JP7263300B2 - Surgical robot with passive end effector - Google Patents

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application is a continuation-in-part of US patent application Ser. No. 16/587,203, filed September 30, 2019. This application also claims the benefit of US Provisional Patent Application No. 62/906,831, filed September 27, 2019. The contents of each of these applications are hereby incorporated by reference in their entirety for all purposes.

TECHNICAL FIELD The present disclosure relates to medical devices and systems, and more particularly to robotic systems and associated end effectors and associated methods and devices for controlling cutting of patient anatomy.

There are several surgical interventions that require osteotomies, i.e., cutting an anatomical structure, such as bone, along a target plane. Total knee arthroplasty usually requires cutting both the femoral and tibial heads to remove the damaged bone and cartilage and introduce the knee prosthesis. A surgeon can use an oscillating surgical saw to make five or more cuts on the femur and one or more cuts on the tibia.

In orthopedic surgery involving joints and knees, it is important to precisely match and stabilize the saw while cutting the bone at the desired location. The surgeon's limited visibility to the surgical site, combined with the difficulty of controlling the movement of the saw, creates the risk of cutting unwanted portions of bone or adjacent tissue. Vibrations produced by the saw during cutting can reduce the accuracy of the cut. In knee surgery, the accuracy of the bone cut (planar cut) affects how accurately the implant can be connected to the exposed bone.

In some knee surgeries, a jig is screwed into the bone to guide the movement of the surgeon's saw during cutting. Misalignment of the jig during cutting and limited stability of the saw blade can limit the accuracy of the cut. Additionally, contact between the saw blade and the jig can create debris, which risks entering the patient.

In conventional orthopedic surgery involving cutting bone with a saw, the saw can be guided using one of the following approaches. (1) a manual approach by the surgeon, (2) a bone grafting jig approach, and (3) a robotic system approach holding a saw handpiece.

The jig may have slots for engaging the saw blade to prevent the saw blade from deviating from the desired planar guidance. This approach has several drawbacks. First, it may be necessary to attach the jig to the bone, usually using pins. Second, it may require backlash between the jig and saw blade, which reduces accuracy. Third, there is friction between the oscillating saw blade and the jig, and this friction creates debris that has potential impact on clinical outcomes, dulls the blade, and blocks some of the important force feedback. remove.

Some known robotic systems are capable of holding and guiding saw handpieces. These robotic systems may assume that the blade oscillates in a certain predefined plane with respect to the handpiece. This approach has drawbacks. For example, the saw blade amplitude mechanism and the saw blade mounting stiffness directly affect the stiffness of the saw blade guide. Additionally, it can be difficult to integrate different power tool/saw handpieces into the robotic system due to the complexity of the external surfaces that the robot must hold onto. As a result, new saws for robotic systems must be developed and obtained by users of robotic systems. Additionally, for overall system safety, there is a potential risk of reduced accuracy if the blade does not move within the expected plane with respect to the handpiece (eg, due to incorrect assembly).

Therefore, there is a need for a direct saw blade guidance system in orthopedic surgery without jig or saw handpiece guidance.

Some embodiments of the present disclosure are directed to direct blade guidance systems. A direct blade guidance system includes a robotic arm that can be positioned by a surgical robot and an end effector arm that includes a base configured to attach to an end effector coupler of the robotic arm. The end effector arm includes a plurality of joints connected by a plurality of joints including a distal joint disposed at the distal end of the end effector arm. The blade guidance system may also include a blade adapter connected to the end effector arm via a distal joint, a blade connected to the blade adapter, and a handpiece connected to the blade.

Some embodiments of the present disclosure are directed to a surgical system that determines the orientation of an anatomical structure cut by a saw blade and has a tracking system configured to determine the orientation of the saw blade. . The surgical system also includes a surgical robot having a robotic base, a robotic arm connected to the robotic base, and at least one motor operably connected to move the robotic arm relative to the robotic base. include. The surgical system also includes a blade guidance system having an end effector arm including a base configured to attach to the end effector coupler of the robotic arm. The end effector arm includes a plurality of joints connected by a plurality of joints including a distal joint disposed at the distal end of the end effector arm. The blade guidance system also includes a blade adapter connected to the end effector arm via a distal joint, a blade connected to the blade adapter, and a handpiece connected to the blade.

The accompanying drawings, which are included to provide a further understanding of the disclosure, and which are incorporated in and constitute a part of this application, illustrate certain non-limiting embodiments of the inventive concept. In the drawing are:
1 illustrates an embodiment of a surgical system according to some embodiments of the present disclosure; 2 illustrates surgical robotic components of the surgical system of FIG. 1, according to some embodiments of the present disclosure; 2 illustrates camera tracking system components of the surgical system of FIG. 1, according to some embodiments of the present disclosure; 4 illustrates an embodiment of a passive end effector connectable to a robotic arm and constructed in accordance with some embodiments of the present disclosure; 1 illustrates a medical procedure in which a surgical robot and camera system are arranged around a patient; 4 illustrates an embodiment of a robotic arm end effector coupler configured to connect to a passive end effector, according to some embodiments of the present disclosure; 7 illustrates a notch embodiment of the end effector coupler of FIG. 6; 1 illustrates a block diagram of components of a surgical system according to some embodiments of the present disclosure; FIG. A surgical robot that is separate from, operably connected to, or at least partially incorporated within a surgical robot, according to some embodiments of the present disclosure. 1 illustrates a block diagram of a surgical system computer platform including a surgical planning computer; FIG. 4 illustrates an embodiment of a C-arm imaging device that can be used in combination with a surgical robot and passive end effectors, according to some embodiments of the present disclosure; 4 illustrates an embodiment of an O-arm imaging device that can be used in combination with a surgical robot and passive end effectors, according to some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; 4 illustrates an alternative embodiment of a passive end effector constructed in accordance with some embodiments of the present disclosure; FIG. 11 is a screen shot of a display showing the progress of cutting a bone during a surgical procedure; FIG. 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 4 illustrates an exemplary embodiment of a portion of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a blade adapter consistent with the principles of the present disclosure; 1 illustrates an exemplary embodiment of a direct blade guidance system consistent with the principles of the present disclosure;

The concepts of the present invention will now be described more fully hereinafter with reference to the accompanying drawings, in which exemplary embodiments of the concepts of the invention are shown. The inventive concepts may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of various inventive concepts to those skilled in the art. Note also that these embodiments are not mutually exclusive. It may be implicitly assumed that elements from one embodiment are present or used in another embodiment.

Various embodiments disclosed herein are directed to improvements in the operation of surgical systems when performing surgical interventions requiring osteotomy. A passive end effector is disclosed that is connectable to a robotic arm that is positioned by a surgical robot. Passive end effectors have a pair of features that constrain the movement of the tool attachment mechanism to a certain range of motion. The tool mount is connectable to a surgical saw for cutting, such as a sagittal saw having an oscillating saw blade. The mechanism may be configured to constrain the cutting plane of the saw blade to be parallel to the work plane. The surgical robot can determine a target plane pose based on a surgical plan that defines where the anatomical structure will be cut and based on the pose of the anatomical structure. Maneuvering information can be generated based on a comparison of the position of the surgical saw and the position of the surgical saw. The steering information positions the saw blade at a distance from the anatomy to be cut where the cutting plane of the saw blade is coincident with the target plane and the saw blade is within the range of motion of the tool attachment mechanism of the passive end effector. indicates where the passive end effector needs to be moved so that

These and other related embodiments can be operated to improve the accuracy of saw blade guidance compared to other robotic and manual (eg, jig) solutions for surgery. The passive end effector mechanism allows the surgeon to focus on interpreting direct force feedback while cutting bone using a surgical saw guided by the passive end effector. can be. The mechanism may, for example, have one to three suitably selected degrees of freedom (e.g., one translation or rotation, two rotations, three It may also be a planar mechanism with end joints (rotational, or other combination, etc.). The surgeon can also more accurately monitor and control the rate of bone removal based on audio and/or visual notification feedback provided through the surgical robot.

These embodiments can provide guidance during joint surgery, especially knee surgery with high precision, high stiffness, ample working space, and direct force feedback. To cut the bone, a tracking system can be used to precisely match the cutting plane and the target plane, as described in detail below. Precision cutting constrains the cutting plane and target plane to remain coincident while the surgeon moves the saw blade along the cutting plane and directly senses the saw blade's force feedback as it cuts through the bone. , can be achieved by a planar mechanism. Moreover, these embodiments can be rapidly deployed in surgical practice through prescribed modifications of existing and accepted surgical workflows.

FIG. 1 illustrates an embodiment of surgical system 2 according to some embodiments of the present disclosure. Prior to performing orthopedic surgery, for example using C-arm imaging device 104 of FIG. 10 or O-arm imaging device 106 of FIG. 11, or computed tomography (CT) images or another medical imaging device such as MRI. , a three-dimensional (“3D”) image scan of the patient's planned surgical area can be performed. This scan can be done preoperatively (eg, most commonly several weeks before the procedure) or intraoperatively. However, any known 3D or 2D image scan can be used in accordance with various embodiments of surgical system 2 . The image scans are sent to a computer platform in communication with surgical system 2, such as surgical robot 800 (eg, robot 2 of FIG. 1) and surgical system computer platform 900 of FIG. A surgeon reviewing the image scan(s) on the display device of surgical planning computer 910 (FIG. 9) produces a surgical plan that defines the target planes in which the patient's anatomy will be cut. This plane is a function of the patient's anatomical constraints, the implant selected, and its size. In some embodiments, a surgical plan defining a target plane is planned on a 3D image scan displayed on a display device.

Surgical system 2 of FIG. 1 can, for example, perform medical procedures by holding tools, matching tools, using tools, guiding tools, and/or positioning tools for use. It can assist the surgeon during the procedure. In some embodiments, surgical system 2 includes surgical robot 4 and camera tracking system 6 . Both systems can be mechanically coupled together by any of a variety of mechanisms. Suitable mechanisms may include, but are not limited to, mechanical latches, bonds, clamps or buttresses, or magnetic or magnetized surfaces. The ability to mechanically couple surgical robot 4 and camera tracking system 6 allows surgical system 2 to be manipulated and moved as a single unit, providing surgical system 2 with a small footprint. , can facilitate movement through narrow passages and turns, and can allow storage within a smaller area.

An orthopedic surgical procedure may begin by moving surgical system 2 from medical storage to a medical procedure room. The surgical system 2 can operate from doorways, halls, and elevators all the way to the medical procedure room. Within the room, surgical system 2 may be physically separated into two separate and distinct systems, surgical robot 4 and camera tracking system 6 . Surgical robot 4 may be positioned adjacent to the patient at any suitable location to adequately assist medical personnel. The camera tracking system 6 may be positioned at the patient base, the patient's shoulders, or any other location suitable for tracking the current and trajectory pose movements of the surgical robot 4 and patient parts. . Surgical robot 4 and camera tracking system 6 may be powered by an on-board power supply and/or plugged into an external wall outlet.

Surgical robot 4 may be used to assist a surgeon by holding and/or using tools during a medical procedure. To properly utilize and hold tools, surgical robot 4 may rely on a number of motors, computers, and/or actuators to function properly. As illustrated in FIG. 1, robot body 8 may act as a structure to which a plurality of motors, computers, and/or actuators may be fixed within surgical robot 4 . Robot body 8 may also provide support for robot telescoping support arm 16 . In some embodiments, robot body 8 may be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, glass fiber, or tough plastics. The size of the robot body 8 can provide a rigid platform to support the attached components and accommodate multiple motors, computers, and/or actuators capable of operating the attached components. , can be hidden and protected.

Robot base 10 may act as a lower support for surgical robot 4 . In some embodiments, the robot base 10 can support the robot body 8 and attach the robot body 8 to multiple powered wheels 12 . This attachment to the wheels allows the robot body 8 to move efficiently through space. The robot base 10 may extend in the length and width directions of the robot body 8 . The robot base 10 can be from about 2 inches to about 10 inches tall. Robot base 10 may be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, glass fiber, or tough plastics or resins. Robotic base 10 can cover, protect, and support powered wheels 12 .

In some embodiments, at least one powered wheel 12 can be attached to the robot base 10, as illustrated in FIG. Motorized wheels 12 may be attached to robot base 10 at any location. Each individual powered wheel 12 can rotate about a vertical axis in any direction. A motor may be disposed on, in, or adjacent to the powered wheel 12 . This motor allows maneuvering the surgical system 2 to any location, stabilizing and/or leveling the surgical system 2 . A rod located in or adjacent to the powered wheel 12 can be driven into the surface by a motor. Rods, not shown, may be made of any metal suitable for lifting surgical system 2 . Suitable metals can be, but are not limited to, stainless steel, aluminum, or titanium. Furthermore, the rod can be provided with a damping material, not shown, at the end facing the contact surface, which can prevent the rod from slipping and/or create a favorable contact surface. The material can be any material suitable to act as a cushioning material. Suitable materials can be, but are not limited to, plastic, neoprene, rubber, or textured metal. The rod lifts the powered wheel 10 capable of lifting the surgical system 2 to any height required to level or otherwise fix the orientation of the surgical system 2 relative to the patient. can be done. The weight of surgical system 2 is supported by rods on each wheel with a small contact area to prevent surgical system 2 from moving during the medical procedure. This rigid positioning may prevent objects and/or people from accidentally moving surgical system 2 .

Movement of surgical system 2 may be facilitated using robotic rail material 14 . Robot rail material 14 provides a person with the ability to move surgical system 2 without grasping robot body 8 . As illustrated in FIG. 1 , the robot rail material 14 may extend in the length direction of the robot body 8 shorter than the robot body 8 and/or may extend longer than the length of the robot body 8 . Robot rail material 14 may be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, glass fiber, or tough plastics. The robot rail material 14 may further provide protection for the robot body 8 and prevent objects and/or personnel from contacting, bumping, or colliding with the robot body 8 .

The robot body 8 can provide support for a horizontal articulated robot, hereinafter referred to as a "scala". SCARA 24 may be beneficial for use within surgical system 2 due to the simultaneous reproducibility and compactness of the robotic arm. The scala's compactness can provide additional space within a medical procedure, which can allow medical professionals to perform medical procedures without undue clutter and restricted areas. . SCARA 24 may include robotic telescoping support 16 , robotic support arm 18 , and/or robotic arm 20 . A robot telescoping support 16 may be disposed along the robot body 8 . As illustrated in FIG. 1, robotic telescoping support 16 may provide support for scala 24 and display 34 . In some embodiments, the robotic telescoping support 16 can extend and retract vertically. Robotic telescoping support 16 may be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium or stainless steel, carbon fiber, glass fiber, or tough plastics. The body of the robotic telescoping support 16 can be of any width and/or height that supports the stresses and weight applied thereto.

In some embodiments, the medical practitioner can move the scala 24 via commands submitted by the medical practitioner. Commands may result from input received at the display 34 and/or the tablet. A command may come from a switch press and/or multiple switch presses. As best illustrated in FIGS. 4 and 5, activation assembly 60 may include a switch and/or multiple switches. Activation assembly 60 may be operable to send movement commands to SCARA 24 to allow an operator to manually manipulate SCARA 24 . When the switch or switches are depressed, the healthcare worker may have the ability to easily move the scala 24 . Additionally, when the scara 24 has not received a command to move it, the scara 24 can be locked in place to prevent accidental movement by personnel and/or other objects. By locking in place, the scara 24 provides a rigid platform ready for the passive end effector 1100 and connected surgical saw 1140 shown in FIGS. 4 and 5 to be used in medical surgery. offer.

The robot support arm 18 may be disposed on the robot telescoping support 16 by various mechanisms. In some embodiments, as best seen in FIGS. 1 and 2, robot support arm 18 rotates in any direction relative to robot telescoping support 16 . The robot support arm 18 can rotate 360 degrees around the robot telescoping support 16 . Robot arm 20 may be connected to robot support arm 18 at any suitable location. Robot arm 20 may be attached to robot support arm 16 by various mechanisms. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball and socket fittings, press fittings, welds, adhesives, screws, rivets, clamps, latches, and/or any combination thereof. The robot arm 20 can rotate in any direction with respect to the robot support arm 18 , and in embodiments the robot arm 20 can rotate 360 degrees with respect to the robot support arm 18 . This free rotation allows the operator to position the robot arm 20 as planned.

The passive end effector 1100 of Figures 4 and 5 may be attached to the robot arm 20 at any suitable location. As described in further detail below, passive end effector 1100 includes a base, a first mechanism, and a second mechanism. The base is configured to attach to an end effector coupler 22 of a robotic arm 20 positioned by surgical robot 4 . Various mechanisms by which the base can be attached to the end effector coupler 22 include latches, clamps, nuts and bolts, ball and socket fittings, press fit, welds, adhesives, screws, rivets, and/or any of these. Combinations can include, but are not limited to. A first mechanism extends between a rotatable connection to the base and a rotatable connection to the implement attachment mechanism. A second mechanism extends between a rotatable connection to the base and a rotatable connection to the implement attachment mechanism. The first and second mechanisms may be configured to pivot about the rotatable connection and constrain movement of the implement attachment mechanism to a range of motion within the work surface. A rotatable connection allows three DOFs of motion, whether it is a pivot joint that allows one degree of freedom (DOF) of motion or a universal joint that allows two DOFs of motion It may be a ball joint that makes The tool attachment mechanism is configured to connect to a surgical saw 1140 having a saw blade or to connect directly to a saw blade. Surgical saw 1140 may be configured to oscillate the saw blade to cut. The first and second mechanisms may be configured to constrain the cutting plane of the saw blade to be parallel to the work plane. Pivot joints can be used to connect planar mechanisms, preferably where passive end effectors are configured to constrain the motion of the saw blade to the cutting plane.

Tool attachment mechanisms are connected to surgical saw 1140 or saw blades via a variety of mechanisms, which may include, but are not limited to, screws, nuts and bolts, clamps, latches, joints, press fits, or magnets. obtain. In some embodiments, dynamic reference array 52 is attached to passive end effector 1100 , eg, a tool attachment mechanism, and/or attached to surgical saw 1140 . A dynamic reference array, also referred to herein as a "DRA," is a rigid body that can be disposed on a patient, surgical robot, passive end effector, and/or surgical saw in a navigated surgical procedure. body. The camera tracking system 6 or other 3D localization system is configured to track the pose (eg, position and rotational orientation) of the DRA's tracking markers in real time. Tracking markers may include the exemplary array of balls or other optical markers. This tracking of the 3D coordinates of the tracking markers may allow surgical system 2 to determine the pose of DRA 52 in any space relative to the target anatomy of patient 50 in FIG.

As illustrated in FIG. 1, a light indicator 28 may be positioned on top of scala 24 . Light indicator 28 may illuminate as any type of light to indicate the "status" in which surgical system 2 is currently operating. For example, green lighting may indicate that all systems are healthy. A red illumination may indicate that the surgical system 2 is not operating properly. Pulsed light may mean that surgical system 2 is performing a function. The combination of light and pulses can create an almost infinite amount of combinations for communicating current operating conditions, states, or other operational indications. In some embodiments, the light may be generated by an LED bulb that may form a ring around light indicator 28 . Light indicator 28 may include a fully transmissive material that allows light to shine through light indicator 28 .

A light indicator 28 may be attached to the lower display support 30 . As illustrated in FIG. 2, the lower display support 30 may allow the operator to maneuver the display 34 to any suitable location. Lower display support 30 may be attached to light indicator 28 by any suitable mechanism. In embodiments, lower display support 30 may rotate about light indicator 28 . In embodiments, lower display support 30 may be rigidly attached to light indicator 28 . The light indicator 28 can then rotate 360 degrees about the robot support arm 18 . Lower display support 30 may be of any suitable length, with suitable lengths ranging from about 8 inches to about 34 inches. Lower display support 30 may act as a base for upper display support 32 .

Upper display support 32 may be attached to lower display support 30 by any suitable mechanism. Upper display support 32 may be of any suitable length, with suitable lengths ranging from about 8 inches to about 34 inches. In an embodiment, as illustrated in FIG. 1, upper display support 32 allows display 34 to rotate 360 degrees relative to upper display support 32 . Similarly, upper display support 32 can rotate 360 degrees relative to lower display support 30 .

Display 34 may be any device capable of being supported by upper display support 32 . In embodiments, as illustrated in FIG. 2, display 34 may produce color images and/or black and white images. The width of display 34 can be from about 8 inches to about 30 inches wide. The height of display 34 can be from about 6 inches to about 22 inches high. The depth of display 34 can be from about 1/2 inch to about 4 inches.

In embodiments, a tablet may be used with display 34 and/or without display 34 . In embodiments, the table may be disposed on the upper display support 32 instead of the display 34 and may be removable from the upper display support 32 during medical surgery. Additionally, the tablet can communicate with the display 34 . The tablet may be connectable to surgical robot 4 by any suitable wireless and/or wired connection. In some embodiments, the tablet may be capable of programming and/or controlling surgical system 2 during a medical procedure. All input and output commands can be duplicated on the display 34 when the tablet is used to control the surgical system 2 . Use of a tablet may allow an operator to manipulate surgical robot 4 without having to move around patient 50 and/or to surgical robot 4 .

As illustrated in FIG. 5, camera tracking system 6 works in conjunction with surgical robot 4 via a wired or wireless communication network. Referring to FIGS. 1 and 5, camera tracking system 6 may include several components similar to surgical robot 4 . For example, camera body 36 may provide functionality found in robot body 8 . The robot body 8 can provide a structure on which the camera 46 is mounted. Structures within the robot body 8 can also provide support for the electronics, communication devices, and power supplies used to operate the camera tracking system 6 . Camera body 36 may be made of the same material as robot body 8 . Camera tracking system 6 may communicate directly with tablet and/or display 34 over a wireless and/or wired network to allow tablet and/or display 34 to control the functions of camera tracking system 6 .

A camera body 36 is supported by a camera base 38 . Camera base 38 may function as robot base 10 . In the embodiment of FIG. 1, camera base 38 may be wider than robot base 10 . The width of camera base 38 may allow camera tracking system 6 to interface with surgical robot 4 . As illustrated in FIG. 1, the width of camera base 38 may be large enough to fit over the outside of robot base 10 . The additional width of camera base 38 may allow for additional maneuverability and support of surgical system 2 when camera tracking system 6 and surgical robot 4 are connected.

Similar to robot base 10 , multiple motorized wheels 12 may be attached to camera base 38 . The powered wheels 12 allow the camera tracking system 6 to stabilize or set a fixed orientation relative to the patient 50, similar to the motion of the robot base 10 and powered wheels 12. can enable This stabilization may prevent camera tracking system 6 from moving during a medical procedure, and as shown in FIG. Losing track of one or more DRAs 52 connected to equipment 58 can be prevented. This stability and maintenance of tracking enhances the ability of surgical robot 4 to operate effectively with camera tracking system 6 . Additionally, wide camera base 38 can provide additional support for camera tracking system 6 . Specifically, as illustrated in FIG. 5, the wide camera base 38 can prevent the camera tracking system 6 from tipping over when the camera 46 is positioned over the patient. Without the wide camera base 38, the widened camera 46 may unbalance the camera tracking system 6, which may result in the camera tracking system 6 falling over.

Camera telescoping support 40 can support camera 46 . In an embodiment, the telescoping support 40 allows the camera 46 to move vertically up and down. Telescoping support 40 may be made of any suitable material for supporting camera 46 . Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, glass fiber, or tough plastics. Camera handle 48 may be attached to camera telescoping support 40 at any suitable location. Camera handle 48 may be of any suitable handle configuration. Suitable configurations may be, but are not limited to, bars, circles, triangles, squares, and/or any combination thereof. As illustrated in FIG. 1, the camera handle 48 may be triangular, allowing the operator to move the camera tracking system 6 to a planned position prior to medical surgery. In embodiments, camera handle 48 may be used to lower and raise camera telescoping support 40 . Camera handle 48 may effect raising and lowering of camera telescoping support 40 by depression of buttons, switches, levers, and/or any combination thereof.

The lower camera support arm 42 can be attached to the camera telescoping support 40 at any suitable location, and in embodiments, as illustrated in FIG. can be rotated 360 degrees. This free rotation allows the operator to position camera 46 in any suitable location. Lower camera support arm 42 may be made of any suitable material for supporting camera 46 . Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, glass fiber, or tough plastics. The cross-section of lower camera support arm 42 may be of any suitable shape. Suitable cross-sectional shapes may be, but are not limited to, circular, square, rectangular, hexagonal, octagonal, or i-beam. The cross-sectional length and width can be about 1-10 inches. The length of the lower camera support arm can be from about 4 inches to about 36 inches. Lower camera support arm 42 may be connected to telescoping support 40 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball and socket fittings, press fittings, welds, adhesives, screws, rivets, clamps, latches, and/or any combination thereof. A lower camera support arm 42 can be used to provide support for the camera 46 . Camera 46 may be attached to lower camera support arm 42 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball and socket fittings, press fittings, welds, adhesives, screws, rivets, and/or any combination thereof. The camera 46 can pivot in any direction with the mounting area between the camera 46 and the lower camera support arm 42 . In embodiments, a curved rail 44 may be disposed on the lower camera support arm 42 .

Curved rail 44 may be disposed at any suitable location on lower camera support arm 42 . As illustrated in FIG. 3, curved rail 44 may be attached to lower camera support arm 42 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, nuts and bolts, ball and socket fittings, press fittings, welds, adhesives, screws, rivets, clamps, latches, and/or any combination thereof. Curved rail 44 may be any suitable shape, which may be crescent, circular, oval, elliptical, and/or any combination thereof. In embodiments, curved rail 44 may be of any suitable length. A suitable length may be from about 1 foot to about 6 feet. Camera 46 may be movably disposed along curved rail 44 . Camera 46 may be attached to curved rail 44 by any suitable mechanism. Suitable mechanisms can be, but are not limited to, rollers, brackets, braces, motors, and/or any combination thereof. Motors and rollers not illustrated can be used to move camera 46 along curved rail 44 . As illustrated in FIG. 3, during a medical procedure, when an object is preventing camera 46 from viewing one or more DRAs 52, the motor uses rollers to move the camera along curved rail 44. 46 can be moved. This motorized movement allows camera 46 to move to a new position where it is no longer obstructed by the object without moving camera tracking system 6 . While camera 46 is prevented from viewing DRA 52, camera tracking system 6 may send a stop signal to surgical robot 4, display 34, and/or tablet. The stop signal can prevent the scalar 24 from moving until the camera 46 has the DRA 52 again. This stop may prevent scara 24 and/or end effector coupler 22 from moving and/or using a medical device without being tracked by surgical system 2 .

As illustrated in FIG. 6, end effector coupler 22 is configured to connect various types of passive end effectors to surgical robot 4 . End effector coupler 22 may include saddle joint 62 , activation assembly 60 , load cell 64 ( FIG. 7 ), and connector 66 . A saddle joint 62 may attach the end effector coupler 22 to the scala 24 . Saddle joint 62 may be made of any suitable material. Suitable materials can be, but are not limited to, metals such as titanium, aluminum, or stainless steel, carbon fiber, glass fiber, or tough plastics. The saddle joint 62 can be made from a single piece of metal that can provide additional strength and durability to the end effector. Saddle joint 62 may be attached to SCARA 24 by attachment points 68 . There may be multiple attachment points 68 disposed about the saddle joint 62 . Attachment point 68 may be recessed over saddle joint 62 , level with saddle joint 62 , and/or disposed on saddle joint 62 . In some embodiments, screws, nuts and bolts, and/or any combination thereof may pass through attachment points 68 to secure saddle joint 62 to SCARA 24 . Nuts and bolts may connect the saddle joint 62 to a motor (not illustrated) within the SCARA 24 . The motor can move the saddle joint 62 in any direction. The motor can be actively servoed at its current location or applied with a spring-actuated brake to further prevent the saddle joint 62 from moving due to accidental bumps and/or accidental contact. can.

End effector coupler 22 may include a load cell 64 interposed between saddle joint 62 and a connected passive end effector. Load cell 64 may be attached to saddle joint 62 by any suitable mechanism, as illustrated in FIG. Suitable mechanisms can be, but are not limited to, screws, nuts and bolts, threads, press fits, and/or any combination thereof.

FIG. 8 illustrates a block diagram of components of surgical system 800 according to some embodiments of the present disclosure. 7 and 8, load cell 64 can be any suitable device used to detect and measure force. In some examples, load cell 64 may be a six-axis load cell, a three-axis load cell, or a single-axis load cell. A load cell 64 can be used to track the force applied to the end effector coupler 22 . In some embodiments, load cell 64 may communicate with multiple motors 850 , 851 , 852 , 853 , and/or 854 . When load cell 64 senses force, information regarding the amount of force applied may be distributed from the switch array and/or multiple switch arrays to controller 846 . Controller 846 can obtain force information from load cell 64 and process it with a switch algorithm. The switch algorithm is used by controller 846 to control motor driver 842 . Motor drivers 842 control the operation of one or more of the motors. A motor driver 842 can instruct a particular motor to generate an equal amount of force measured by the load cell 64 through the motor, for example. In some embodiments, the force generated may come from multiple motors, eg, 850-854, as directed by controller 846. FIG. Additionally, motor driver 842 may receive input from controller 846 . Controller 846 may receive information from load cell 64 regarding the direction of force sensed by load cell 64 . Controller 846 can process this information using motion controller algorithms. This algorithm can be used to provide information to a particular motor driver 842 . Controller 846 can activate and/or deactivate a particular motor driver 842 to duplicate the direction of force. Controller 846 can control one or more motors, eg, one or more of 850-854, to induce motion of passive end effector 1100 in the direction of force sensed by load cell 64. . This force-controlled motion allows the operator to move the scara 24 and passive end effector 1100 effortlessly and/or with little resistance. Movement of passive end effector 1100 positions passive end effector 1100 in any suitable orientation (i.e., location and angle relative to a defined three-dimensional (3D) orthogonal reference axis) for use by medical personnel. orientation).

Connector 66 is configured to be connectable to the base of passive end effector 1100 and is connected to load cell 64 . Connector 66 may include attachment points 68 , sensing buttons 70 , implement guides 72 , and/or implement connections 74 . There may be multiple attachment points 68, as best illustrated in FIGS. Attachment points 68 may connect connector 66 to load cell 64 . Attachment points 68 may be recessed above connector 66 , flush with connector 66 , and/or disposed on connector 66 . Attachment points 68 and 76 may be used to attach connector 66 to load cell 64 and/or passive end effector 1100 . In some examples, attachment points 68 and 76 may include screws, nuts and bolts, press fits, magnetic attachments, and/or any combination thereof.

As illustrated in FIG. 6, sensing buttons 70 may be disposed around the center of connector 66 . When the passive end effector 1100 is connected to the scala 24, the sense button 70 can be depressed. Depressing the sensing button 70 can alert the surgical robot 4 and thus the medical personnel that the passive end effector 1100 is attached to the scala 24 . As illustrated in FIG. 6, guides 72 can be used to facilitate proper attachment of the passive end effector 1100 to the scala 24. As shown in FIG. Guide 72 may be recessed over connector 66 , flush with connector 66 , and/or disposed over connector 66 . In some embodiments, there may be multiple guides 72, may have any suitable pattern, and may be oriented in any suitable direction. Guide 72 may be of any suitable shape to facilitate attachment of passive end effector 1100 to scala 24 . Suitable shapes may be, but are not limited to, circular, oval, square, polyhedral, and/or any combination thereof. Further, the guides 72 may be cut at bevels, straight lines, and/or any combination thereof.

Connector 66 may have attachment points 74 . As illustrated in FIG. 6, attachment points 74 may form a ledge and/or multiple ledges. Attachment points 74 can provide connector 66 with a surface against which passive end effector 1100 can clamp. In some embodiments, attachment points 74 are disposed about any surface of connector 66 and oriented in any suitable manner relative to connector 66 .

Activation assembly 60 , best illustrated in FIGS. 6 and 7 , may surround connector 66 . In some embodiments, activation assembly 60 may take the form of a bracelet that wraps around connector 66 . In some embodiments, activation assembly 60 may be located within any suitable area within surgical system 2 . In some embodiments, activation assembly 60 may be located on any portion of scala 24, any portion of end effector coupler 22, and may be worn (and wirelessly) by medical personnel and/or any combination thereof. communicate). Activation assembly 60 may be made of any suitable material. Suitable materials can be, but are not limited to, neoprene, plastic, rubber, gel, carbon fiber, fabric, and/or any combination thereof. Activation assembly 60 may include primary button 78 and secondary button 80 . Primary button 78 and secondary button 80 may completely surround connector 66 .

Primary button 78 may be a single ridge that may surround connector 66, as illustrated in FIG. In some embodiments, primary button 78 may be disposed on activation assembly 60 along the edge furthest away from saddle joint 62 . Primary button 78 may be disposed on primary activation switch 82 best illustrated in FIG. A primary activation switch 82 may be disposed between connector 66 and activation assembly 60 . In some embodiments, there may be multiple primary activation switches 82 that may be disposed adjacent and beneath primary button 78 along the entire length of primary button 78 . Depressing primary button 78 on primary activation switch 82 allows the operator to move scala 24 and end effector coupler 22 . As discussed above, once installed, the scara 24 and end effector coupler 22 cannot be moved until the operator programs the surgical robot 4 to move the scara 24 and end effector coupler 22. or moved using primary button 78 and primary activation switch 82 . In some embodiments, it may be necessary to depress at least two non-adjacent primary activation switches 82 before the scala 24 and end effector coupler 22 respond to operator commands. Depressing at least two primary activation switches 82 may prevent accidental movement of the scara 24 and end effector coupler 22 during a medical procedure.

When activated by primary button 78 and primary activation switch 82, load cell 64 can measure the magnitude and/or direction of force exerted on end effector coupler 22 by an operator, i.e., a medical practitioner. This information can be transferred to a motor within SCARA 24 that can be used to move SCARA 24 and end effector coupler 22 . Information about the magnitude and direction of the force measured by load cell 64 allows the motor to move scala 24 and end effector coupler 22 in the same direction sensed by load cell 64 . This force-controlled movement allows the operator to move the scala 24 and end effector coupler 22 at the same time that the motor moves the scala 24 and the end effector coupler 22 so that the operator can easily and without great effort 24 and end effector coupler 22 can be moved.

As illustrated in FIG. 6, secondary button 80 may be disposed on the end of actuation assembly 60 closest to saddle joint 62 . In some embodiments, secondary button 80 may include multiple ridges. A plurality of ridges may be disposed adjacent to each other and may surround the connector 66 . Further, secondary button 80 may be disposed on secondary activation switch 84 . As illustrated in FIG. 7, secondary activation switch 84 may be disposed between secondary button 80 and connector 66 . In some embodiments, secondary button 80 may be used by the operator as a "select" device. During a medical procedure, surgical robot 4 may notify medical personnel of certain conditions via display 34 and/or light indicator 28 . Medical personnel may be prompted by surgical robot 4 to select functions, modes, and/or assess the status of surgical system 2 . A single depression of secondary button 80 on secondary activation switch 84 activates a particular function, mode, and/or confirms information communicated to medical personnel via display 34 and/or light indicator 28 can do. Additionally, multiple depressions of the secondary button 80 on the secondary activation switch 84 in rapid succession activate additional features, modes, and/or alert the healthcare professional via the display 34 and/or the light indicator 28. The information that is communicated can be selected. In some embodiments, at least two non-adjacent secondary activation switches 84 can be depressed before the secondary button 80 functions properly. This requirement may prevent medical personnel from accidentally bumping activation assembly 60 through unintended use of secondary button 80 . Primary button 78 and secondary button 80 may use software architecture 86 to communicate medical personnel commands to surgical system 2 .

FIG. 8 illustrates a block diagram of components of a surgical system 800 configured in accordance with some embodiments of the present disclosure and which may correspond to surgical system 2 described above. Surgical system 800 includes platform subsystem 802 , computer subsystem 820 , motion control subsystem 840 and tracking subsystem 830 . Platform subsystem 802 includes battery 806 , power distribution module 804 , connector panel 808 , and charging station 810 . Computer subsystem 820 includes computer 822 , display 824 , and speakers 826 . Motion control subsystem 840 includes driver circuitry 842 , motors 850 , 851 , 852 , 853 , 854 , stabilizers 855 , 856 , 857 , 858 , end effector connector 844 , and controller 846 . Tracking subsystem 830 includes position sensor 832 and camera converter 834 . Surgical system 800 may also include removable foot pedals 880 and removable tablet computer 890 .

Input power is supplied to surgical system 800 via a power supply that may be provided to power distribution module 804 . Power distribution module 804 is configured to receive input power and generate different power supply voltages that are provided to other modules, components, and subsystems of surgical system 800 . Power distribution module 804 is provided from other components such as computer 822, display 824, speakers 826, drivers 842, for example, to power motors 850-854 and end effector 844, as well as camera converter 834 and surgical system 800. can be configured to provide the connector panel 808 with different voltage supplies that can be provided to the components of the . The power distribution module 804 may also be connected to a battery 806, which serves as a temporary power source when the power distribution module 804 does not receive power from the input power. In other cases, power distribution module 804 may help charge battery 806 .

Connector panel 808 may help connect different devices and components to surgical system 800 and/or associated components and modules. Connector panel 808 may include one or more ports to receive wires or connections from different components. For example, connector panel 808 may include ground terminal ports that may ground surgical system 800 to other equipment, ports that connect foot pedals 880, position sensors 832, camera converters 834, and marker tracking cameras 870. and a port that connects to subsystem 830 . Connector panel 808 may also include other ports that allow USB, Ethernet, HDMI communication to other components such as computer 822 .

Control panel 816 may provide various buttons or indicators that control operation of surgical system 800 and/or provide information from surgical system 800 for operator observation. For example, the control panel 816 is used to turn the surgical system 800 on and off, to lift and lower the vertical posts 16, and to engage the casters 12 to physically move the surgical system 800. Buttons may be included for raising and lowering the stabilizers 855-858 which may be designed to lock against movement. Other buttons can stop the surgical system 800 in an emergency, thereby removing all motor power and applying a mechanical brake to stop all movement from occurring. can. The control panel 816 may also have indicators that inform the operator of certain system conditions, such as a hardwire power indicator or the state of charge of the battery 806 .

Computer 822 of computer subsystem 820 includes an operating system and software for operating assigned functions of surgical system 800 . Computer 822 can receive and process information from other components (eg, tracking subsystem 830, platform subsystem 802, and/or motion control subsystem 840) to display the information to the operator. . In addition, computer subsystem 820 can provide output to an operator via speaker 826 . The speaker may be part of the surgical robot, part of the head mounted display component, or within another component of surgical system 2 . Display 824 may correspond to display 34 shown in FIGS. 1 and 2, or may be an augmented reality (AR) display that projects images onto a see-through display screen and overlays real-world objects visible through the see-through display screen. ) may be a head-mounted display that forms an image.

Tracking subsystem 830 may include position sensor 832 and camera converter 834 . Tracking subsystem 830 may correspond to camera tracking system 6 of FIG. Marker tracking camera 870 works with position sensor 832 to determine the pose of DRA 52 . This tracking can be done in a manner consistent with this disclosure, including using infrared or visible light technology to track the location of active or passive elements of DRA 52, such as LEDs or reflective markers, respectively. The location, orientation and position of structures having these types of markers such as DRA 52 can be provided to computer 822 and shown to the operator on display 824 . For example, as shown in FIGS. 4 and 5, surgical saw 1240 (which may also be referred to as navigation space) having DRA 52 or connected to end effector coupler 22 having DRA 52 tracked in this manner is , can be shown to the operator in relation to the three-dimensional image of the patient's anatomy.

Motion control subsystem 840 may be configured to physically move vertical strut 16 , upper arm 18 , lower arm 20 or rotate end effector coupler 22 . Physical movement can be accomplished by using one or more motors 850-854. For example, motor 850 may be configured to vertically lift or lower vertical strut 16 . Motor 851 may be configured to laterally move upper arm 18 about a point of engagement with vertical post 16, as shown in FIG. Motor 852 may be configured to laterally move lower arm 20 about a point of engagement with upper arm 18, as shown in FIG. Motors 853 and 854 may be configured to move end effector coupler 22 to provide translational motion and rotation along about three-dimensional axes. Surgical planning computer 910, shown in FIG. 9, provides control inputs to controller 846 that guides movement of end effector coupler 22 to connect passive end effectors to the anatomy that is severed during surgery. It can be positioned in a planned pose (ie, location and angular orientation with respect to a defined 3D orthogonal reference axis) relative to the physical structure. Motion control subsystem 840 may be configured to measure the position of passive end effector structures using integrated position sensors (eg, encoders). In one of the embodiments, the position sensor is directly connected to at least one joint of the passive end effector structure, but is positioned elsewhere in the structure and is controlled by timing belts, wire interconnections, Or joint position can be measured remotely by any other synchronous transmission interconnection.

FIG. 9 is separate from surgical robot 800 and may be operatively connected to surgical robot 800 or at least partially within surgical robot 800, according to some embodiments of the present disclosure. 9 illustrates a block diagram of a surgical system computer platform 900 including a surgical planning computer 910 that can be incorporated into the surgical system. Alternatively, at least a portion of the operations disclosed herein for surgical planning computer 910 may be performed by components of surgical robot 800 such as by computer subsystem 820 .

9, surgical planning computer 910 includes display 912, at least one processor circuit 914 (also referred to as processor for brevity), and at least one memory circuit 916 that includes computer readable program code 918. (also referred to as memory for brevity) and at least one network interface 920 (also referred to as network interface for brevity). Network interface 920 may connect to C-arm imaging device 104 of FIG. 10, O-arm imaging device 106 of FIG. 11, another medical imaging device, image database 950 of medical images, components of surgical robot 800, and/or other It can be configured to connect to an electronic device.

When surgical planning computer 910 is at least partially integrated within surgical robot 800, display 912 corresponds to display 34 of FIG. 2 and/or tablet 890 and/or head mounted display of FIG. Thus, network interface 920 may correspond to platform network interface 812 in FIG. 8, and processor 914 may correspond to computer 822 in FIG.

Processor 914 may include one or more data processing circuits such as general-purpose and/or special-purpose processors, eg, microprocessors and/or digital signal processors. Processor 914 executes computer readable program code 918 in memory 916 to perform operations that may include some or all of the operations described herein as being performed by a surgical planning computer. Configured.

Processor 914 is operable to display bone images received from one of imaging devices 104 and 106 and/or from image database 950 via network interface 920 on display device 912 . Processor 914 may, such as by operator touch selecting a location on display 912 for the planned surgical cut or using a mouse-based cursor to define the location of the planned surgical cut. An operator's definition of where one or more bones are to be cut is received, as shown in one or more images.

Surgical planning computer 910 performs knee surgical procedures such as measurements of various angles to determine hip center, angle center, natural landmarks (e.g., trans-epicondylar line, Whiteside line, posterior condylar line, etc.). Enables anatomical measurements useful for Some measurements may be automatic, while some other measurements involve human input or assistance. This surgical planning computer 910 allows the operator to select the correct implant for the patient, including size and fit selection. Surgical planning computer 910 enables automatic or semi-automatic (with human input) segmentation (image processing) for CT images or other medical images. A patient's surgical plan may be stored on a cloud-based server for retrieval by surgical robot 800 . During surgery, the surgeon uses augmented reality interaction via a computer screen (e.g., touchscreen) or, e.g., a head-mounted display, to determine which cut (e.g., posterior femur, proximal tibia, etc.) choose to do The surgical robot 4 positions the surgical saw blade such that the target plane of the planned cut is optimally positioned within the workspace of the passive end effector interconnecting the surgical saw blade and the robotic arm 20 . It can be automatically moved to the planned position. Commands that enable movement may be given by the user using various modalities, eg, foot pedals.

In some embodiments, the surgical system computer platform 900 uses two DRAs to track the patient's anatomical position, one with respect to the patient's tibia and one with respect to the patient's femur. can be done. Platform 900 can use standard navigation instruments for alignment and confirmation (eg, pointers similar to those used in the Globus Excelsius GPS system for spinal surgery). Tracking markers can also be used that allow detection of motion of the DRA in relation to the tracked anatomy.

A key difficulty in knee surgery is how to plan the position of the knee implant, which many surgeons struggle with on a computer screen, which is a 2D representation of the 3D anatomy. are doing. Platform 900 can address this issue by using an augmented reality (AR) head-mounted display to create an implant overlay around the actual patient's knee. For example, the surgeon can operationally display virtual handles to grasp and move the implant to a desired orientation and adjust the planned implant placement. Later, during surgery, the platform 900 can render navigation via the AR head-mounted display to show the surgeon what is not directly visible. Also, bone removal progress, eg, depth or cut, can be displayed in real time. Other features that can be displayed via AR include gap or ligament balance along the range of joint motion, implant contact lines along the range of joint motion, ligament tension by color or other graphic overlays and/or or relaxation and the like, but are not limited to these.

In some embodiments, surgical planning computer 910 performs standard implants, such as posterior stabilization and cruciate retention implants, cemented and cementless implants, such as total or partial knee replacement, and/or It may be possible to plan the use of the corrective system for hip replacement and/or trauma surgery.

Processor 912 can graphically illustrate on display 912 one or more cutting planes that intersect the displayed anatomy at locations selected by the operator to cut the anatomy. The processor 912 also determines one of the angular orientations and locations at which the end effector coupler 22 must be positioned to align the surgical saw blade cutting plane with the target plane to perform the operator defined cut. Determine these sets and store the set of orientations and locations of those angles as data in the surgical planning data structure. The processor 912 uses the known range of motion of the passive end effector tool attachment mechanism to determine where the end effector coupler 22 attached to the robot arm 20 needs to be positioned.

The computer subsystem 820 of the surgical robot 800 indicates data from the surgical planning data structure as well as the current pose of the anatomy to be cut, tracked via passive end effectors and/or DRA It receives information from the camera tracking system 6 indicating the current pose of the surgical saw. Computer subsystem 820 determines the pose of the target plane based on the surgical plan, which defines where the anatomy is to be cut, and the pose of the anatomy. Computer subsystem 820 produces steering information based on a comparison of the pose of the target plane and the pose of the surgical saw. The steering information positions the saw blade at a distance from the anatomy to be cut where the cutting plane of the saw blade is coincident with the target plane and the saw blade is within the range of motion of the tool attachment mechanism of the passive end effector. indicates where the passive end effector needs to be moved so that

As described above, a surgical robot includes a robot base, a robot arm connected to the robot base, and at least one motor operably connected to move the robot arm relative to the robot base. ,including. The surgical robot also includes at least one controller, eg, computer subsystem 820 and motion control subsystem 840, connected to at least one motor and configured to implement movements.

As described in further detail below with respect to FIGS. 12-19, the passive end effector includes a base configured to attach to an actuation assembly of a robotic arm, a first mechanism, and a second mechanism. ,including. A first mechanism extends between a rotatable connection to the base and a rotatable connection to the implement attachment mechanism. A second mechanism extends between a rotatable connection to the base and a rotatable connection to the implement attachment mechanism. The first and second mechanisms may be configured to pivot about the rotatable connection and constrain movement of the implement attachment mechanism to a range of motion within the work surface. A rotatable connection allows three DOFs of motion, whether it is a pivot joint that allows one degree of freedom (DOF) of motion or a universal joint that allows two DOFs of motion It may be a ball joint that makes The tool attachment mechanism is configured to connect to a surgical saw that includes a saw blade for cutting. The first and second mechanisms may be configured to constrain the cutting plane of the saw blade to be parallel to the work plane.

In some embodiments, the motion performed by at least one controller of the surgical robot includes the cutting plane of the saw blade coinciding with the target plane, and the saw blade aligning the tool attachment mechanism of the passive end effector. Controlling movement of the at least one motor based on the steering information to reposition the passive end effector so that it is positioned at a distance from the anatomy to be cut that is within the range of motion. is also included. The steering information may be displayed to guide operator movement of the surgical saw and/or may be used by at least one controller to automatically move the surgical saw.

In one embodiment, the motions performed by at least one controller of the surgical robot include a saw blade cutting plane coincident with a target plane, and the saw blade controlling movement of the passive end effector tool attachment mechanism. Providing steering information for display on a display device to guide operator movement of the passive end effector as positioned at a distance from the anatomy to be cut within range. be The display device may correspond to display 824 (FIG. 8), display 34 of FIG. 1, and/or head-mounted display.

For example, steering information may be displayed on a head-mounted display that projects an image onto a see-through display screen to form an augmented reality image overlaid on real-world objects visible through the see-through display screen. The operation can display a graphical representation of target planes with poses overlaid on the bones and relative orientations between them, allowing the surgical procedure to plan how to cut the bones. Accommodate plans. The operation may alternatively or additionally display a graphical representation of the cutting plane of the saw blade so that the operator can see the cutting plane and the planned target plane for cutting the bone. can be matched more easily. Thereby, the operator can visually monitor and perform the movement of the saw blade to align the cutting plane with the target plane, whereby the saw blade is held in a planned attitude relative to the bone and passively. positioned within the range of motion of the tool attachment mechanism of the end effector.

Automated imaging systems can be used in conjunction with surgical planning computer 910 and/or surgical system 2 to acquire preoperative, intraoperative, postoperative, and/or real-time image data of a patient. An exemplary automated imaging system is illustrated in FIGS. 10 and 11. FIG. In some embodiments, the automated imaging system is a C-arm 104 (FIG. 10) imaging device or O-arm® 106 (FIG. 11). (O-arm® is copyrighted by Medtronic Navigation, Inc. with offices in Louisville, Colorado, USA) Frequent manual repositioning of the patient, which may be required in X-ray systems It may be desirable to take X-rays of a patient from several different positions without the need for . C-arm 104 X-ray diagnostic equipment can solve the problem of frequent manual repositioning and may be familiar in the medical field of surgery and other interventional procedures. As illustrated in FIG. 10, the C-arm includes elongated C-shaped members terminating in opposed "C"-shaped distal ends 112 . The C-shaped member is attached to the x-ray source 114 and the image receiver 116 . The space within the C-arm 104 of the arm provides room for the physician to attend to the patient with substantially no interference from the x-ray support structure.

The C-arm is mounted to allow rotational movement of the arm in two degrees of freedom (ie about two orthogonal axes in spherical motion). The C-arm is slidably mounted to the x-ray support structure, which allows for orbital rotational movement about the C-arm's center of curvature to move the x-ray source 114 and image receiver 116 vertically and vertically. /or can be selectively oriented horizontally. The C-arm also rotates laterally (i.e., perpendicular to the orbital direction to allow for selectively adjustable positioning of the x-ray source 114 and image receiver 116 relative to both the width and length of the patient). It may be possible. The spherical rotation aspect of the C-arm device allows the physician to take the X-ray of the patient at the optimal angle determined for the particular anatomical situation being imaged.

The O-arm® 106 illustrated in FIG. 11 includes a gantry housing 124 that can enclose an image capture portion, not illustrated. The image capturing portion includes an x-ray source and/or emitting portion and an x-ray receiving and/or image receiving portion, which are disposed approximately 180 degrees to each other and are aligned with the rotor ( not illustrated). The image capture portion may be operable to rotate 360 degrees during image acquisition. The image capture portion can rotate about a center point and/or axis, allowing patient image data to be acquired from multiple directions or in multiple planes.

O-arm® 106 with gantry housing 124 has a central opening for positioning around the object to be imaged and a radiation source rotatable around the interior of gantry housing 124. , the radiation source may be adapted to project radiation from a plurality of different projection angles. The detector system is adapted to detect radiation at each projection angle to acquire images of the object quasi-simultaneously from multiple projection planes. The gantry can be attached in a cantilever fashion to an O-arm® support structure, such as a wheeled mobile cart having wheels. A positioning unit, preferably under the control of a computerized motion control system, translates and/or tilts the gantry to planned positions and orientations. The gantry may include a source and detector disposed opposite each other on the gantry. The source and detector may be fixed to a motorized rotor that allows the source and detector to rotate about the interior of the gantry in unison. The source can be pulsed at multiple positions and orientations over a partial and/or full 360 degree rotation for multi-planar imaging of a target object located inside the gantry. The gantry may further comprise rails and bearing systems for guiding the rotor as it rotates, which may carry the sources and detectors. Both and/or either the O-arm® 106 and C-arm 104 can be used as an automated imaging system to scan the patient and send information to the surgical system 2 .

Images captured by the automated imaging system may be displayed on a display device of surgical planning computer 910 , surgical robot 800 , and/or another component of surgical system 2 .

Various embodiments of passive end effectors configured for use in surgical systems will now be described in the context of FIGS. 12-19.

As described in further detail below, the various passive end effectors illustrated in FIGS. 12-19 each include a base, a first planar feature, and a second planar feature. The base is configured to attach to an end effector coupler (eg, end effector coupler 22, FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18, FIGS. 1 and 2) positioned by a surgical robot. Various clamping mechanisms can be used to securely attach the base to the end effector coupler, eliminate backlash, and ensure suitable stiffness. Irreversible clamping mechanisms that may be used to attach the base to the end effector coupler may include, but are not limited to, toggle articulation mechanisms or irreversible locking screw(s). A user may use additional tools such as screwdrivers, torque wrenches, or drivers to activate or tighten the clamping mechanism. A first mechanism extends between a rotatable connection to the two bases and a rotatable connection to the implement attachment mechanism. A second mechanism extends between a rotatable connection to the base and a rotatable connection to the implement attachment mechanism. The first and second mechanisms pivot about the rotatable connection. A rotatable connection allows three DOFs of motion, whether it is a pivot joint that allows one degree of freedom (DOF) of motion or a universal joint that allows two DOFs of motion It may be a ball joint that makes When using a pivot joint, the first and second mechanisms may be configured to constrain the movement of the implement attachment mechanism to a range of motion within the work plane. The tool attachment mechanism is configured to connect to a surgical saw having a saw blade configured to oscillate for cutting. The first and second mechanisms may be configured to constrain the cutting plane of the saw blade to be parallel to the work plane, for example via a pivot joint having one DOF of motion. Tool attachment mechanisms may be connected to surgical saws or saw blades via a variety of mechanisms, including but not limited to screws, nuts and bolts, clamps, latches, joints, press fits, or magnets. . The DRA can be connected to the tool mounting mechanism or surgical saw to allow tracking of the saw blade pose by camera tracking system 6 (FIG. 3).

As described above, the surgical system (eg, surgical system 2 of FIGS. 1 and 2) cuts with a surgical robot (eg, surgical robot 4 of FIGS. 1 and 2) and a saw blade. a tracking system (eg, camera tracking system 6 of FIGS. 1 and 3) configured to determine the pose of the anatomy and to determine the pose of the saw blade. The surgical robot includes a robot base and a robot arm rotatably connected to the robot base and configured to position a passive end effector. At least one motor is operably connected to move the robot arm relative to the robot base. At least one controller is connected to the at least one motor and determines the orientation of the target plane based on a surgical plan that defines where the anatomy will be cut and the orientation of the anatomy. A surgical plan is generated by the surgical planning computer 910 of FIG. 9 based on input from an operator, e.g., a surgeon or other surgical personnel. obtain. The operation further includes generating steering information based on a comparison of the pose of the target plane and the pose of the surgical saw. The maneuver information indicates where the passive end effector should be moved in order to position the working plane of the passive end effector such that the cutting plane of the saw blade coincides with the target plane.

In some further embodiments, the motions performed by the at least one controller include aligning the cutting plane of the saw blade with the target plane, and the saw blade moving through the range of motion of the tool attachment mechanism of the passive end effector. Controlling movement of at least one motor based on the steering information to reposition the passive end effector such that it is positioned at a distance from the anatomy to be severed within. be

This action involves a saw blade cutting plane and a target plane coinciding with the saw blade at a distance from the anatomy to be cut that is within the range of motion of the tool attachment mechanism of the passive end effector. Providing steering information for display on a display device to guide operator movement of the passive end effector as positioned may be included.

As described above, some surgical systems may include head-mounted display devices that can be worn by surgeons, nurses, and/or other persons assisting in surgical procedures. . The surgical system allows the wearer to more accurately position the passive end effector and/or match the saw blade with the target plane for cutting the planned location on the anatomy. status, information can be displayed that allows confirmation that the passive end effector has been correctly positioned. The operation of providing steering information to the display device includes the anatomy in which the cutting plane of the saw blade coincides with the target plane and the saw blade is within the range of motion of the passive end effector tool attachment mechanism. configuring the steering information for display on a head-mounted display device having a see-through display screen that displays the steering information as an overlay on the severed anatomy, such that the steering information is positioned at a distance from the passive directing operator movement of the end effector.

The acts of configuring the maneuver information for display on the head-mounted display device include producing a graphical representation of the target plane displayed as an overlay anchored to and aligned with the anatomy to be cut; and generating another graphic representation of the cutting plane of the saw blade that is anchored to the blade and displayed as a matching overlay therewith. The wearer can thereby move the surgical saw to provide a visually observed match between the graphically rendered target plane and the graphically rendered cut plane.

The act of configuring the steering information for display on the head mounted display device includes creating a graphical representation of the depth of cut made by the saw blade within the graphical representation of the anatomy being cut. can be included. Therefore, to better monitor how the saw blade cuts through the bone, even though the wearer directly observes that the cut is obstructed by tissue or other structure. In addition, a graphical representation of the depth of cut can be used.

The tracking system may be configured to determine the orientation of the anatomical structure to be cut by the saw blade based on determining the orientation of a tracking marker, e.g., a DRA attached to the anatomical structure; It may be configured to determine the orientation of the surgical saw based on determining the orientation of tracking markers connected to at least one of the surgical saw and the passive end effector. A tracking system determines the attitude of the surgical saw based on rotary position sensors configured to measure the rotational positions of the first and second mechanisms while the tool attachment mechanism moves within the work plane. can be configured to As described above, the position sensor may be directly connected to at least one joint of the passive end effector structure, but may be positioned elsewhere in the structure and may be attached to timing belts, wire interconnections, or any Joint position can also be measured remotely by other synchronous transmission interconnections. Additionally, the saw blade attitude can be determined based on tracking markers attached to the structure base, passive structure position sensors, and kinematic models of the structure.

The various passive end effectors disclosed herein may be sterilizable or non-sterile (covered with a sterile drape) passive 3 DOF (degrees of freedom) mechanical structure, A surgical saw or saw blade, such as a sagittal saw, along two translations in a plane parallel to the saw blade (defining the cutting plane) and one rotation (instrument orientation) perpendicular to this cutting plane allows mechanical induction of During surgery, the surgical robot 4 connects the end effector coupler 22 and the passive end effector and its attached surgical robot so that all bones to be cut are within the working space of the passive end effector. Automatically move the saw to a position close to the knee or other anatomy. This location will depend on the cut being made as well as the surgical plan and implant construct. As shown in FIG. 12, a passive end effector can have 3 DOFs for guiding a sagittal saw or saw blade in the cutting plane, 2 translations (X and Y directions) and 1 DOF. Provides rotation (about the Z axis) of 100 degrees.

Once the surgical robot 4 reaches the planned position, it holds that position (either through brakes or active motor control) and does not move during the cutting of the particular bone. A passive end effector allows the saw blade of a surgical saw to be moved along a planned target plane. Such planar cuts are particularly useful in classical total knee arthroplasty where all bone cuts are planar. Partial knee replacements have a special type of implant called an "onlay" that can be used in conjunction with a saw-prepared bone surface. Various passive end effectors have a mechanical structure that can ensure precision of guidance during cutting with higher accuracy than classical jigs, working space range for cutting all planned bones while providing a sufficient range of (corresponding to a locked DOF ) provide sufficient lateral stiffness.

At the same time, it is preferable to measure the position of the passive end effector, as the surgical robot 4 can inform the surgeon how much bone has been removed (procedure progress). One method of providing real-time information on bone removal is that the surgical robot 4 measures where the saw blade has passed relative to the bone, since the blade can only pass where the bone has been cut. It is to be. A DRA can be attached to a surgical saw and/or a passive end effector to measure saw blade position. This allows direct or indirect measurement of the position of the saw in 3D space. An alternative method of measuring saw blade position uses a mathematical model of a defined relationship between the position of the passive end effector geometry and the position of the saw blade tip. is to integrate position (rotational or translational) sensors (e.g. encoders, resolvers) with passive end effector position information to calculate .

In one embodiment, a conventional sagittal saw mechanism can be used with the surgical system computer platform 900 with little or no modification. Potential modifications would involve adapting the outer shield to allow easy attachment of the surgical saw to the passive end effector, but not necessarily with modification of the internal mechanics. . A passive end effector may be configured to connect to a conventional sagittal saw provided by DeSoutter, for example. Additionally, the saw blade may be attached directly to a passive end effector without a saw handpiece.

To prevent the saw from unintentionally moving the passive end effector as the surgical robot 4 positions the passive end effector, e.g., to prevent the surgical saw from falling onto the patient due to gravity. Additionally, a passive end effector may include a locking mechanism that moves between engagement and disengagement motions. While engaged, the locking mechanism brakes or locks a particular joint either directly by locking the degrees of freedom (DOF) of the surgical saw or a passive end effector. indirectly by blocking movement of the saw blade relative to the robot end effector coupler. While disengaged, the passive end effector first and second mechanisms can move relative to the base without interference from the locking mechanism. The locking mechanism may also be used when the surgeon controls the movement of surgical robot 4 by holding the surgical saw and applying force and torque to the surgical saw. Surgical robot 4 uses load cell 64 , FIGS. To produce upwards, the surgeon can more easily move the passive end effector back and forth, side to side, and apply rotation about various axes.

A first embodiment of a passive end effector is shown in FIG. Referring to FIG. 12, passive end effector 1200 is an end effector coupler (eg, end effector coupler of FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18 of FIGS. 1 and 2) positioned by a surgical robot. 22), which includes a base 1202 configured to be attached to. Passive end effector 1200 further includes first and second mechanisms extending between a rotatable connection to base 1202 and a rotatable connection to an implement attachment mechanism. A rotatable connection allows three DOFs of motion, whether it is a pivot joint that allows one degree of freedom (DOF) of motion or a universal joint that allows two DOFs of motion It may be a ball joint that makes The first and second mechanisms form a parallel architecture that positions the rotational axis of the surgical saw at the cutting plane.

First and second connecting segments 1210a and 1220a form a first planar mechanism, and third and fourth connecting segments 1210b and 1220b form a second planar mechanism. First link segment 1210a extends between a rotatable connection to a first location on base 1202 and a rotatable connection to the end of second link segment 1220a. A third link segment 1210b extends between a rotatable connection to a second location on base 1202 and a rotatable connection to the end of fourth link segment 1220b. The first and second locations on the base 1202 are spaced on either side of the axis of rotation of the base collar when rotated by the robotic arm. A tool attachment mechanism is formed by a fifth linking segment extending between the rotatable connections to the distal ends of the second linking segment 1220a and the fourth linking segment 1220b relative to the base 1202 . The first and second mechanisms (first and second connecting segments 1210a-1220a and third and fourth connecting segments 1210b-1220b) pivot about their rotatable connections to Constrains the movement of the attachment mechanism 1230 to a range of motion within the work plane. Tool attachment mechanism 1230 is configured to connect to a surgical saw 1240 having a saw blade 1242 configured to oscillate for cutting. The first and second mechanisms (first and second connecting segments 1210a-1220a, and third and fourth connecting segments 1210b-1220b), for example, via pivot joints with one DOF of motion, It can be configured to constrain the cutting plane of saw blade 1242 to be parallel to the work plane. Tool attachment mechanism 1230 may be connected to surgical saw 1240 via a variety of mechanisms including, but not limited to, screws, nuts and bolts, clamps, latches, joints, press fits, or magnets. DRA 52 may be connected to tool attachment mechanism 1230 or surgical saw 1240 to allow tracking of saw blade 1242 pose by camera tracking system 6 (FIG. 3).

The passive end effector 1200 provides passive guidance of the surgical saw 1240 to constrain the saw blade 1242 to a defined cutting plane and extend its mobility to three degrees of freedom (DOF), the saw blade 1242 to two translations Tx and Ty in a plane parallel to the cutting plane and one rotation Rz about an axis perpendicular to the cutting plane.

In some embodiments, the tracking system determines the attitude of the saw blade 1242 based on rotary position sensors connected to the revolute joints of at least some of the articulated segments of the passive end effector 1200. configured to The rotary position sensor is configured to measure the rotational position of the joined connecting segments during movement of the implement attachment mechanism within the work plane. For example, a rotary position sensor can be configured to measure rotation of a first connecting segment 1210a relative to base 1202, and another rotary position sensor can measure rotation of a second connecting segment relative to first connecting segment 1210a. 1220a, and another rotary position sensor can be configured to measure rotation of the implement attachment mechanism 1230 relative to the second coupling segment 1220a. Surgical saw 1240 may be connected to have a fixed orientation with respect to tool attachment mechanism 1230 . A serial kinematic chain of passive end effectors 1200 connecting saw blade 1242 and robotic arm 22, with serialized connecting segments and pivot joints, provides surgical saw 1240 with the necessary mobility. . The position of the tip of the saw blade 1242 in the plane defined by the passive kinematic linkage, the joint angle sensed via the rotary position sensor, and the structural geometry of the interconnected link segments It can be completely determined by the shape. Thus, for example, by measuring the relative angle between each connected connecting segment along one or more interconnecting paths between base 1202 and surgical saw 1240, saw blade 1242 in the cutting space. can be computerized using the proposed forward kinematic model. If the position and orientation of the distal end of the robotic arm 22 relative to the bone is known, the position and orientation of the saw blade 1242 relative to the bone can be computerized and displayed as feedback to the surgeon. In an exemplary implementation in which the saw blade is directly attached to the passive end effector, the frequency of measurements provided by the rotary position sensor is the amplitude of the saw blade to measure saw blade position even during amplitude. can be at least two times higher than the frequency.

Exemplary types of rotary position sensors that may be used with the passive end effectors herein include potentiometric sensors, optical sensors, capacitive sensors, rotary variable differential transformer (RVDT) sensors, linear variable Non-limiting examples include differential transformer (LVDT) sensors, Hall effect sensors, and incoder sensors.

Potentiometer-based sensors are passive electronic components. A potentiometer works by varying the position of a sliding contact across a uniform resistance. In a potentiometer, the total input voltage is applied across the entire length of the resistor and the output voltage is the voltage drop between the fixed and sliding contacts. To receive and absolute position, calibration position is required. A potentiometer may have a measuring range of less than 360°.

An optical encoder may include a rotating disk, a light source, and a photodetector (photosensor). A disc mounted on a rotating shaft has a pattern of opaque and transparent sectors encoded into the disc. As the disc rotates, these patterns interrupt the light impinging on the photodetector and produce a digital or pulsed signal output. Encoding the signal on the disk allows absolute and relative measurements, as well as multi-turn measurements.

A capacitive encoder uses a high frequency reference signal to detect changes in capacitance. This is accomplished in three main parts: stationary transmitter, rotor, and stationary receiver. A capacitive encoder can also be provided in a two-part configuration with a rotor and a transmitter/receiver combination. The rotor may be etched with a sinusoidal pattern that modulates the transmitter's high frequency signal in a predictable manner as the rotor rotates. The encoder may be a multi-turn encoder, but absolute measurements are difficult to achieve. Start-up calibration is required.

RVDT and LVDT sensors operate when the transformer core is in the null position and the output voltages of the two windings, primary and secondary, are equal in magnitude but opposite in direction. The overall output at null locations is always zero. Angular displacement from the null position induces a total differential output voltage. The total angular displacement is therefore directly proportional to the linear differential output voltage. The differential output voltage increases clockwise and decreases counterclockwise. This encoder works with absolute measurements and may not be multi-turn compatible. Calibration is required during assembly.

In Hall effect sensors, a current is applied along a thin strip of metal. In the presence of a magnetic field, electrons in the metal strip are deflected towards one edge, creating a voltage gradient across the short side of the strip, ie perpendicular to the feeding current. In its simplest form, the sensor operates as an analog transducer and returns a direct voltage. Using a known magnetic field, the distance from the Hall plate can be determined. A group of sensors can be used to estimate the relative position of the magnets. By combining multiple sensor elements with patterned magnet plates, absolute and relative positions can be detected, similar to optical encoders.

The encoder sensor functions in a manner similar to a rotary variable transformer sensor, brushless resolver, or synchro. The stator receives DC power and produces a low power AC electromagnetic field between the stator and rotor. This magnetic field is modified by the rotor according to the angle. The stator senses the resulting magnetic field and outputs the rotation angle as an analog or digital signal. Unlike resolvers, encoders use laminated circuits rather than wound spools. This technique allows the encoder to be of compact form, low mass, low inertia and high accuracy without high precision installation. A signal (Z) is sent that counts one full rotation. Multi-turn and absolute sensing are possible.

A second embodiment of a passive end effector is shown in FIG. Referring to FIG. 13, a passive end effector 1300 is an end effector coupler (eg, the end effector coupler of FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18 of FIGS. 1 and 2) positioned by a surgical robot. 22), which includes a base 1302 configured to be attached to. Passive end effector 1300 further includes first and second mechanisms extending between a rotatable connection to base 1302 and a rotatable connection to an implement attachment mechanism. The rotatable joint can be a pivot joint that allows one DOF of motion, a universal joint that allows two DOFs of motion, or a ball joint that allows three DOFs of motion. may be First and second connecting segments 1310a and 1320a form a first planar mechanism, and third and fourth connecting segments 1310b and 1320b form a second planar mechanism. First link segment 1310a extends between a rotatable connection to a first location on base 1302 and a rotatable connection to the end of second link segment 1320a. A third link segment 1310b extends between a rotatable connection to a second location on base 1302 and a rotatable connection to the end of fourth link segment 1320b. The first and second locations on the base 1302 are spaced on either side of the axis of rotation of the base collar when rotated by the robotic arm. The distal ends of second linking segment 1320 a and fourth linking segment 1320 b from base 1302 are rotatably connected to each other and to tool attachment mechanism 1330 . The first and second mechanisms (first and second connecting segments 1310a-1320a, and third and fourth connecting segments 1310b-1320b) rotate about their rotatable connections, e.g. It can be configured to pivot via a pivot joint having a DOF of motion to constrain the movement of the tool attachment mechanism 1330 to a range of motion within the work plane. Tool attachment mechanism 1330 is configured to connect to a surgical saw 1240 having a saw blade 1242 configured to oscillate for cutting. The first and second mechanisms (first and second connecting segments 1310a-1320a and third and fourth connecting segments 1310b-1320b) align the cutting plane of saw blade 1242 parallel to the work plane. Constrain. Tool attachment mechanism 1330 may be connected to surgical saw 1240 via a variety of mechanisms including, but not limited to, screws, nuts and bolts, clamps, latches, joints, press fits, or magnets. The DRA can be connected to the tool attachment mechanism 1330 or the surgical saw 1240 to allow tracking of the saw blade 1242 pose by the camera tracking system 6 (FIG. 3).

A third embodiment of a passive end effector is shown in FIG. Referring to FIG. 14, a passive end effector 1400 is an end effector coupler (eg, the end effector coupler of FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18 of FIGS. 1 and 2) positioned by a surgical robot. 22), which includes a base 1402 configured to be attached to. The base 1402 includes first and second elongated base segments 1404a and 1404b that extend from spaced locations on either side of the axis of rotation of the base 1402 when rotated by the robotic arm. First and second elongated base segments 1404a and 1404b extend away from the end effector coupler of the robot arm when attached to passive end effector 1400 . Passive end effector 1400 further includes first and second mechanisms extending between rotatable connections to elongated base segments 1404a and 1404b and rotatable connections to implement attachment mechanisms. . One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion.

The first mechanism includes a first linking segment 1411a, a second linking segment 1410a, a third linking segment 1420a, and a fourth linking segment 1430a. First and second linking segments 1411a and 1410a are rotatable connections to spaced locations on first elongated base segment 1404a and rotation to spaced locations on third linking segment 1420a. extending parallel to each other between possible connections. The end of third link segment 1420a is rotatably connected to the end of fourth link segment 1430a.

The second mechanism includes a fifth linking segment 1411b, a sixth linking segment 1410b, and a seventh linking segment 1420b. Fifth and sixth link segments 1411b and 1410b are rotatable connections to spaced locations on second elongated base segment 1404b and rotation to spaced locations on seventh link segment 1420b. extending parallel to each other between possible connections. The implement attachment mechanism includes an eighth link segment 1440 extending between the rotatable connections from the base 1402 to the distal ends of the fourth and seventh link segments 1430a and 1420b. In a further embodiment, the eighth coupling segment 1440 of the instrument attachment mechanism includes an attachment member 1442 that extends away from the base 1402 to a rotatable connector configured to connect to the surgical saw 1240. . Attachment member 1442 extends from a location on eighth link segment 1440 that is closer to fourth link segment 1430a than to seventh link segment 1420b.

The first and second mechanisms (the set of linking segments 1411a, 1410a, 1420a, 1430a and the set of linking segments 1411b, 1410b, 1420b) pivot about their rotatable connections to provide a tool attachment mechanism. It can be configured to constrain the movement of 1440 to a range of motion within the work plane. Tool attachment mechanism 1440 is configured to connect to a surgical saw 1240 having a saw blade 1242 configured to oscillate for cutting. The first and second mechanisms may be configured to constrain the cutting plane of saw blade 1242 to be parallel to the work plane, eg, via a pivot joint having one DOF of motion. Tool attachment mechanism 1440 may be connected to surgical saw 1240 via a variety of mechanisms including, but not limited to, screws, nuts and bolts, clamps, latches, joints, press fits, or magnets. The DRA can be connected to a tool mounting mechanism 1440, such as mounting member 1442, or surgical saw 1240 to allow tracking of saw blade 1242 pose by camera tracking system 6 (FIG. 3).

Passive end effector 1400 of FIG. 14 has a parallel architecture that allows positioning of the surgical saw about its axis of rotation in the cutting plane. Synchronous and/or differential movements of the transverse parallelograms allow positioning of the rotational axis of the surgical saw at the cutting plane.

A fourth embodiment of a passive end effector is shown in FIG. Passive end effector 1500 is adapted to be attached to an end effector coupler (eg, end effector coupler 22, FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18, FIGS. 1 and 2) positioned by a surgical robot. includes a base 1502 configured to: The base 1502 can include first and second elongated base segments extending from spaced locations on either side of the axis of rotation of the base 1502 when rotated by the robotic arm. The first and second elongated base segments extend away from each other. Passive end effector 1500 further includes first and second mechanisms extending between a rotatable connection to base 1502 and a rotatable connection to an implement attachment mechanism. One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion.

The first mechanism includes a first connecting segment 1510a. A second mechanism includes a second segment 1510b. The equipment attachment mechanism includes a third linking segment 1520, a fourth linking segment 1530, a fifth linking segment 1540a, a sixth linking segment 1540b, and a seventh linking segment 1550. First and second connecting segments 1510a and 1510b are rotatable to first and second locations on base 1502, respectively, e.g., first and second elongated base segments extending away from base 1502. and rotatable connections at the ends of the third link segment 1520 . The first and second locations on the base 1502 are spaced on either side of the base's axis of rotation when rotated by the robotic arm. A fourth connecting segment 1530 extends from the third connecting segment 1520 in a direction toward the base 1502 . Fifth and sixth link segments 1540 a and 1540 b are rotatable to spaced locations on fourth link segment 1530 and rotatable to spaced locations on seventh link segment 1550 . and parallel to each other. Seventh coupling segment 1550 is configured with a rotatable connector configured to connect to surgical saw 1240 .

The first through sixth link segments 1510a&b, 1520, 1530, and 1540a&b pivot about their rotatable connections to mirror the motion of the seventh link segment 1550 in the work plane. can be configured to constrain the range of Seventh coupling segment 1550 is configured to connect to surgical saw 1240 having saw blade 1242 configured to oscillate for cutting. The first through sixth connecting segments 1510a-b, 1520, 1530, and 1540a-b cut the saw blade 1242 parallel to the work plane, for example, via pivot joints with one DOF of motion. It can be configured to constrain a face. Seventh connecting segment 1550 is connected to surgical saw 1240 via various mechanisms that may include, but are not limited to, screws, nuts and bolts, clamps, latches, joints, press-fits, or magnets. obtain. A DRA may be connected to the seventh articulation segment 1550 or to the surgical saw 1240 to allow tracking of the saw blade 1242 pose by the camera tracking system 6 (FIG. 3).

A fifth embodiment of a passive end effector is shown in FIG. Passive end effector 1600 is adapted to be attached to an end effector coupler (eg, end effector coupler 22, FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18, FIGS. 1 and 2) positioned by a surgical robot. includes a base 1602 configured to: Passive end effector 1600 further includes first and second mechanisms extending between a rotatable connection to base 1502 and a rotatable connection to the implement attachment mechanism. The first mechanism includes a first connecting segment 1610a. A second mechanism includes a second segment 1610b. The equipment attachment mechanism includes a third linking segment 1620, a fourth linking segment 1630, a fifth linking segment 1640a, a sixth linking segment 1640b, and a seventh linking segment 1650. One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion.

First and second connecting segments 1610a and 1610b are respectively rotatable connections to first and second locations on base 1602 and rotatable connections at both ends of third connecting segment 1620. extends between The first and second locations on base 1602 are spaced on either side of the axis of rotation of base 1602 when rotated by a robotic arm. A fourth connecting segment 1630 extends away from the base 1602 from the third connecting segment 1620 . Fifth and sixth link segments 1640 a and 1640 b are rotatable connections to spaced locations on fourth link segment 1630 and rotatable to spaced locations on seventh link segment 1650 . and parallel to each other. Seventh coupling segment 1650 is configured with a rotatable connector configured to connect to surgical saw 1240 .

The first through sixth link segments 1610a&b, 1620, 1630, and 1640a&b pivot about their rotatable connections to mirror the motion of the seventh link segment 1650 in the work plane. can be configured to constrain the range of Seventh coupling segment 1650 is configured to connect to surgical saw 1240 having saw blade 1242 configured to oscillate for cutting. First through sixth connecting segments 1610a-b, 1620, 1630, and 1640a-b may be configured to pivot while constraining the cutting plane of saw blade 1242 to be parallel to the work plane. Seventh connecting segment 1650 is connected to surgical saw 1240 via various mechanisms that may include, but are not limited to, screws, nuts and bolts, clamps, latches, joints, press-fits, or magnets. obtain. A DRA may be connected to the seventh articulation segment 1650 or to the surgical saw 1240 to allow tracking of the saw blade 1242 pose by the camera tracking system 6 (FIG. 3).

Passive end effector 1600 provides two orthogonal translational movements for positioning the rotational axis of the surgical saw in the cutting plane, the two translations being implemented by a parallelogram.

A sixth embodiment of a passive end effector is shown in FIG. Passive end effector 1700 is adapted to be attached to an end effector coupler (eg, end effector coupler 22, FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18, FIGS. 1 and 2) positioned by a surgical robot. and a base 1702 configured to. Passive end effector 1700 further includes first and second mechanisms extending between a rotatable connection to base 1702 and a rotatable connection to an implement attachment mechanism. One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion. The first and second mechanisms are connected to provide translation along the distance from the center of the parallelogram to each side. The first mechanism includes first and second connecting segments 1710 and 1720b. First link segment 1710 extends between a rotatable connection to base 1702 and a rotatable connection to the end of second link segment 1720b. A second mechanism includes a third connecting segment 1720a. The implement attachment mechanism includes a fourth connecting segment 1730 . Second and third link segments 1720b and 1720a are rotatably connected to spaced locations on first link segment 1710 and spaced apart on fourth link segment 1730 in a direction away from base 1702. parallel to each other between the rotatable connections to the Fourth coupling segment 1730 includes a mounting member 1732 that extends away from the base to a rotatable connector configured to connect to surgical saw 1240 . Attachment member 1732 extends from a location on fourth link segment 1730 that is closer to third link segment 1720a than to second link segment 1720b.

The first through third link segments 1710, 1720b, 1720a pivot about their rotatable connections to constrain the movement of the fourth link segment 1730 to a range of motion within the working plane. can be configured. A fourth coupling segment 1730 is configured to connect to a surgical saw 1240 having a saw blade 1242 configured to oscillate for cutting. First through third connecting segments 1710, 1720b, 1720a may be configured to pivot and constrain the cutting plane of saw blade 1242 to be parallel to the work plane. The fourth connecting segment 1730, e.g., its attachment member 1732, may be through various mechanisms including, but not limited to, screws, nuts and bolts, clamps, latches, joints, press-fits, or magnets. It may be connected to surgical saw 1240 . The DRA may be connected to a fourth coupling segment 1730, eg, mounting member 1732, or surgical saw 1240 to allow tracking of saw blade 1242 pose by camera tracking system 6 (FIG. 3).

A seventh embodiment of a passive end effector is shown in FIG. Passive end effector 1800 is adapted to be attached to an end effector coupler (eg, end effector coupler 22, FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18, FIGS. 1 and 2) positioned by a surgical robot. includes a base 1802 configured to: Passive end effector 1800 further includes first and second mechanisms extending between a rotatable connection to base 1802 and a rotatable connection to an implement attachment mechanism. One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion. The first mechanism includes a first connecting segment 1810a. A second mechanism includes a second connecting segment 1810b. The implement attachment mechanism includes a third connecting segment 1820 . First and second connecting segments 1810a and 1810b are respectively rotatable connections to first and second locations on base 1802 and rotatable connections at both ends of third connecting segment 1820. extends between The first and second locations on base 1802 are spaced on either side of the axis of rotation of base 1802 when rotated by a robotic arm. Third coupling segment 1820 includes a mounting member 1822 that extends away from base 1802 to a rotatable connector configured to connect to surgical saw 1240 . Attachment member 1822 extends from a location on third link segment 1820 that is closer to first link segment 1810a than second link segment 1810b. One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion.

First and second linking segments 1810a and 1810b pivot about their rotatable connections between base 1802 and third linking segment 1820 to direct movement of mounting member 1822 in the work plane. can be configured to constrain the range of motion of the In some other embodiments, one or more of the rotatable connections are universal joints that allow motion of two DOFs, such that motion is not constrained to the work surface, even three joints. It may be a ball joint that allows movement of the DOF. Mounting member 1822 is configured to connect to a surgical saw 1240 having a saw blade 1242 configured to oscillate for cutting. First and second connecting segments 1810a and 1810b pivot while constraining the cutting plane of saw blade 1242 to be parallel to the work plane. Attachment member 1822 may be connected to surgical saw 1240 via a variety of mechanisms including, but not limited to, screws, nuts and bolts, clamps, latches, joints, press fits, or magnets. The DRA may be connected to a third coupling segment 1820, eg, mounting member 1822, or surgical saw 1240 to allow tracking of saw blade 1242 pose by camera tracking system 6 (FIG. 3).

An eighth embodiment of a passive end effector is shown in FIG. Passive end effector 1900 is adapted to be attached to an end effector coupler (eg, end effector coupler 22, FIGS. 4 and 5) of a robotic arm (eg, robotic arm 18, FIGS. 1 and 2) positioned by a surgical robot. and a base 1902 . Passive end effector 1900 further includes a first connecting segment 1910 and a second connecting segment 1920 . First link segment 1910 extends between a rotatable connection to base 1902 and a rotatable connection to one end of second link segment 1920 . The other end of the second coupling segment 1920 is rotatably connected to the equipment attachment mechanism. Axes of rotation q1, q2, and q3 are parallel to each other to provide blade 1242 with a planar cutting surface. Thus, the three DOF motion of saw 1240 includes x-direction Tx, y-direction Ty, and rotational direction Rz about the z-axis. One or more of the rotatable connections disclosed for this embodiment may be pivotal joints that allow motion in one DOF or universal joints that allow motion in two DOFs. may also be ball joints that allow three DOFs of motion.

Real-time location of the blade 1242 and blade tip relative to the patient's bone being cut using tracking markers 52 attached to the end effector base 1902 and saw 1240, along with tracking markers on bones (e.g., tibia and femur) can be accurately and continuously monitored. Although not explicitly shown in the other figures, tracking markers are attached to the saw 1240 and all end effectors 1902 in all embodiments to track the location of the blade relative to the patient's bone during cutting. can be done. Although not shown, as an alternative to or in addition to tracking markers, encoders are positioned within each of the articulating segments 1910 and 1920 to determine exactly where the tip of the saw blade is at all times. be able to.

Exemplary Surgical Procedures Exemplary surgical procedures using the surgical robot 4 in the operating room (OR) can include the following.
Optional Step: Surgery is preoperatively planned based on medical images.

1. The Surgical Robot 4 system is outside the operating room (OR). A nurse brings the system to the OR when the patient is being prepared for surgery.

2. The nurse powers on the robot and deploys the robotic arm. A nurse verifies the accuracy of the robot and tracking system.

3. For sterile passive end effectors, an operating room nurse applies a sterile drape onto the robotic arm and mounts the passive end effector with sagittal saw onto the robotic arm. The operating room nurse locks the passive end effector with a locking mechanism. (If necessary) The operating room nurse attaches the DRA to the passive structure via a drape. For non-sterile passive end effectors, the drape is placed after mounting the passive end effector on the robotic arm, the DRA is attached to the passive end effector with the drape in between, and is sterilized. A saw or saw blade is attached to a passive end effector with a drape in between. A locking mechanism is engaged to fix the position of the saw blade relative to the end effector coupler.

4. The surgeon attaches the navigational markers to the patient's bone(s), such as the tibia and femur. The bones are registered with the camera tracking system 6 using, for example, the Horn point-to-point algorithm, matching algorithm, or other algorithms. An assessment of soft tissue balance can be performed whereby the system, for example, measures the relative femur and tibia when the surgeon applies forces in different directions (e.g., varus/valgus forces). Tracking motion allows the surgeon to assess soft tissue balance within the operating room. Soft tissue balance information can be used to modify surgical planning (eg, move implant components, change implant type, etc.).

5. When the surgeon is ready to cut the bone, the operating room nurse carries the surgical robot 4 to the operating table near the knee to be operated on and stabilizes the surgical robot 4 on the floor. The system can guide the nurse in locating the robot 4 so that all cutting planes are in the workspace of the robot and passive structures.

6. The surgeon selects different parameters on the screen of the surgical robot 4 according to the surgeon's plan for making the initial cut (bone to be cut, desired cut plane, etc.).

7. The surgical robot 4 determines a distance from the anatomy to be cut where the saw blade cutting plane and target plane are coincident and the saw blade is within the range of motion of the passive end effector tool attachment mechanism. The passive end effector is repositioned by automatically moving the robotic arm 22 so that it is positioned at .

8. The surgeon unlocks the passive end effector.

9. The surgeon performs a cut constrained to the cutting plane provided by the passive end effector. The surgical robot 4 can provide a real-time display of the tracked location of the saw blade relative to the bone, allowing the surgeon to monitor the progress of bone removal. In one method, the tracking subsystem processes the location of the saw relative to the bone in real time based on camera images and various tracking markers attached to the saw, robotic arm, end effector, femur, and tibia. . The surgeon can then use the locking mechanism to lock the passive end effector once the cut is complete.

10. The surgeon selects the next cut to perform on the screen and continues as before.

11. The surgeon can perform trial implant placements and intermediate soft tissue balance assessments, and modify implant plans and associated amputations based thereon.

12. After completing all cuts, the nurse removes the surgical robot 4 from the operating table and detaches the passive end effector from the robotic arm.

13. The surgeon places the implant and completes the surgery.

In step 9 above, the tissue and ligaments surrounding the bone, debris created by the cut, and other surgical instruments near the bone make it difficult for the physician to visually check the progress of the cut. Sometimes. Even if visual confirmation is acceptable, there are areas of the bone that the physician cannot see, such as cutting the posterior portion of the bone.

Advantageously, one robotic system embodiment of the present invention provides a method for the physician to check the progress of the bone being cut in multiple dimensions. The camera tracking system 6 includes a tracking sub, along with tracking markers attached to the end effector base (1100, 1202, 1302, 1402, 1502, 1602, 1702, 1802, 1902), the robotic arm 20, and the saw (1140, 1240). System 830 and computer subsystem 820 allow real-time calculation of the exact position of the saw blade relative to the bone, thereby allowing the surgeon to monitor the progress of bone removal.

FIG. 20 is a screen shot of a display showing the progress of cutting a bone during a surgical procedure. FIG. 20 shows subsystems 830 and 820 that display three images: side view, AP view, and top view. In each image, display 34 displays the real-time location of saw blade 1242 relative to the bone (eg, tibia 2000). Side and top views may be particularly useful to the physician as they show the position of the saw blade, which is not easily visible. At the top of the display, the computer subsystem 830, 820 displays the number of cutting programs and what program is currently running. For example, as the screenshot shows, the physician may have programmed 6 planar cuts and the current cut program is the first cut. Subsystems 830 and 820 can also track with tracking markers where the blade may have advanced, so that how much of the bone cut (area cut) for a particular cutting program has been completed. can be determined and the progress is displayed on display 34 . The bone images themselves are preferably obtained from actual images of the patient's body for a more accurate representation. The bone image is augmented by subsystem 820 with contour lines showing cortical bone 2004 and cancellous bone 2002 . This may be important to the physician, as the amount of resistance to cutting varies greatly between the two types of bone.

If an Augmented Reality (AR) head-mounted display is used, the computer subsystem 820 generates the same contour lines showing the cortical and cancellous bone, which are displayed continuously as the doctor moves his head. can be layered over the actual leg. Already cut areas can be overlaid on top of the actual bone in a darker shade. Additionally, the implant inserted over the cut area can be overlaid on the bone to indicate to the physician that the cut is made correctly along the plane of the implant. This is all possible because the subsystems 830 and 820 along with the tracking markers and camera subsystem can track the position of the blade and the history of the blade's movement relative to the bone.

21-32, exemplary embodiments of direct blade guidance systems in the context of orthopedic surgery are described. As shown in FIGS. 21, 22, 29, and 30, a direct blade guidance system 2100 can include a robotic system holding an end effector arm (EEA) 2102. As shown in FIG. EEA 2102 may include a base configured to attach to an end effector coupler of a robotic arm. Other exemplary embodiments of end effector arms consistent with the principles of the present disclosure are described with respect to FIGS. 12-19. To achieve a planar cut, saw blade 2104 should be guided in the plane in which it vibrates. The high vibration frequency of saw blades (eg, 200-300 Hz) makes mechanical guidance difficult to achieve. The EEA 2102 may include a number of joints and joints 2106, 2108 that may be used to achieve in-plane motion of the tip 2110 of the EEA 2102. Similar to the embodiment of FIGS. 12-18, the tip 2110 of the EEA 2102 can have three degrees of freedom, two directions of motion in a plane, and rotation about an axis perpendicular to that plane. The EEA 2102 allows for planar cuts and access to the target bone from all angles. System 2100 can also include handpiece 2112 and blade adapter 2114, each connected to EEA 2102 and blade 2104. FIG.

The concept of directly guiding the saw blade 2104 involves aligning the axis of rotation of the distal end of the coupling 2110 (the distal revolute joint 2116 of the EEA 2102) with the axis of oscillation of the blade. Sagittal saws are present in most mounting mechanisms that produce small rotational movements (oscillations/amplitudes) of the saw blade about an axis close to the saw blade attachment. By aligning the axis of rotation with the distal revolute joint 2116 of the EEA 2102 (at the distal end of the coupling 2108), the joint 2116 allows rotation of a typical saw handpiece and allows oscillation of the saw blade. can be configured to

Saw blade 2104 may be configured to be coupled to the distal articulation axis of EEA 2102 by blade adapter 2114 . Blade adapter 2114 may be configured to clamp saw blade 2104 . Different sagittal saws can be integrated into system 2100 by adapting blade adapter 2114 . Exemplary configurations of blade adapter 2114 consistent with this disclosure are discussed below. An exemplary blade adapter is illustrated in FIG.
Permanent Fixation In the permanent fixation configuration, the blade 2104 can be permanently clamped to the blade adapter 2114 . A user (eg, an operating room nurse) can assemble blade 2104 into blade adapter 2114 while the surgeon prepares the surgical field. Exemplary permanent fixation configurations may include:

Blade 2104 may be securely clamped to blade adapter 2114 using components such as screws or spring-loaded latches configured to provide a clamping force against blade 2104 .

Blade 2104 may include interfaces, such as through holes, configured to secure blade 2104 to blade adapter 2114 .

Blade 2104 and blade adapter 2114 may be manufactured as a single reusable device that is later provided on EEA 2102 . An exemplary implementation involves a metal blade attached to a PEEK or stainless steel blade adapter. Assembly of the blade to the blade adapter is performed by an operating room nurse.

The blade 2104 and blade adapter can also be manufactured as disposable (single use) devices delivered sterile. An exemplary implementation involves a metal blade overmolded using plastic injection molding techniques.

FIG. 22 illustrates system 2200, an exemplary embodiment consistent with the principles of the present disclosure. In this embodiment, the blade adapter can be permanently attached to the saw blade in a base that can rotate about the axis of rotation of the saw blade and a clamping component that clamps the blade to the blade adapter base by means of screws. can. FIG. 23 illustrates a blade 2204, blade adapter 2214, distal revolute joint 2216, and clamp 2218 consistent with this configuration. These components may be the same as or similar to those described above with respect to FIG.
Separable Fixation The separable fixation configuration allows the blade to be quickly attached to and disconnected from the blade adapter in the field. The blade adapter integrates a clamping mechanism that can be active (normally closed clamping mechanism opened by electrical signal) or passive (quick coupling and/or quick release mechanism).
Moment of Inertia The blade adapter 2114 can significantly increase the moment of inertia of the combined "blade/blade adapter" that rotates about the axis of rotation of the blade. As soon as the blade adapter 2114 oscillates with the saw blade 2104, the unbalanced inertia creates dynamic forces and torques that are transmitted to the mechanical structure and the hands of the surgeon. To optimize the implementation, the inertia of the vibrating element about the vibrating axis can be minimized. That is, the mass of the vibrating element is lighter than the vibrating axis, and the closer, the better. The moment of inertia of the saw blade element about the axis of oscillation for the concept of handpiece guidance is:

D is the distance between the blade vibration axis and the distal joint rotation axis, M is the weight of the blade (the weight of the saw blade element), and _Id is the moment of inertia of the saw blade element about the blade vibration axis is. The moment of inertia is then reduced by ^MD2 using the concept of direct blade guidance. This is minimized when the distance between the vibration axis and the blade vibration axis is 0 (the axes are mated).

FIG. 24 illustrates a system using a standard jig 2402. FIG. Under the principles discussed herein, direct blade guidance provides a longer effective cutting length of the blade than that provided by standard jigs such as jig 2402 illustrated in FIG. obtain. _LG represents the guided length (the length to which the saw blade is guided) and _LE represents the effective length of the blade. The concept of direct blade guidance allows for a short guide length, resulting in a longer effective length of the blade. This may be more comfortable for the surgeon and allows the surgeon to cut through more bone.

The accuracy of the cut is controlled by the robotic system, from the floor to the tip of the saw blade, including the robotic system, the EEA 2102, the handpiece sagittal saw, the saw blade amplitude mechanism (blade adapter 2114 or 2214), and the saw blades 2104, 2204. It depends on the stiffness of the various constituent elements. With direct blade guidance, handpiece backlash and inaccuracy may be greatly minimized or eliminated entirely because the saw blade is directly clamped to the blade adapter.

Additionally, the concept of direct blade guidance may facilitate integration with a variety of existing sagittal saws Blade adapters can simplify geometry Elements that only need to clamp the saw blade As such, it may not be necessary to build sagittal saw shape-specific (manufacturer-specific) components. Additionally, the blade adapter can be easily sterilized. It is a small, lightweight and relatively simple mechanical element, without any tight spaces and can be made in such a way that it can be easily disassembled. As previously mentioned, the blade, including the blade adapter, may be delivered as a single reusable device.
Tracking FIG. 25 illustrates a direct blade guidance system 2100 that may include a navigational marker or series of markers 2500 attached to the sagittal saw handpiece 2112 . Marker 2500 allows the sagittal saw to be tracked by a camera such as camera tracking system 6 . Optical tracking can measure the position of the saw, but it can be difficult to measure the position of the saw blade directly during cutting (high frequency of blade vibration). Furthermore, due to the low stiffness of the blade/saw handpiece connection, tracking directly measures the deflection of saw handpiece 2112 relative to blade 2104 .

For direct saw blade position measurement, FIG. Encoder measurements can typically be made at higher frequencies and rotational accuracies than using optical tracking. For example, the measurement frequency may be at least two times higher than the frequency of the saw blade amplitude. The blade position signal can be used to provide additional useful information such as saw vibration frequency, on/off state, and whether the saw blade is stuck in bone (e.g., by interpreting the vibration and its derivatives). can be extracted.

In an exemplary embodiment consistent with the principles of the present disclosure, vibration of a sagittal saw handpiece held by a surgeon can be reduced. By reducing handpiece vibration, tactile feedback can be improved and cutting efficiency can be increased. As mentioned above, vibrations transmitted to the surgeon's hand result from transmitted dynamic forces and torques created by the unbalanced inertia of the blade/blade adapter coupling about the blade axis of rotation.

One approach to reducing vibration can be accomplished by filtering the vibration. In FIG. 27, dampening element 2700 may be connected between handpiece 2112 and EEA 2102 . This can be implemented using rubber, pneumatic, or hydraulic cylinders.

Another approach to reducing vibration can be achieved by dynamically balancing the combined saw/saw adapter inertia about the saw's axis of rotation. This can be implemented by dynamically compensating the transmitted forces and torques produced by the oscillating saw blade using compensating inertias that implement opposite motions with the same dynamics. FIGS. 28 and 32 illustrate exemplary embodiments in which a mechanical inverter 2800 can be used to couple the corrective inertia to the primary inertia for balancing.
Further provisions and embodiments:
In the above description of various embodiments of the inventive concept, the terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the inventive concept. Please understand. Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this inventive concept belongs. . Terms, as defined in commonly used dictionaries, are to be construed as having a meaning consistent with their meaning in the context of this specification and the relevant technical field, and are expressly defined herein. is not to be construed in the idealized or overly formal sense so defined.

When an element is referred to as being "connected," "coupled," "responsive," or variants thereof to another element, that Elements may be directly connected, coupled, or responsive to other elements, or there may be intervening elements. In contrast, an element is "directly connected," "directly coupled," "directly responsive," or variants thereof to another element. , there are no intervening elements. Like numbers refer to like elements throughout. Furthermore, as used herein, "coupled," "connected," "responsive," or variants thereof, means wirelessly coupled, connected , or responding. As used herein, the singular forms "a," "an," and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. Well-known functions or constructions may not be described in detail for brevity and/or clarity. The term "and/or" includes any and all combinations of one or more of the associated listed items.

Although the terms first, second, third, etc. may be used herein to describe various elements/acts, these elements/acts should not be limited by these terms. It will be understood. These terms are only used to distinguish one element/act from another. Thus, a first element/act in some embodiments could be termed a second element/act in other embodiments without departing from the teachings of the inventive concept. The same reference numbers or numbers refer to the same or similar elements throughout the specification.

As used herein, "comprise", "comprising", "comprises", "include", "include", "includes" The terms , “have,” “has,” “having,” or variations thereof, without limitation, include any one or more of the recited features, integers, elements, steps, including a component or function, but does not exclude the presence or addition of one or more other features, integers, elements, steps, components, functions, or groups thereof. Furthermore, as used herein, the general abbreviation "e.g.", derived from the Latin "exempli gratia", refers to a generic example(s) of the foregoing item. ) and is not intended to limit such items. The general abbreviation "i.e.", derived from the Latin "id est", may be used to designate a particular item from a more general enumeration.

Exemplary embodiments are described herein with reference to block diagrams and/or flowchart illustrations of computer-implemented methods, apparatus (systems and/or devices) and/or computer program products. It will be understood that the blocks in the block diagrams and/or flowchart illustrations, and combinations of blocks in the block diagrams and/or flowchart illustrations, can be implemented by computer program instructions being executed by one or more computer circuits. These computer program instructions may be provided to processor circuitry of general purpose computer circuitry, special purpose computer circuitry, and/or other programmable data processing circuitry to produce a machine, thereby providing a computer processor and/or other Instructions executed through the programmable data processing unit of , transform and control the transistors, values stored in memory locations, and other hardware components within such circuitry to provide block diagrams and/or or means (functions) for implementing the functions/acts specified in the flowchart block(s) and thereby implementing the functions/acts specified in the block diagrams and/or flowchart block(s); / Or create a structure.

These computer program instructions can also be used by a computer to manufacture an article of manufacture, the instructions stored on the computer-readable medium including instructions for implementing the functions/acts specified in the block diagram and/or flowchart block or blocks. or stored on a tangible computer readable medium capable of directing other programmable data processing apparatus to function in a particular manner. Accordingly, embodiments of the inventive concept are hardware and/or software (firmware) running on processors such as digital signal processors, which may be collectively referred to as "networks", "modules", or variants thereof. , resident software, microcode, etc.).

It should also be noted that, in some alternative implementations, the functions/acts noted in the blocks may occur out of the order noted in the flowcharts. For example, two blocks shown in succession may actually be executed substantially concurrently or the blocks may be executed in the reverse order depending on the functionality/acts involved. Further, the functionality of a given block of the flowcharts and/or block diagrams may be separated into multiple blocks and/or the functionality of two or more blocks of the flowcharts and/or block diagrams may be separated, at least in part, from may be integrated. Finally, other blocks may be added/inserted between the illustrated blocks and/or blocks or operations may be omitted without departing from the scope of the inventive concepts. Additionally, although some of the figures include arrows on the communication paths to indicate the primary direction of communication, it should be understood that communication may occur in the opposite direction of the depicted arrows. .

Many variations and modifications can be made to the embodiments without substantially departing from the principles of the inventive concept. All such changes and modifications are intended to be included herein within the scope of the inventive concept. Accordingly, the above-disclosed subject matter is to be considered illustrative rather than restrictive, and the accompanying example embodiments include all such modifications that fall within the spirit and scope of the inventive concept; It is intended to cover enhanced examples, as well as other embodiments. Therefore, to the fullest extent permitted by law, the scope of the inventive concepts should be determined by the broadest permissible interpretation of this disclosure, including the following example embodiments and their equivalents. , should not be restricted or limited by the preceding detailed description.

Claims (18)

A direct blade guidance system,
a robotic arm configured to be positioned by a surgical robot;
An end effector arm including a base configured to attach to an end effector coupler of the robotic arm, the end effector arm including a distal joint disposed at a distal end of the end effector arm. wherein the end effector coupler includes a connector to which the base of the end effector arm is attached , a primary button surrounding the connector, and a primary actuation located below the primary button. an end effector arm comprising a switch, wherein depressing the primary button on the primary activation switch enables movement of the end effector arm;
a blade adapter adapted to be rotatably connected to the end effector arm through the distal joint about an axis of rotation ;
a blade adapted to be connected to the blade adapter and having an axis of oscillation coincident with the axis of rotation when the blade adapter is connected to the distal joint;
a handpiece removably attached to the blade adapter and adapted to oscillate the blade along the oscillation axis . The system of claim 1, wherein the handpiece is a sagittal saw handpiece. 2. The system of claim 1, further comprising an encoder disposed on each joint for keeping track of the position of the tip of the blade . 2. The system of claim 1, wherein the blade is clamped to the blade adapter. 3. The system of claim 1, wherein the blade is threaded to the blade adapter. 3. The system of claim 1, wherein the blade and blade adapter are integrated as a single unit. The blade adapter is attached directly to the distal joint of the end effector arm, and the handpiece is configured to rotate the blade adapter and the blade together along the axis of rotation. Item 1. The system according to item 1. 2. The system of claim 1, wherein said blade adapter and said blade are attached via an active clamping mechanism. 2. The system of claim 1, wherein said blade adapter and said blade are attached via a passive clamping mechanism. A surgical system comprising:
a tracking system configured to determine the orientation of an anatomical structure cut by a saw blade and to determine the orientation of the saw blade;
a surgical robot,
robot base,
a robotic arm connected to the robotic base;
a surgical robot comprising at least one motor operably connected to move the robotic arm relative to the robotic base;
a blade guidance system, said blade guidance system comprising:
An end effector arm including a base configured to attach to an end effector coupler of the robotic arm, the end effector arm including a distal joint disposed at a distal end of the end effector arm. wherein the end effector coupler includes a connector to which the base of the end effector arm is attached , a primary button surrounding the connector, and a primary actuation located below the primary button. an end effector arm comprising a switch, wherein depressing the primary button on the primary activation switch enables movement of the end effector arm;
a blade adapter adapted to be rotatably connected to the end effector arm through the distal joint about an axis of rotation ;
a blade adapted to be connected to the blade adapter and having an axis of oscillation coincident with the axis of rotation when the blade adapter is connected to the distal joint;
a handpiece attached to the blade adapter and adapted to oscillate the blade along the oscillation axis . 11. The system of claim 10, wherein the handpiece is a sagittal saw handpiece. 11. The system of claim 10, further comprising angle sensors disposed on each joint for detecting rotation angles . 11. The system of claim 10, wherein said blade is clamped to said blade adapter. 11. The system of claim 10, wherein the blade is threaded onto the blade adapter. 11. The system of claim 10, wherein the blade and blade adapter are integrated as a single unit. 11. The system of claim 10, wherein the handpiece is adapted to vibrate the blade adapter and the blade along the vibration axis. 11. The system of claim 10, wherein said blade adapter and said blade are attached via an active clamping mechanism. 11. The system of claim 10, wherein said blade adapter and said blade are attached via a passive clamping mechanism.

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