] FIG. 8 depicts operations 800 for providing navigation assistance for operating a surgical instrument within a bounding condition.

[0059] Example operation 802 determines the position of a tool portion of an operating surgical instrument with respect to a boundary of operation.

[0060] Example operation 804 determines a navigational assistance measure configured to avoid navigation of the operating surgical instrument past the boundary.

[0061] Example operation 806 applies the navigational assistance measure.

[0062] FIG. 9 illustrates an example computing device 900 for use in implementing the described technology’. The computing device 900 may be a client computing device (such as a laptop computer, a desktop computer, or a tablet computer), a server / cloud computingHolzer Patel Drennan 17 Attorney Docket No.: 708038PCTdevice, an Intemet-of-Things (loT), any other ty pe of computing device, or a combination of these options. The computing device 900 includes one or more hardware processor(s) 902 and a memory 904. The memory 904 generally includes both volatile memory (e.g., RAM) and nonvolatile memory (e.g., flash memon ). although one or the other type of memory may be omitted. An operating system 910 resides in the memory 904 and is executed by the processor(s) 902. In some implementations, the computing device 900 includes and / or is communicatively coupled to storage 920.

[0063] In the example computing device 900, as shown in FIG. 9, one or more software modules, segments, and / or processors, such as applications 940, a navigation assistance system, a measurement system, a navigation assistance component, a navigation component, a display, a medical imager, an image repositors’, and other program code and modules are loaded into the operating system 910 on the memory 904 and / or the storage 920 and executed by the processor(s) 902. The storage 920 may store bounding conditions, current and past positions of the operating surgical instrument, imaging data, and other data and be local to the computing device 900 or may be remote and communicatively connected to the computing device 900. In particular, in one implementation, components of a system for classifying a dataset may be implemented entirely in hardware or in a combination of hardware circuitry and software.

[0064] The computing device 900 includes a power supply 916, which may include or be connected to one or more batteries or other power sources, and which provides power to other components of the computing device 900. The power supply 916 may also be connected to an external power source that overrides or recharges the built-in batteries or other power sources.

[0065] The computing device 900 may include one or more communication transceivers 930, which may be connected to one or more antenna(s) 932 to provide network connectivity (e.g., mobile phone network, Wi-Fi®, Bluetooth®) to one or more other servers, client devices, loT devices, and other computing and communications devices. The computing device 900 may further include a communications interface 936 (such as a network adapter or an I / O port, which are types of communication devices). The computing device 900 may use the adapter and any other types of communication devices for establishing connections over a wide-area network (WAN) or local-area network (LAN). It should be appreciated that the network connections shown are exemplar}' and that other communications devices and means for establishing a communications link between the computing device 900 and other devices may be used.Holzer Patel Drennan 18 Attorney Docket No.: 708038PCT

[0066] The computing device 900 may include one or more input devices 934 such that a user may enter commands and information (e.g., a keyboard, trackpad, or mouse). These and other input devices may be coupled to the server by one or more interfaces 938, such as a serial port interface, parallel port, or universal serial bus (USB). The computing device 900 may further include a display 922, such as a touchscreen display.

[0067] The computing device 900 may include a variety' of tangible processor-readable storage media and intangible processor-readable communication signals. Tangible processor- readable storage can be embodied by any available media that can be accessed by the computing device 900 and can include both volatile and nonvolatile storage media and removable and non-removable storage media. Tangible processor-readable storage media excludes intangible, transitory communications signals (such as signals per se) and includes volatile and nonvolatile, removable, and non-removable storage media implemented in any method, process, or technology for storage of information such as processor-readable instructions, data structures, program modules, or other data. Tangible processor-readable storage media includes, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology. CDROM, digital versatile disks (DVD) or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage, or other magnetic storage devices, or any other tangible medium which can be used to store the desired information and which can be accessed by the computing device 600. In contrast to tangible processor-readable storage media, intangible processor-readable communication signals may embody processor- readable instructions, data structures, program modules, or other data resident in a modulated data signal, such as a carrier wave or other signal transport mechanism. The term "modulated data signal" means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, intangible communication signals include signals traveling through wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared, and other wireless media.

[0068] Some implementations may comprise an article of manufacture, which excludes software per se. An article of manufacture may comprise a tangible storage medium to store logic and / or data. Examples of a storage medium may include one or more types of computer-readable storage media capable of storing electronic data, including volatile memory or nonvolatile memory, removable or non-removable memory, erasable or nonerasable memory, writeable or re-writeable memory, and so forth. Examples of the logic may include various software elements, such as software components, programs, applications.Holzer Patel Drennan 19 Attorney Docket No.: 708038PCTcomputer programs, application programs, system programs, machine programs, operating system software, middleware, firmware, software modules, routines, subroutines, operation segments, methods, procedures, software interfaces, application program interfaces (API), instruction sets, computing code, computer code, code segments, computer code segments, words, values, symbols, or any combination thereof. In one implementation, for example, an article of manufacture may store executable computer program instructions that, when executed by a computer, cause the computer to perform methods and / or operations in accordance with the described embodiments. The executable computer program instructions may include any suitable types of code, such as source code, compiled code, interpreted code, executable code, static code, dynamic code, and the like. The executable computer program instructions may be implemented according to a predefined computer language, manner, or syntax, for instructing a computer to perform a certain operation segment. The instructions may be implemented using any suitable high-level, low-level, object-oriented, visual, compiled, and / or interpreted programming language.

[0069] In some aspects, the techniques described herein relate to a method for providing navigation assistance for operating a surgical instrument relative to a bounding condition, including: determining a position of a tool portion of an operating surgical instrument relative to the bounding condition; and responsive to determining that the position does not satisfy the bounding condition, applying a navigational assistance measure.

[0070] In some aspects, the techniques described herein relate to a method, wherein the bounding condition includes a first proximity to a boundary specified by the bounding condition, wherein determining that the position does not satisfy the bounding condition includes determining that the position is at or within the first proximity, and wherein applying the navigational assistance measure increases a force required to move the operating surgical instrument closer to the boundary than the first proximity.

[0071] In some aspects, the techniques described herein relate to a method, wherein the navigational assistance measure includes changing a center of gravity of the operating surgical instrument.

[0072] In some aspects, the techniques described herein relate to a method, wherein changing the center of gravity includes causing a weight within the operating surgical instrument to shift position.

[0073] In some aspects, the techniques described herein relate to a method, wherein applying the navigational assistance measure includes operating a gyroscope of the operatingHolzer Patel Drennan 20 Attorney Docket No.: 708038PCTsurgical instrument to generate a resistive force against an operating force applied by operator to the operating surgical instrument.

[0074] In some aspects, the techniques described herein relate to a method, wherein the resistive force is less than the operating force.

[0075] In some aspects, the techniques described herein relate to a method, wherein the navigational assistance measure includes applying a force to the operating surgical instrument.

[0076] In some aspects, the techniques described herein relate to a method, wherein applying the force includes instructing a robotic arm in contact with the surgical instrument to apply the force to the operating surgical instrument.

[0077] In some aspects, the techniques described herein relate to a method, wherein the force is less than an orienting force applied by an operator to the operating surgical instrument.

[0078] In some aspects, the techniques described herein relate to a method, wherein the position includes a trajectory toward the bounding condition, wherein applying the navigational assistance measure increases an operating force required to maintain the operating surgical instrument on a trajectory.

[0079] In some aspects, the techniques described herein relate to a method, wherein the navigational assistance measure includes haptic feedback.

[0080] In some aspects, the techniques described herein relate to a method, wherein the navigational assistance measure includes an alert, wherein applying the navigational assistance measure includes instructing a display device to output the alert.

[0081] In some aspects, the techniques described herein relate to a method, wherein the alert includes one or more of a visual alert or an auditory alert.

[0082] In some aspects, the techniques described herein relate to a method, wherein the bounding condition includes a first proximity to a boundary specified by the bounding condition, wherein determining that the position does not satisfy the bounding condition includes determining that the position is at or within the first proximity, and wherein the navigational assistance measure is applied at a first intensity, and further including: responsive to determining that a subsequent position of the operating surgical instrument is within a second proximity to the boundary', applying a subsequent navigational assistance measure, the second proximity being closer to the boundary than the first proximity, the subsequent navigational assistance measure being the navigational assistance measure applied at a second intensity, the second intensity being greater than the first intensity.Holzer Patel Drennan 21 Attorney Docket No.: 708038PCT

[0083] In some aspects, the techniques described herein relate to a system for providing navigation assistance for operating a surgical instrument within a boundary condition, including: a navigation component configured to determine a position of a tool portion of an operating surgical instrument relative to the boundary7condition; and a navigation assistance component configured to apply, responsive to determining that the position does not satisfy the boundary condition, a navigational assistance measure.

[0084] The implementations described herein are implemented as logical steps in one or more computer systems. The logical operations may be implemented (1) as a sequence of processor-implemented steps executing in one or more computer systems and (2) as interconnected machine or circuit modules within one or more computer systems. The implementation is a matter of choice, dependent on the performance requirements of the computer system being utilized. Accordingly, the logical operations making up the implementations described herein are referred to variously as operations, steps, objects, or modules. Furthermore, it should be understood that logical operations may be performed in any order, unless explicitly claimed otherwise or a specific order is inherently necessitated by the claim language. While this specification contains many specific implementation details, these should not be construed as limitations on the scope of any technologies or of what may be claimed, but rather as descriptions of features specific to particular implementations of the particular described technology. Certain features that are described in this specification in the context of separate implementations can also be implemented in combination in a single implementation. Conversely, various features that are described in the context of a single implementation can also be implemented in multiple implementations separately or in any suitable sub-combination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a sub-combination or variation of a sub-combination.

[0085] Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In certain circumstances, multitasking and parallel processing may be advantageous. Moreover, the separation of various system components in the implementations described above should not be understood as requiring such separation in all implementations, and it should be understood that the described program components andHolzer Patel Drennan 22 Attorney Docket No.: 708038PCTsystems can generally be integrated together in a single software product or packaged into multiple software products.

[0086] Thus, particular implementations of the subject matter have been described. Other implementations are within the scope of the following claims. In some cases, the actions recited in the claims can be performed in a different order and still achieve desirable results. In addition, the processes depicted in the accompanying figures do not necessarily require the particular order shown, or sequential order, to achieve desirable results. In certain implementations, multitasking and parallel processing may be advantageous.

[0087] A number of implementations of the described technology' have been described. Nevertheless, it will be understood that various modifications can be made without departing from the spirit and scope of the recited claims.Holzer Patel Drennan 23 Attorney Docket No.: 708038PCT

Claims

What is claimed is:

1. A method for providing navigation assistance for operating a surgical instrument relative to a bounding condition, comprising: determining a position of a tool portion of an operating surgical instrument relative to the bounding condition; and responsive to determining that the position does not satisfy the bounding condition, applying a navigational assistance measure.

2. The method of claim 1, wherein the bounding condition includes a first proximity to a boundary specified by the bounding condition, wherein determining that the position does not satisfy the bounding condition includes determining that the position is at or within the first proximity, and wherein applying the navigation assistance measure increases a force required to move the operating surgical instrument closer to the boundary than the first proximity.

3. The method of claim 1, wherein the navigational assistance measure comprises changing a center of gravity of the operating surgical instrument.

4. The method of claim 3, wherein changing the center of gravity includes causing a weight within the operating surgical instrument to shift position.

5. The method of claim 1 , wherein applying the navigational assistance measure comprises operating a gy roscope of the operating surgical instrument to generate a resistive force against an operating force applied by operator to the operating surgical instrument.

6. The method of claim 5, wherein the resistive force is less than the operating force.

7. The method of claim 1, wherein the navigational assistance measure comprises applying a force to the operating surgical instrument.

8. The method of claim 7, wherein applying the force includes instructing a robotic arm in contact with the surgical instrument to apply the force to the operating surgical instrument.

9. The method of claim 6, wherein the force is less than an orienting force applied by an operator to the operating surgical instrument.Holzer Patel Drennan 24 Attorney Docket No.: 708038PCT10. The method of claim 1, wherein the position comprises a trajectory toward the bounding condition, wherein applying the navigation assistance measure increases an operating force required to maintain the operating surgical instrument on a trajectory.

11. The method of claim 1, wherein the navigational assistance measure comprises haptic feedback.

12. The method of claim 1, wherein the navigation assistance measure comprises an alert, wherein applying the navigational assistance measure includes instructing a display device to output the alert.

13. The method of claim 12, wherein the alert comprises one or more of a visual alert or an auditory alert.

14. The method of claim 1, wherein the bounding condition includes a first proximity to a boundary specified by the bounding condition, wherein determining that the position does not satisfy the bounding condition includes determining that the position is at or within the first proximity, and wherein the navigational assistance measure is applied at a first intensity, and further comprising: responsive to determining that a subsequent position of the operating surgical instrument is within a second proximity to the boundary, applying a subsequent navigational assistance measure, the second proximity being closer to the boundary than the first proximity, the subsequent navigational assistance measure being the navigational assistance measure applied at a second intensity, the second intensity being greater than the first intensity.

15. A system for providing navigation assistance for operating a surgical instrument within a boundary condition, comprising: a navigation component configured to determine a position of a tool portion of an operating surgical instrument relative to the boundary condition; and a navigation assistance component configured to apply, responsive to determining that the position does not satisfy the boundary condition, a navigational assistance measure.Holzer Patel Drennan 25 Attorney Docket No.: 708038PCT

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